vascular

Question 1

what indentation will be seen on barium swallow with an abberant right subclavian artery ?

Answer 1

posterior indentation

Question 2

what is the diverticulum of kommerel ?

Answer 2

small bulge at the origin of an aberrant subclavian artery (usually aberrant right subclavian artery with a left sided aortic arch)

Question 3

what is the most common cause of an aortic dissection ?

Answer 3

high blood pressure

Question 4

what does the false lumen usually look like on CT ?

Answer 4

the false lumen is usually larger with lower contrast density on arterial phase - it can also become thrombosed due to slower flowing blood

Question 5

where does a Stanford B aortic dissection start ?

Answer 5

between the brachiocephalic trunk and left subclavian artery

Question 6

what are the vasa vasorum ?

Answer 6

the small blood vessels that supple the walls of the large arteries

Question 7

what are intramural haematomas caused by ?

Answer 7

rupture of the vasa vasorum

Question 8

where do traumatic aortic injurys tend to occur ?

Answer 8

aortic rooth, isthmus and hiatus

Question 9

what is aortic transection?

Answer 9

complete tear through all the layers of the aorta

Question 10

what is the size criteria of a thoracic aortic aneurysm ?

Answer 10

ascending aorta > 4cm
Descending aorta >3.5cm

Question 11

what is annuloaortic ectasia associated with ?

Answer 11

marfans, Ehlers-danlos, homocystinuria and osteogenesis imperfecta

Question 12

when is surgical treatment recommended for a thoracic aortic aneurysm ?

Answer 12

> 5.5cm ascending
6cm descending TAA

Question 13

which arteries does GCA tend to affect ?

Answer 13

upper extremity vessels
temporal artery
subclavian, brachial, axillary

Question 14

what type of wall thickening does GCA tend to cause ?

Answer 14

long smooth stenosis with circumferential wall thickening

Question 15

what are the most common infections causing infectious aortitis ?

Answer 15

s.aures
e.coli
salmonella
pneumococcus
syphillis

Question 16

what is takayasu arteritis ?

Answer 16

large vessel vasculitis causing long smooths circumferential thickening and stenosis of the large vessels including the aorta, subclavicn, carotid, pulmonary and mesenteric arteries

Question 17

what is shone syndrome

Answer 17

left sided obstructive congenital heart disease
1 - supravalvular mitral membrane
2. subvalvular aortic stenosis
3. parachute mitral valve
4. aortic coarctation

Question 18

what is subclavian steal syndrome ?

Answer 18

proximal stenosis / occlusion of the subclavian artery
causing retrograde flow from the vertebral artery into the subclavian artery

Question 19

how does subclavian steal syndrome present ?

Answer 19

syncope exacerbated by arm exercise.

Question 20

what are the common causes of SVC obstruction

Answer 20

compression due to thoracic malignancy
catheter associated thrombosis
mediastinal fibrosis due to histoplasmosis exposure

Question 21

what is the classic abdominal imaging finding of SVC obstruction ?

Answer 21

increased enhancement of hepatic segment 4a due to collateral opacification of the vein of sappey

Question 22

where does a left sided SVC usually drain into ?

Answer 22

coronary sinus -> the right atrium

Question 23

what is the size criteria for an abdominal aortic aneurysm ?
what size is treatment recommended

Answer 23

> 3cm
5.5 - surgical treatment

Question 24

what is leriche syndrome ?

Answer 24

Complete occlusion of the distal abdominal aorta due to atherosclerosis

Question 25

what is polyarteritis nodosa ?

Answer 25

systemic necrotizing vasculitis or small and medium sized arteries - causing multiple small visceral aneurysms with raised p-anca

Question 26

which arteries does Polyarteritis nodosa commonly affect ?

Answer 26

hepatic, mesenteric and renal

Question 27

which medical conditions is PAN associated with ?

Answer 27

CLASH Cryoglobulinemia leukaemia Rheumatoid arteritis srogens syndrome hepatitis B

Question 28

what is the treatment of splenic aneurysms ?

Answer 28

endovascualar coil embolisation

Question 29

what is fibromuscular dysplasia ?

Answer 29

idiopathic, non-infectious, non-inflammatory vascular disease primary affecting the renal and carotid arteries

Question 30

what is the classic imaging feature of fibromuscular dysplasia

Answer 30

string of beads sign caused by alternating stenosis and aneurysmal dilatation of the renal artery

Question 31

what is the treatment of firbomuscular dysplasia

Answer 31

angioplasty

Question 32

what's the most common cause of renal artery stenosis in children

Answer 32

takayasu

Question 33

in a GI bleed - what is the rate of bleeding that can be detected on a CTA ?

Answer 33

0.3-0.5 ml/min

Question 34

what is may-thurner syndrome ?

Answer 34

chronic compression of the left common iliac vein by crossing right common iliac artery against the lumbar vertebrae

Question 35

what is the most common site of stenosis of the SFA?

Answer 35

at the adductor hiatus

Question 36

what's the gold standard investigation for calf caldication?

Answer 36

DSA

Question 37

what is thrombosisangitis obliterans ?

Answer 37

non-atheroscerlotic arteritis of the small vessels - usually hands and feet. that occurs in young male smokers. Causes extensive occlusive disease

Question 38

what criteria makes fixing an abdominal aorta with end-vascular repair Okay ?

Answer 38

>10mm from the renal arteries angle of the neck <60 or >120 Common iliac arteries >7mm diameter and >20mm long

Question 39

what is neurogenic thoracic outlet syndrome ?

Answer 39

nerve compression of the brachial plexus

Question 40

what is adsons manoeuvre ?

Answer 40

tests for aterial thoracic outlet syndrome test the radial pulse, get the patient to move their head to the other side and then the pulse reduces

Question 41

what is the most common cause of subclavian artery compression ?

Answer 41

cervical rib

Question 42

what is mccleery syndrome ?

Answer 42

subclavian vein compression without thrombosis

Question 43

what is paget-schroetter syndrome

Answer 43

thrombosis of the subclavian vein as it enters the thorax - occurs in young men

Question 44

what is the classic feature of hypothenar hammer syndrome ?

Answer 44

CTA shows a corkscrew appearance of the ulnar artery -

Question 45

what is the definition of an iliac artery aneurysm and when should it be treated ?

Answer 45

> 2.5cm and treated if > 3cm

Question 46

what is burgers disease ?

Answer 46

chronic inflammatory thrombotic arteritis that affects the lower extremities - usually the feet/. seen in young male smokers

Question 47

what is the preferred treatment for an iliac artery ?

Answer 47

end-vascular stent-graft

Question 48

what is a persistent sciatic artery?

Answer 48

where the fetal sciatic artery persists to supply the majority of the blood to the leg. it arises from the internal iliac artery

Question 49

what is the Rutherford classification used for ?

Answer 49

categorizes chronic limb ischemia

Question 50

what is the most common source of an acute thromboembolic disease ?

Answer 50

left atrial thrombus

Question 51

what is popliteal entrapment syndrome

Answer 51

compression of the popliteal artery by a fibrous band or calf muscle

Question 52

what is cystic adventitial disease ?

Answer 52

a cause of distal claudication where there are mucoid cysts in the adventitia of the popliteal artery - which leads to luminal compression

Question 53

what is the normal peak systolic velocity in the large arteries ? (carotid )

Answer 53

60-100cm/sec

Question 54

if the peak systolic velocity is >125cm/sec what does it suggest ?(carotid )

Answer 54

>50% stenosis

Question 55

if the peak systolic velocity is >230 cm/sec what does it suggest ?(carotid )

Answer 55

> 70 % stenosis

Question 56

, what peak systolic velocity would indicate renal artery stenosis

Answer 56

>180cm/sec