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Cardiac Surgery
Surgery 2
| Question | Answer |
|---|---|
| what is the treatment for AAA | surgery--repair |
| name the 5 P's for symptoms of Acute Arterial Occlusion | pain, pulselessness, pallor, poikilothermia, paresthesias/paralysis |
| what is the most effective treatment for stable claudication | lifestyle modification, smoking cessation, regimented excercise, and medications (Pletal) |
| what is the leading cause of death in Western culture | atherosclerosis |
| what is the result of narrowing of lumen in atherosclerotic disease | distal ischemia, acute thrombosis, downstream embolization |
| name the 3 types of lessions associated with atherosclerotic disease | fatty streaks, fibrous plaques, complex plaques |
| the most common location for atherosclerosis | at a bifurcation |
| what are the secondary risk factors for atherosclerosis | age, family history, male, obesity |
| what causes pain with PVD | ischemia of muscle tissue |
| name the arteries responsible for claudication pain in the buttocks | distal aorta/common iliac |
| name the arteries responsible for claudication pain in the thigh | external iliac |
| name the arteries responsible for claudication pain in the calf | superficial femoral |
| describe typical pain with claudication | reproducible, exercise induced pain in foot, calf, or buttock |
| vascular physical exam assessment includes | documented pulses at each level, evaluate each level for signs of ischemia and tissue loss |
| Is an arteriography always necessary for diagnosis of claudication? | only needed if intervention is planned |
| velocity of blood in vessels is determined by use of __ | duplex ultrasound |
| what is the normal value of ABI in the normal patient | >1 |
| what is the ABI in a patient with intermittent claudication | .5-.7 |
| what is the ABI in a patient with claudication type pain at rest | <0.3 |
| the ratio of the blood pressure in the lower legs to the blood pressure in the arms. Compared to the arm, lower blood pressure in the leg is a symptom of blocked arteries (peripheral vascular disease). | Ankle Brachial Index (ABI) |
| what is the common ABI of DM patients | >1 due to calcified non-compressible vessels |
| what is the best test for determination of atherosclerotic disease status | arteriography |
| indications for surgical intervention in PVD | lifestyle modifications, rest pain, or tissue loss |
| one important complication of lower extremity amputation | MI |
| 80% of claudication patients have __ claudication | stable |
| essential test to obtain prior to referral of PVD patient | NIVT |
| test of choice for carotid artery disease | duplex scan (doppler US) |
| what is the gold standard for diagnosing lesions of aortic arch, carotid artery, vertebral artery, and intracranial artery | four vessel arteriography |
| leading cause of death CEA | cardiac complication |
| what are the indications for AAA repair | >5cm, size increase >0.5cm/yr, symptomatic, rupture |
| most common post op complication of AAA | MI |
| what is the etiology of acute arterial occlusion | thrombosis or embolism |
| name 2 common sites of AAO | lower extremity vessels and diseased vessels |
| list the three most common post-MI complications | VSD, Acute mitral insufficiency, LV aneurysm |
| list the criteria for CABG | left main disease >50%, three vessel coronary disease, failed medical management, failed angioplasty, decreased LV function, complicated disease, diabetes mellitus |
| what is the patency of the radial artery when used as a conduit for CABG | 84% five years |
| which conduit is most commonly used in CABG | greater saphenous |
| list the classic triad of symptoms associated with aortic stenosis | angina, syncope, CHF |
| indications for aortic valve replacement | dyspnea on exertion, decreased LV function, pressure gradient >50 mmHg by cath |
| best for diagnosing aortic dissection | TEE |
| percentage of benign cardiac tumors | 75% |
| diagnosis of cardiac tumor | echo |
| diagnosis of pericarditis | echo |
| interpretation of blood flow in a doppler ultrasound | BART-blue away, red toward |
| ABI in normal patients | >1 |
| ABI in patients with intermittent claudication | 0.5-0.7 |
| ABI in patients with rest pain | <0.3 |
| treatment for lower extremity rest pain | arteriography, bypass surgery |
| indications for surgical intervention in PVD | tissue loss, rest pain, lifestyle limiting claudication |
| leading cause of postoperative mortality | MI |
| risk of stroke in patients with carotid stenosis depends on | degree of stenosis, and presence of symptoms |
| what seemingly related symptoms are not associated with carotid disease | diplopia, syncope, paresthesias |
| which vessels are assoc w/ sx of diplopia, syncope, and paresthesias | vertebrobasilar arteries |
| physical exam finding is consistent with carotid vascular disease | carotid bruit |
| gold standard for defining anatomy of carotid artery disease | doppler US |
| gold standard for defining anatomy of carotid lesions | arteriography |
| cause of amaurosis fugax | embolization of the retinal artery, resulting in a transient monocular blindness |
| treatment for a 75% symptomatic carotid stenosis | carotid endarterectomy |
| at what size is AAA repair indicated | >5cm in diameter |
Created by:
Abarnard
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