Fiser Chapter 27 VASCULAR Flashcards Preview

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Flashcards in Fiser Chapter 27 VASCULAR Deck (233)
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1

Lymphedema tx

Leg elevation, compression, antibiotics for infection

2

How do you expose the SMA?

Divide the LOT. SMA is to the right of this near the base of the transverse colon mesentery.

3

Swollen red toe with pus coming out and red streaks up leg, sepsis

Wet gangrene, surgical emergency, may need amputation

4

Inflammatory aneurysms complications

Just inflammation (not infection), occurs in 10% of AAA patients; weight loss, high ESR, thickened rim above calcifications on CT; resolves after aortic graft placement

-Adhesions to 3rd and 4th duodenum
-Ureteral entrapment

5

Watershed areas

Griffith's: splenic flexure

Sudak's: upper rectum

6

Mal perforans ulcer

Metatarsal heads
2nd MTP joint most common
Possible OM (Diabetics)

7

Leakage of clear fluid after groin surgery

Lymphocele

Tx: percutaneous drainage; resection of that fails

Can inject isosulfan blue dye into foot to identify lymphatic channels supplying lymphocele

8

Indication for repair of descending aortic aneurysms

> 5.5 cm if endovascular repair possible
> 6.5cm if open repair needed

9

Risk factors for visceral artery aneurysms

Medial fibrodysplasia
Portal HTN
Inflammation (pancreatitis causing arterial disruption)

10

Swelling right after lower extremity bypass

Reperfusion injury
can lead to compartment syndrome, lactic acidosis, hyperkalemia, myoglobinuria

11

Tx of acute arterial embolism

Embolectomy
Fasciotomy if ischemia > 4-6 hours
Aortoiliac emboli (loss of both femoral pulses): bilateral femoral artery cutdowns and bilateral embolectomies

12

Atheroma embolism diagnosis and treatment

Dx: CT CAP (look for aneurysmal source) and ECHO

Tx: aneurysm repair or arterial exclusion with bypass

13

Most common congenital hypercoagulable disorder

Leiden factor: resistance to activated protein C

14

Indication for repair of ascending aortic aneurysm

Acutely symptomatic
>/= 5.5 cm (> 5cm with Marfan's)
Rapid increase in size (>0.5 cm/yr)

15

Most common cause of acute death after AAA repair

MI

16

Major vein injured with prximal cross-clamp in AAA repair

Retro-aortic left renal vein

17

Most common visceral aneurysm, and indication for repair

Splenic artery aneurysm

High rate of rupture in 3rd trim pregnancy

Repair if symptomatic, if pregnant, if childbearing age, or is >3-4cm

18

Indications for shunt during CEA

Stump pressures < 50, or
Contralateral side is tight

19

Signs of PAD

-Pallor
-Dependent rubor
-Hair loss
-Slow capillary refill

20

Most common location of pseudoaneurysm

femoral artery

21

Risk factors for AAA

Males
Age
Smoking
Family history

22

Atherosclerosis risk factors

-Smoking
-HTN
-Hypercholesterolemia
-DM
0Hereditary factors

23

Femoropopliteal graft 5-year patency

75%
Improved if for claudication rather than limb salvage

24

Carotid endarterectomy indications

> 70% stenosis and symptoms, or
> 80% stenosis

25

HTN in young women, string of beads appearance

FMD: Most commonly renal artery followed by carotid and iliac
If carotids involved, HA or stroke

Tx: PTA best, bypass if fails

26

Postnatal angiogenesis mechanism

Budding from preexisting vessels
Involved angiogenin

27

Most complication of aneurysms above versus below inguinal ligament

Rupture above

Thrombosis and emboli below

28

Dacron graft use

Aorta and large vessels

29

Treatment of pseudoaneurysm after percutaneous interention

US-guided compression with thrombin injection
Surgical repair if flow remains afterward

30

Pain, paresthesia, poikilothermia, paralysis

acute arterial embolus

pallor -> cyanosis -> marbling