vascular disease

Question 1

Pathophysiology of vascular disease

Answer 1

Atherosclerosis
Inflammatory
Vasospastic
Compression
Traumatic
Pro-thrombotic conditions

Question 2

plaque formation - key points needed to know

Answer 2

progressive
different cellular components of it
end stage unstable plaque that can do several different things- thrombosis/embolism

Question 3

What happens to the placque when we get an acute clinical complications- ulceration?

Answer 3

• acute thrombosis with occlusion.
• dislodging and peripheral embolism

Question 4

What happens to the placque when we get an acute clinical complications- thrombosis?

Answer 4

• acute ischaemia/ necrosis

Question 5

What happens to the placque when we get an acute clinical complications- growth?

Answer 5

chronic ischemia

Question 6

What happens to the placque when we get an acute clinical complications- necrosis?

Answer 6

aneurysm development

Question 7

What are the modifiable risk factors in PAD?

Answer 7

Smoking
Hypertension
Diabetes
Hypercholesterolaemia

Question 8

What are the non- modifiable risk factors in PAD?

Answer 8

Age
Sex

Question 9

what acute ischaemia occurs in lower limbs?

Answer 9

-6Ps
-Acute-embolus (AF, MI)
-Acute on chronic-thrombus- (different to the embolic event)

Question 10

what chronic ischaemia occurs in lower limbs?

Answer 10

-IC- intermittent claudificaiton
-Rest pain- end stage of chronic ischaemia
-Tissue loss- insufficient blood so can no longer survive
-Burgers test

Question 11

what is the anterior circulation in the circle of wills?

Answer 11

MCA
ACA
Anterior choroidal artery

Question 12

what is the posterior circulation in the circle of wills?

Answer 12

vertebral artery
basilar artery
PCA

Question 13

CAROTID endarterectomy

Answer 13

local anaesthetic
isolate three vessels: internal external and common carotid with a
clamp
clean out vessels
nice and clear

Question 14

why do you do a CAROTID endarterectomy

Answer 14

Plaque ulceration and embolisation

Question 15

symptoms and signs of a stroke

Answer 15

Anterior circulation strokes
Unilateral weakness
Unilateral sensory loss or inattention
- Isolated dysarthria
- Dysphasia
Vision
- Homonymous hemianopia
* Monocular blindness
- Visual inattention

Question 16

Visceral

Answer 16

Mesenteric and Renal artery disease

Question 17

what are the different types of aneurysms?

Answer 17

true
false
mycotic

Question 18

describe true aneurysms

Answer 18

weakening of the arterial wall leading to dilatation

common location is the infra-renal aorta

Question 19

What information does duplex give you?

Answer 19

duplex is a form of an ultrasound
- info about flow

Question 20

What are the advantages of MRA over CTA?

Answer 20

cta- involves radiation, nephrotoxicity higher
mra- doesnt involve radiation

Question 21

what are cross sectional imaging used for?

Answer 21

-to look for aneurysms
- carotid stenoses

Question 22

treatment for peripheral vascular disease?

Answer 22

Risk factor modification
Antiplatelets
Statin
Stop smoking
Good control of BP
Good control of DM
ACE inhibitors?

Exercise programme

Question 23

invasive treatment for Lowe limbs to treat endo- vascular problems?

Answer 23

-Stenoses
-Short occlusions
-DEB
-DES

Question 24

invasive treatment for Lowe limbs to treat bypass surgery problems?

Answer 24

-Better patency and limb salvage rates
-Higher morbidity and mortality

Question 25

what are the two ways aneurysms in the aorta are treated?

Answer 25

-endovascular -open surgery

Question 26

describe endovascular aneurysms in aorta treatment

Answer 26

-Morphology -Lower morbidity and mortality -Life long surveillance

Question 27

describe open surgery aneurysms in aorta treatment

Answer 27

-Higher initial morbidity and mortality -Lower long term morbidity and mortality

Question 28

what are the three categories of rare vascular conditions?

Answer 28

- inflammatory - vaso spastic -compressive

Question 29

name 4 inflammatory rarer vascular conditions

Answer 29

Buergers disease Giant Cell Arteritis Takayasu Mixed Connective Tissue

Question 30

name one vasopressin spastic rarer vascular conditions

Answer 30

Raynauds – Primary/Secondary

Question 31

name two compressive rarer vascular conditions

Answer 31

Thoracic outlet syndrome Coeliac compression

Question 32

lymphatic vascular pathologies

Answer 32

Primary Secondary – Radiation, Surgery

Question 33

A-V malformations

Answer 33

Low flow High Flow

Question 34

superficial veins

Answer 34

can easily treat

Question 35

deep veins

Answer 35

more difficult to treat incompetant deep veins, if back flow- compression

Question 36

what prevents blood from flowing distally?

Answer 36

Venous return Valves Muscle pump Incompetence Obstruction Mixed

Question 37

clinical presentations of veins

Answer 37

C0 – No signs C1 – Telangiectasia/reticular C2 – Truncal C3 – Oedema C4 – Skin Changes (Pigmentation/Eczema/LDS) C5 – Healed ulcer C6 – Active Ulcer

Question 38

Pathophysiology

Answer 38

Reflux- blood is going w gravity against where the body wants it to go Obstruction Mixed

Question 39

Where is the SFJ located?

Answer 39

4 patient fingerbreaths lateral and inferior to the pubic tubercle

Question 40

Treatment of Superficial Venous Disease

Answer 40

Lifestyle Compression Sclerotherapy Endo-venous treatments Surgical stripping

Question 41

Treatment of Deep Venous Disease

Answer 41

Lifestyle Compression Stents Valves MOST IMPORTANT ONE IS COMPRESSION