Vascular surgery Flashcards
PAD + Post operative complications (8 cards)
Which one of the following statements regarding risk of peripheral arterial disease (PAD) is NOT correct?
a. Risk is increased in smokers.
b. Risk is greater in white vs black patients.
c. Risk is greater in high vs low levels of HbA1c.
d. Risk is greater in high vs low levels of blood pressure.
Answer: b
PAD is more common in BLACK patients.
- (c) High HbA1c = Poorly controlled diabetes
The ankle-brachial pressure index (ABPI) is used for diagnosis of peripheral arterial disease (PAD). Which one of the following statements regarding the ABPI is NOT correct?
a. The pressure in the lower limb is normally equal to or higher than that obtained in the upper limb.
b. The leg pressure measurement is divided by the arm pressure measurement.
c. A ratio of 0.4 would be indicative of severe PAD.
d. The test compares diastolic blood pressure in the lower and upper limbs.
Answer: d
The test compares SYSTOLIC blood pressure in the lower and upper limbs.
- (c) ABPI abnormal = 0.9 or less
Which one of the following would NOT be included in the management of peripheral arterial disease (PAD)?
a. Administration of ‘statins’ (lipid lowering medication).
b. Avoidance of aspirin.
c. Smoking cessation.
d. A supervised exercise programme.
Answer: b
Management would include anti-platelet therapy (i.e. taking aspirin).
Which one of the following statements regarding symptoms of peripheral arterial disease (PAD) would NOT be correct?
a. Symptoms of claudication are alleviated by a brief period of rest.
b. Symptoms are a prerequisite for a diagnosis of PAD.
c. Ischaemic rest pain is a sign of critical limb ischaemia.
d. Claudication is the result of ischaemic neuropathy and local intramuscular acidosis.
Answer: b
Symptoms are NOT required for the diagnosis of PAD - some people with PAD are asymptomatic.
PAD is diagnosed using tools like ABPI.
Slide 3-4 - Vascular Surgery
* Claudication = pain in the legs or arms that occurs while walking or using the arms.
Which one of the following radiological procedures would NOT be regarded as helpful in diagnosing PAD?
a. Magnetic resonance angiography
b. X-rays of the ankles and feet
c. CT scan with contrast
d. Ultrasound
Answer: b
X-rays show bone structure - they do NOT provide visualisation of vasculature.
Which one of the following general statements regarding peripheral arterial disease is NOT correct?
a. Extreme disease may result in gangrene.
b. The condition is invariably symptomatic.
c. Symptoms may appear at rest.
d. Typical symptoms are induced by exercise such as walking.
Answer: b
PAD is NOT invariably symptomatic.
A portion of PAD patients are asymptomatic (especially in the early stages).
- (c) Critical limb ischaemia - blood flow is so compromised that pain can occur even at rest - particularly at night or when the leg is elevated.
- (d) Most common symptom of PAD = Intermittent claudication - pain triggered by walking and relieved at rest.
Which one of the following statements regarding post-operative complications is NOT correct?
a. Elderly patients may become delirious and should receive prophylactic anti-delirium medication.
b. The patient may develop atelectasis.
c. The patient may develop a venous thrombosis which may lead to a pulmonary embolus.
d. If catheterised there is a risk of urinary tract infection.
Answer:
Prophylactic anti-delirium medications are NOT routinely recommended.
Which of the following statements regarding associations with peripheral arterial disease is NOT correct?
a. Chronic renal failure may be a factor.
b. C-reactive protein may be elevated.
c. In general, risks for development of PAD are not related to the risks for development of atherosclerosis.
d. Dyslipidaemia may be a factor.
Answer: c
PAD is essentially a manifestation of systemic atherosclerosis.
