Beloy - Vascular Surgery (Exam 4) Flashcards Preview

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Flashcards in Beloy - Vascular Surgery (Exam 4) Deck (24)
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1
Q

What is the INR goal for someone on Coumadin?

A

INR 2-3

2
Q

How do we reverse Coumadin?

A

FFP and vitamin K

3
Q

Where do you place a chest tube?

A
  • Mid axial line, 5th intercostal space (level of the nipple line).
  • Slide the tube over the top of the rib (because the intercostal a/n/v is on the bottom of the rib)
4
Q

Once you have placed a chest tube you want to _________________________________.

A

Once you have placed a chest tube you want to put to suction or water seal.

5
Q

What are the 3 most common vessels used for CABGs?

A
  1. Internal mammary a.
  2. Saphenous v.
  3. Radial a.
6
Q

If a vessel is clogged, you can either unclog it (aka __________), make an opening (aka __________), or create a new pathway for the blood to flow (aka __________)

A

If a vessel is clogged, you can either unclog it (aka angioplasty), make an opening (aka place a stent), or create a new pathway for the blood to flow (aka bypass).

7
Q

In order to sew new vessels to the heart you must stop the heart. This includes cooling and a high potassium based solution. What is this process called?

A

Cardiopulmonary bypass

8
Q

T/F: Your pt’s carotid artery is 65% stenosed. This is indication for a carotid endarterectomy.

A

False - only if >70% stenosed

9
Q

No matter the location of an aneurysm or dissection, what are your two options for fixing it? Describe each method

A
  • Endovascular:
    • an incision is made in the femoral and/or brachial a. and a stent is introduced, directed under fluoroscopy and is deployed in the landing zone
  • Open repair:
    • Traditional repair. Longer healing time, actually will replace the injured blood vessel section with graft (new plumbing).
10
Q

How do you classify aortic dissections?

A
  • Debakey:
    • ​Type I: involves ascending aorta, aortic arch, and descending aorta
    • Type II: ascending aorta only
    • Type III: descending aorta only
  • Stanford:
    • ​Type A: includes Debakey types I and II
    • Type B: Debakey type III
11
Q
  • Stanford type A aortic dissections require ____________.
  • Stanford type B aortic dissections require ____________.
A
  • Stanford type A aortic dissections require surgery.
  • Stanford type B aortic dissections require BP control.
12
Q

What is an endoleak?

A

An endoleak is an endovascular repair complication. It’s when you have persistent blood flow outside the lumen of the endoluminal graft but within the aneurysm sac or adjacent segment being treated by the device.

13
Q

Which type of endoleak is the most common?

A

Type II: patent lumbar arteries

14
Q

What is the normal range for ABI?

A

0.9-1.4

15
Q

Where are the 5 locations you can amputate on the lower extremities?

A
  • Toe
  • Transmetatarsal
  • Below-knee
  • Above-knee
  • Hip disarticulation
16
Q

Name that wound: Wounds that are thought to occur due to improper functioning of venous valves, usually of the legs, a major cause of chronic wounds.

A

Venous stasis ulcers

17
Q

What score are you going to get on this exam?

A

100%

18
Q

How do you reverse heparin?

A

Protamine

19
Q

What focused Physical exam should you do for every patient in vascular surgery?

A
  1. vitals
    1. record blood pressure in both arms to check for subclavian disease
  2. Head/neck
    1. asess quality of temporal and carotid pulses, listen to bruits
  3. Chest
    1. assess heart sounds, rate, rhythym, murmurs, pericardial rubs
  4. abdomen
    1. assess for pulsatile masses, listen for bruits over viseral/renal/iliac vessels
  5. lower extemeties
    1. assess the quality of pulses, femoral, popliteral, dorsalis pediss, posterior tibial, check the skin for ulcerations and color changes
    2. hair distribution, edema
20
Q

What is the most common blockage in the coronary arteries?

A

LAD (left anterior descending)

21
Q

If someone has a 100% block carotid artery that occured over time, what is your plan?

A

Doesn’t necessarily need to be fixed, but should exercise extreme caution and monitoring of the other carotid artery.

22
Q

During angiogram and intervention of PAD, which artery is access usually obtained through?

A

Lower extremity/aorta - Common femoral

Upper extremity - brachial or femoral depending on location

23
Q

What blood thinning medication would you use for carotid-subclavian bypass?

A

Heparin.

24
Q

What is steal syndrome? What causes it?

A
  • vascular access steal syndrome is a syndrome caused by ischemia (not enough blood flow) resulting from a vascular access device (such as an arteriovenous fistula or synthetic vascular graft–AV fistula) that was installed to provide access for the inflow and outflow of blood during hemodialysis.