Absite Vascular

Front 1

MC congenital hypercoagulable disorder

Back 1

resistance to activated protein C (Leiden factor)

Front 2

MC acquired hypercoagulable disorder

Back 2

smoking

Front 3

3 stages of atherosclerosis

Back 3

1st - foam cells
2nd - smooth mm proliferation
3rd - intimal disruption

Front 4

Atherosclerosis is disease of

Back 4

intima

Front 5

HTN is disease of

Back 5

media

Front 6

1st branch of external carotid artery

Back 6

superior thyroid artery

Front 7

communication b/n ICA and ECA

Back 7

ophthalmic artery and internal maxillary artery

Front 8

MC diseased intracranial artery

Back 8

MCA

Front 9

etiology of most strokes

Back 9

arterial embolization

Front 10

Management of carotid traumatic injury with major fixed deficit

Back 10

do not fix if occluded

Front 11

indications for CEA in symptomatic vs asymptomatic pts

Back 11

>70% vs >80%

Front 12

When do you shunt in CEA

Back 12

stump pressures<50

Front 13

Equal b/l stenosis; which side to fix first

Back 13

dominant side first

Front 14

CEA complications

Back 14

CN injury
HTN (20%) give nipride

Front 15

MC M&M s/p CEA

Back 15

MI

Front 16

MC CN injury

Back 16

vagus nerve

Front 17

Rate of stenosis after CEA

Back 17

15%

Front 18

vertebrobasilar insufficiency

Back 18

diploplia
Dysarthria
Vertigo
drop attacks

Front 19

management and presentation of carotid body tumors

Back 19

painless neck mass
resect

Front 20

Thoracic aortic transection mechanism

Back 20

usually decel injury
fix other life threatening injuries first
@ ligamentum arteriosum
left heart bypass with repair mediastinal widening (from bridging veins not aorta itself)

Front 21

Ascending aortic aneurysms etiology

Back 21

connective tissue disorder
MC cystic medial necrosi

Front 22

different presentations of ascending AA

Back 22

back pain
voice changes
SOB
dysphagia

Front 23

transverse aortic arch aneurysm etiology

Back 23

atherosclerosis

Front 24

Descending aortic aneurysms

Back 24

2/2 atherosclerosis
5-10% paraplegia
reimplant intercostal vessels below T8

Front 25

Indications to repair ascending aortic aneurysm

Back 25

acute symptomatic
>7cm
>6 with marfan's
2x >nl diameter
rapid growth

Front 26

RF for aortic dissection

Back 26

severe HTN
Marfan's
prior coarctation repair
atherosclerosis
infection

Front 27

What layer of blood vessel does dissection usually occur

Back 27

media

Front 28

dissection is a/w aortic

Back 28

insufficiency 70%

Front 29

death from dissection usually 2/2

Back 29

cardiac failure

Front 30

when to operate in dissection

Back 30

all ascending
descending with visceral, renal, leg ischemia; persistent pain or large size

Front 31

abd AA

Back 31

2/2 atherosclerosis
medial degeneration
old HTN male smokers

Front 32

most likely location of rupture in AAA

Back 32

left posterolateral 2-4 cm below renal

Front 33

more likely AAA rupture with what comorbidities

Back 33

COPD
diastolic HTN

Front 34

%mortality w. ruptured AAA

Back 34

50

Front 35

Repair AAA if

Back 35

>5cm
growth >0.5cm/year

Front 36

when to reimplant IMA?

Back 36

backpressure <40
prior colon surgery
stenotic SMA

Front 37

Major vein injury with proximal cross clamp

Back 37

retroaortic renal vein

Front 38

complications of AAA repair

Back 38

impotence 33%

Front 39

#1 cause of acute death s/p AAA repair

Back 39

MI

Front 40

#1 cause of late death s/p AAA repair

Back 40

renal failure

Front 41

MC late complication after aortic graft

Back 41

atherosclerotic occlusion

Front 42

rate of graft infection and pseudoaneurysm

Back 42

1% for both

Front 43

Inflammatory aneurysms

Back 43

10% AAA
adhesions to 3/4 duodenum
ureteral entrapment (25%)
not from INFECTION

Front 44

bugs in mycotic aneurysms

Back 44

#1 salmonella
#2 Staph
(infect plaque causing aneurysm)

Front 45

Management of mycotic aneurysm

Back 45

ax-bifem bypass and resect infrarenal aorta

Front 46

Aortic graft infections bugs

Back 46

#1 Staph
#2 Ecoli
resect graft and bypass via noncontaminated field

Front 47

Aortoenteric fistula timing and presentation

Back 47

>6 months after surgery
herald bleed with hematemesis then BRBPR
aortobifem bypass

Front 48

Type 1-4 endoleaks

Back 48

1) @ proximal/distal attachment sites
2) collaterals (lumbar)
3) fabric tears/graft interfaces
4) porosity <24h; transient

Front 49

Dimensions needed for stent tube grafts

Back 49

proximal and distal neck >1.5 cm in length & <3cm diameter

Front 50

Anterior leg compartment contains

Back 50

deep peroneal nerve
anterior tib artery

Front 51

lateral leg compartment

Back 51

superficial peroneal nerve (eversion lateral foot)

Front 52

deep posterior leg compartment

Back 52

tibial nerve (plantarflexion)
posterior tibial artery
peroneal artery

Front 53

superficial posterior

Back 53

sural nerve

Front 54

signs of PVD

Back 54

pallor
hair loss
dependent rubor
abnl nail growth
slow cap refill

Front 55

% of gangrene and amputation

Back 55

2 vs 1%

Front 56

Leriche Syndrome

Back 56

No fem pulses
butt/thigh claudication
impotence
lesion @ aortic bifurcation

Front 57

MC site of atherosclerotic occlusion

Back 57

hunter's canal

Front 58

ABI for claudication, rest pain, ulcers, gangrene

Back 58

0.9, 0.6, 0.5, 0.3

Front 59

management of isolated iliac lesions

Back 59

angioplasty with stent is 1st choice

Front 60

5 year patency of fem-pop grafts

Back 60

75%

Front 61

5 year patency rate of fem-distal graft

Back 61

50%

Front 62

#1 and #2 cause of leg swelling after bypass

Back 62

DVT and edema from reperfusion

Front 63

#1 cause of late and early failure of RSVG

Back 63

atherosclerosis and technical

Front 64

Location and tx of malperforans ulcer

Back 64

@ metatarsal head
2nd mTP MC
DM
Debridement of metatarsal head (remove cartilage)

Front 65

pseudoaneurysm after arteriography

Back 65

thrombin injection with u/s
u/s duplex best first test

Front 66

compartment pressures

Back 66

>20-30 ----> fasciotomy

Front 67

40M with loss of pulses with plantarflexion

Back 67

popliteal entrapment syndrome
loss of pulses with active plantarflexion/passive dorsi
medial deviation of artery around medial head of gastrocnemius

Front 68

management of popliteal entrapment syndrome

Back 68

resect medial head of gastroc

Front 69

Adventitial cystic dz

Back 69

mens
40s
popliteal usually (b/l)
intermittent claudication
dx with angio
tx: vein graft if occluded if not just resect cyst

Front 70

Most common sit of peripheral obstruction of emboli?

Back 70

CFA

Front 71

MC involved in atheroma embolism

Back 71

renals

Front 72

Blue toe syndrome

Back 72

good distal pulses
aortoiliac disease most common source
NEED CT chest/abd/pelvis and ECHO

Front 73

thrombosed PTFE graft

Back 73

thrombolytics and a/c or OR if limb is threatened

Front 74

Path of right renal artery

Back 74

posterior to IVC

Front 75

Renal atherosclerosis vs fibromuscular dysplasia

Back 75

left, proximal 1/3, men vs right, distal 1/3, women
same management: PTA stent

Front 76

Renal artery stenosis

Back 76

bruits, DBP>115, drug resistant HTN
PTA with stent

Front 77

indications for nephrectomy with renal HTN

Back 77

atrophic kidney <6cm and minimal collaterals with persistently high renin

Front 78

MC site of upper ext. occlusive dz

Back 78

subclavian

Front 79

subclavian steal syndrome

Back 79

operate if symptomatic
carotid to SC bypass

Front 80

brachial plexus irritation

Back 80

2/2 thoracic outlet syndrome
nl neuro exam
Ulnar nerve (C8-T1) MC

Front 81

operation for thoracic outlet syndrome

Back 81

resect cervical rib, divided ant/middle scalenes, +/- 1st rb resection`

Front 82

absent radial pulse with maximal arm abduction

Back 82

subclavian artery occlusion from ant scalene hypertrophy

Front 83

Paget-von Schrotter dz tx

Back 83

effort induced SC vein thrombosis
thrombolytics, a/c

Front 84

4 MC reasons

Back 84

#1) embolic
#2) thrombosis
#3) low flow
#4) venous thrombosis

Front 85

SMA embolism

Back 85

#1 source is heart

Front 86

SMA thrombosis

Back 86

food fear
weight loss
chronic history
thrombectomy +/- SMA bypass

Front 87

SMV thrombosis

Back 87

a/c
history of vasculitis or portal HTN

Front 88

Median arcuate ligament syndrome

Back 88

celiac compression
epigastric bruit
chronic pain & diarrhea, weight loss
resect ligament

Front 89

chronic mesenteric angina

Back 89

weigh loss
food fear
30 mins after eating --> pain
PTA? bypass?
obtain lateral visceral aorthgraphy

Front 90

important collateral between SMA and celiac

Back 90

arc of riolan

Front 91

above vs below inguinal ligament complications of aneurysm

Back 91

rupture vs thrombo/emboli

Front 92

indications for repair of splanchnic aneurysms

Back 92

all except splenic

Front 93

MC visceral aneurysm

Back 93

splenic
2% rupture
MC in women

Front 94

indications to repair splenic artery

Back 94

pregnant
enlarging
women of childbearing age

Front 95

repair for most visceral aneurysms

Back 95

exclusion and bypass

Front 96

Indications to repair iliac aneurysm

Back 96

symptomatic
>3cm (2.5cm for femoral, 2cm for popliteal)
mycotic
exclude and bypass

Front 97

MC peripheral aneurysm

Back 97

popliteal
1/2 b/l and have asstd aneurysms
surgery if sx, >2cm, mycotic

Front 98

surgery for popliteal aneurysm

Back 98

exclude and bypass

Front 99

femoral pseudoaneurysm

Back 99

repair of flow remains in pseudoaneurysm or @ suture site
if not u/s thrombin

Front 100

when to operate on renal aneurysm

Back 100

>1.5 cm
expanding
sx
women who want pregnancy
recon with vein patch, nephrectomy if ruptures

Front 101

treatment of hypersensitivity angiitis

Back 101

CCB

Front 102

MC failure of AVF

Back 102

venous obstruction 2/2 intimal hyperplasia

Front 103

superficial vs suppurative thrombophlebitis

Back 103

NSAIDs vs resecting vein

Front 104

DVTs are more common on what side?

Back 104

left due to longer left iliac vein compressed by right iliac artery

Front 105

Virchows triad

Back 105

venous stasis
hypercoagulability
venous wall injury

Front 106

phlegmasia alba dolens

Back 106

white, edema, tender
need heparin

Front 107

phlegmasia cerulea dolens

Back 107

blue, massive edema, tender
need heparin

Front 108

treatment duration for 1st, 2nd, 3rd DVT

Back 108

6 vs 12 vs lifetime coumadin

Front 109

IVC filter

Back 109

PE while on coumadin
free floating iliofemoral thrombi
after pulm. embolectomy

Front 110

PE

Back 110

lifetime coumadin

Front 111

5 places that don't have lymphatics

Back 111

bone
muscle
tendon
cartilage
brain
cornea

Front 112

MC infection in lymphedema

Back 112

strep
congenital L>R

Front 113

Stewart-Treves syndrome

Back 113

lymphangiosarcoma after breast axillary dissection

Front 114

Dx/Tx of lymphangiectasia

Back 114

dilation of preexisting lymphatic channels
lymphangiography
resection

Front 115

Lymphocele

Back 115

s/p groin dissection
clear fluid leake
injecting blue dye into foot to ID channels and resect if alrge or symptomatic