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Chapter_27:_Vascular
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Published
07/07/2024
The most common congenital hypercoagulable disorder is {{c1::Factor 5 Leiden}}
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07/07/2024
The most common acquired hypercoagulable disorder is {{c1::smoking}}
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07/07/2024
The first stage in atherosclerosis is the formation of {{c1::foam cells}}
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07/07/2024
The second stage in atherosclerosis is characterized by {{c1::smooth muscle cell}} proliferation
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07/07/2024
The third stage in atherosclerosis is characterized by {{c2::intimal disruption}}, which leads to exposure of {{c1::collagen}} in …
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07/07/2024
The carotid arteries supply {{c1::85}}% of blood flow to the brain
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The most common site of stenosis in the carotid artery is at the {{c1::carotid bifuraction}}
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07/07/2024
Normally, the {{c2::internal}} carotid artery has {{c1::continuous forward}} flow
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Normally, the {{c2::external}} carotid artery has {{c1::triphasic}} flow
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The first branch of the internal carotid artery is the {{c1::ophthalmic}} artery
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The first branch of the external carotid artery is the {{c1::superior thyroid}} artery
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The external and internal carotid arteries communicate via the {{c2::ophthalmic}} artery and {{c1::internal maxillary}} artery
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The most commonly diseased intracranial artery is the {{c1::middle cerebral}} artery
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Cerebral ischemic events are most commonly from arterial {{c1::embolization}}
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07/07/2024
The most common embolic source for a cerebral ischemic event is the {{c1::internal carotid artery}}
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07/07/2024
Mental status changes and slowing are symptoms typical of {{c1::anterior}} cerebral artery events
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07/07/2024
Motor deficits and speech deficits are symptoms typical of {{c1::middle}} cerebral artery events
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Vertigo, tinnitus, drop attacks, and incoordination are symptoms typical of {{c1::posterior}} cerebral artery events
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Occlusion of the ophthalmic branch of the ICA is known as {{c2::amaurosis fugax}}, which shows {{c1::Hollenhorst plaques}} on ophthalmologic exam
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Carotid traumatic injury with major fixed deficit can be repaired if it is {{c1::not occluded}}
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Carotid endarterectomy is indicated in symptomatic patients with > {{c1::50}}% stenosis
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Carotid endarterectomy is indicated in asymptomatic patients with > {{c1::70}}% stenosis
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Patients with fluctuating neurologic symptoms or crescendo/evolving TIAs may benefit from {{c1::emergent}} carotid endarterectomy
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In a patient with asymptomatic and asymmetric bilateral carotid stenosis, the {{c1::tighter}} side is repaired first
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In a patient with symmetric bilateral carotid stenosis, the {{c1::dominant}} side is repaired first
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Which part(s) of the artery wall are removed during carotid endarterectomy?{{c1::Intima and part of media}}
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The most important technical concern during carotid endarterectomy is getting a good {{c1::distal end}} point
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A shunt is used during carotid endarterectomy if the back pressure is < {{c1::50}} mmHg or if the contralateral side is {{c2::occluded}}
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The management of 100% carotid artery stenosis is {{c1::nothing}}
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The most commonly injured cranial nerve in carotid endarterectomy is the {{c1::vagus}} nerve
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Hoarseness can occur after carotid endarterectomy due to {{c1::vagus}} nerve injury
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Tongue deviation can occur after carotid endarterectomy due to {{c1::hypoglossal}} nerve injury
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Difficulty swallowing can occur after carotid endarterectomy due to {{c1::glossopharyngeal}} nerve injury
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The neck strap muscles are innervated by the {{c1::ansa cervicalis}} nerve
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Defects involving the corner of the mouth after carotid endarterectomy are concerning for {{c1::mandibular}} branch of the facial nerve injury
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07/07/2024
The branches of the facial nerve (CN 7)1) {{c1::Temporal}}2) {{c2::Zygomatic}}3) {{c3::Buccal}}4) {{c4::Mandibular}}5) {{c5::Cervical}}
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The management for an acute event following carotid endarterectomy is {{c1::return to OR}}
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A pulsatile, bleeding mass present after carotid endarterectomy is concerning for {{c1::pseudoaneurysm}}
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Injury to the {{c2::carotid body}} can result in {{c1::hypertension}} after carotid endarterectomy, which is treated with {{c3::sodium nitroprusside}}
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The most common cause of non-stroke morbidity and mortality after carotid endarterectomy is {{c1::myocardial infarction}}
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The percentage of patients who get restenosis after carotid endarterectomy is {{c1::15}}%
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High-risk patients that cannot undergo carotid endarterectomy can receive {{c1::carotid stenting}}
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The two vertebral arteries arise from the {{c1::subclavian}} arteries then combine to form the {{c2::basilar}} artery
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Vertebrobasilar artery disease is treated with {{c1::PTA with stenting}}
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Carotid body tumors arise as a painless neck mass, are extremely {{c2::vascular}}, and can secrete {{c1::catecholamines}}
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The brachiocephalic artery is also known as the {{c1::innominate}} artery
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Ascending aortic aneurysms are repaired when they are acutely symptomatic, ≥ {{c1::5.5}} cm, or rapid increase in size > {{c2::0.5}} cm/year
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Descending aortic aneurysms are repaired when they are > {{c1::5.5}} cm if endovascular repair is possible
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Descending aortic aneurysms are repaired when they are > {{c1::6.5}} cm if open repair is needed
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During open descending aortic aneurysm repair, intercostal arteries below spinal level {{c1::T8}} are reimplanted
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Any ascending aortic involvement in aortic dissection is Stanford class {{c1::A}}
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Only descending aortic involvement in aortic dissection is Stanford class {{c1::B}}
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07/07/2024
Ascending and descending aortic involvement in aortic dissection is DeBakey type {{c1::I}}
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Ascending only aortic involvement in aortic dissection is DeBakey type {{c1::II}}
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Descending only aortic involvement in aortic dissection is DeBakey type {{c1::III}}
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Most aortic dissections start in the {{c1::ascending}} aorta
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95% of patients with aortic dissection have severe {{c1::hypertension}} at presentation
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The dissection in an aortic dissection occurs in the tunica {{c1::media}} of the vessel wall
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Aortic insufficiency occurs in {{c1::70}}% of patients with aortic dissection
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Death from aortic dissection is typically due to rupture or {{c1::cardiac failure}}
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All patients with aortic dissection are treated medically initially with IV {{c1::beta blockers}} and {{c1::nitroprusside}}
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Operation with {{c2::open}} repair is required for all {{c1::ascending}} aortic aneurysms
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The surgical incision approach for open ascending aortic aneurysm repair is via {{c1::median sternotomy}}
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The surgical incision approach for open descending aortic aneurysm repair is via {{c1::left thoracotomy}}
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07/07/2024
Descending aortic aneurysms only require surgical repair when there is {{c2::ischemia}} or {{c1::contained rupture}}
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Patients with history of aortic dissection are followed with lifetime serial {{c1::MRI}}
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Postop complications for aortic surgery include {{c3::myocardial infarction}}, {{c2::renal}} failure, and {{c1::paraplegia}}
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Paraplegia can occur after descending thoracic aortic surgery due to occlusion of {{c2::intercostal}} arteries and the artery of {{c1::Adamkiewic…
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07/07/2024
The normal abdominal aorta has a diameter of {{c1::2}}-{{c1::3}} cm
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The most common cause of abdominal aortic aneurysm is {{c2::atherosclerosis}}, which results in degeneration of the tunica {{c1::media}}
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07/07/2024
Abdominal aortic aneurysm rupture is diagnosed with {{c1::CT angiography}}
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07/07/2024
CT angiography of abdominal aortic aneurysm rupture shows fluid in the {{c1::retroperitoneal}} space and {{c2::extraluminal}} contrast present
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Abdominal aortic aneurysms are most likely to rupture on the {{c2::left::left or right}} {{c3::postero}}-lateral wall, 2-4 cm below the {{c1::renal}} …
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07/07/2024
Abdominal aortic aneurysms are most likely to rupture in the presence of {{c2::dia}}-stolic hypertension or {{c1::COPD}}
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07/07/2024
If a patient with ruptured abdominal aortic aneurysm reaches the hospital alive, they still have a {{c1::50}}% mortality rate
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07/07/2024
Repair is indicated for asymptomatic abdominal aortic aneurysms if the size is ≥ {{c1::5.5}} cm for males or ≥ {{c1::5.0}} cm for …
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07/07/2024
Repair for asymptomatic abdominal aortic aneurysm is indicated if the growth is > {{c1::1.0}} cm per year or > {{c1::0.5}} cm per 6 months
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07/07/2024
Other than size and growth rate, abdominal aortic aneurysms should be repaired if they are either symptomatic or {{c1::infected (mycotic)}}
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07/07/2024
Which type of abdominal aortic aneurysm repair is preferred for higher risk patients?{{c1::EVAR}}
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07/07/2024
During abdominal aortic aneurysm repair, the inferior mesenteric artery should be reimplanted if the backpressure is < {{c1::40}} mmHg
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07/07/2024
Bleeding lumbar arteries found during abdominal aortic aneurysm repair should be {{c1::ligated}}
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07/07/2024
If performinng an aorto-bifemoral repair instead of a straight graft for abdominal aortic aneurysm repair, ensure blood flow to at least one inte…
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07/07/2024
EVAR has better {{c1::short}}-term outcomes than open abdominal aortic aneurysm repair, but {{c1::long}}-term outcomes are equal
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07/07/2024
Complications of abdominal aortic aneurysm repair include major vein injury with {{c1::proxim}}al cross-clamping
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Impotence occurs in 1/3 of abdominal aortic aneurysm repairs due to {{c1::nerve}} and vessel injury
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The most common cause of acute death after abdominal aortic aneurysm repair is {{c1::myocardial infarction}}
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The most common cause of late death after abdominal aortic aneurysm repair is {{c1::renal failure}}
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The #1 risk factor for mortality after abdominal aortic aneurysm repair is {{c1::creatinine > 1.8}}
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07/07/2024
The most common organism to cause vessel graft infection is {{c1::Staphylococcus epidermidis}}
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07/07/2024
Rates of graft infection and pseudoaneurysm formation after abdominal aortic aneurysm repair are both {{c1::1}}%
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07/07/2024
The most common late complication after aortic graft placement is {{c1::atherosclerotic occlusion}}
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07/07/2024
Diarrhea after abdominal aortic aneurysm repair is concerning for {{c1::ischemic colitis}}
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07/07/2024
Ischemic colitis after abdominal aortic aneurysm repair is most likely due to compromise of the {{c1::inferior mesenteric}} artery
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07/07/2024
An incompetent seal at the proximal or distal attachment sites after EVAR is termed a type {{c1::I}} endoleak
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07/07/2024
A patent IMA or lumbar branches causing retrograde flow into the aneurysm sac after EVAR is termed a type {{c1::II}} endoleak
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07/07/2024
A leak from disconnection of the endograft components after EVAR is termed a type {{c1::III}} endoleak
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07/07/2024
Leak after EVAR due to increased porosity of the graft causing plasma exudation is termed a type {{c1::IV}} endoleak
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Continued aneurysm sac expansion without a leak found on imaging is termed a type {{c1::V}} endoleak
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A type V endoleak is also termed {{c1::endotension}}
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07/07/2024
Are inflammatory aortic aneurysms caused by infection?{{c1::No}}
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07/07/2024
Inflammatory aortic aneurysms may cause adhesions to the {{c1::duodenum}}
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07/07/2024
Inflammatory aortic aneurysms cause {{c1::ureteral}} entrapment in 25% of patients
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07/07/2024
Weight loss, increased ESR, and a thickened rim above calcifications on CT scan is concerning for {{c1::inflammatory}} aortic aneurysm
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07/07/2024
Mycotic aortic aneurysms are most commonly caused by {{c2::Staphylococcus (#1)}} species, followed by {{c1::Salmonella (#2)}}
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07/07/2024
Periaortic fluid, gas, retroperitoneal soft tissue edema, and lymphadenopathy are concerning for {{c1::mycotic}} aortic aneurysm
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07/07/2024
Aortic graft infections are more common with grafts that go to the {{c1::groin}}
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07/07/2024
Are blood cultures more likely positive in mycotic aortic aneurysms or in aortic graft infections?{{c1::Mycotic aortic aneurysms}}
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07/07/2024
A herald bleed with hematemesis after abdominal aortic surgery is concerning for {{c1::aortoenteric fistula}}
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07/07/2024
An aortoenteric fistula most commonly involves the aortic graft eroding into the {{c1::duodenum}}
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07/07/2024
The 4 compartments of the lower leg are:1) {{c1::Anterior}}2) {{c1::Lateral}}3) {{c2::Deep posterior}}4) {{c2::Superficial posterior}}
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The anterior leg compartment receives innervation from the {{c1::deep peroneal}} nerve
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07/07/2024
The lateral leg compartment receives innervation from the {{c1::superficial peroneal}} nerve
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The deep posterior leg compartment receives innervation from the {{c1::tibial}} nerve
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The superficial posterior leg compartment receives innervation from the {{c1::sural}} nerve
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Peripheral artery disease (PAD) is most commonly due to {{c1::atherosclerosis}}
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The #1 preventative agent for atherosclerosis in PAD is {{c1::statins}}
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07/07/2024
First line therapy for claudication in PAD includes {{c2::smoking cessation}} (#1) and {{c1::aspirin}}
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07/07/2024
Buttock claudication in PAD indicates {{c1::aortoiliac}} disease
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07/07/2024
Mid-thigh claudication in PAD indicates {{c1::external iliac}} disease
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07/07/2024
Calf claudication in PAD indicates {{c1::common femoral artery}} or {{c2::proximal superficial femoral artery}} disease
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Foot claudication in PAD indicates {{c1::distal superficial femoral artery}} or {{c2::popliteal artery}} disease
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Claudication in PAD can be mimicked by {{c1::lumbar}} stenosis
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Rest pain in PAD can be mimicked by {{c1::diabetic}} neuropathy
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07/07/2024
The blockage of the abdominal aorta as it transitions into the common iliac arteries is known as {{c1::aortoilliac occlusive}} disease
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07/07/2024
The combination of buttock/thigh claudication, decreased femoral pulses, and erectile dysfuntion is known as {{c1::Leriche}} syndrome
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07/07/2024
Treatment for Leriche syndrome is {{c1::aorto-bifemoral bypass graft}}
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07/07/2024
The most common atherosclerotic occlusion site in the lower extremities is at {{c1::Hunter's}} canal
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The borders of Hunter's canal are:1) {{c1::Sartorius}} (anterior)2) {{c1::Vastus medialis}} (medial)3) {{c1::Adductor longus}} (posterior)
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07/07/2024
Abnormal pressure gradients from PAD can cause {{c1::collateral}} circulation
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Postnatal angiogenesis is the budding of new vessels from existing vessels and involves the protein {{c1::angiogenin}}
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07/07/2024
Claudication in PAD starts to occur at an ankle-brachial index (ABI) of < {{c1::0.9}}
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Rest pain in PAD starts to occur at an ankle-brachial index (ABI) of < {{c1::0.5}}
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Ulcers in PAD start to occur at an ankle-brachial index (ABI) of < {{c1::0.4}}
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Gangrene in PAD starts to occur at an ankle-brachial index (ABI) of < {{c1::0.3}}
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Ankle-brachial index (ABI) measurements can be very inaccurate in patients with {{c1::diabetes}}
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{{c1::Pulse volume}} recordings are used to find significant occlusion and the level of the occlusion
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If a pulse volume recording (PVR) suggests significant disease, the next best step is {{c1::arteriogram}}
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07/07/2024
Rest pain, ulceration/gangrene, lifestyle limitation, and atheromatous embolization are all {{c1::surgical}} indications for PAD
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07/07/2024
PAD bypasses above the knee can be performed with {{c1::PTFE (Gortex)}}
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07/07/2024
PAD bypasses below the knee can be performed with {{c1::the saphenous vein}}
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07/07/2024
PAD bypasses at the aorta and other large vessels can be performed with {{c1::Dacron}}
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The best predictor of long-term patency in PAD surgery is {{c1::vein}} quality
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Patients who receive lower extremity vessel bypass should be prescribed {{c1::aspirin}}
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The imaging modality preferred for graft surveillance after PAD surgery is {{c1::duplex ultrasound}}
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07/07/2024
Isolated iliac lesions in PAD should be treated surgically with {{c1::PTA with stenting}}
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07/07/2024
The popliteal artery below the knee is bordered posteriorly by the {{c1::gastrocnemius}} muscle and anteriorly by the {{c1::popliteus}} muscle
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Hostile surgical conditions in the abdomen can be avoided in PAD surgery by using {{c1::extra-anatomic}} grafts
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07/07/2024
Vascular steal can occur in the donor leg of a patient who has received a {{c1::femoral-to-femoral crossover}} graft for PAD
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07/07/2024
Early swelling after lower extremity bypass is concerning for {{c1::reperfursion}} injury and {{c1::compartment}} syndrome
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07/07/2024
Late swelling after lower extremity bypass is concerning for {{c1::DVT}}
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07/07/2024
The #1 cause of early failure of reversed saphenous vein grafts is {{c1::technical problem}}
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07/07/2024
The #1 cause of late failure of reversed saphenous vein grafts is {{c1::vein atherosclerosis}}
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07/07/2024
Patients with a heel ulceration that reaches bone are treated with {{c1::amputation}}
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07/07/2024
Is dry gangrene infectious?{{c1::No}}
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Is wet gangrene infectious?{{c1::Yes}}
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Compartment syndrome caused by reperfusion injury is mediated by {{c1::neutrophils::cell type}}
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Compartment syndrome is most likely to occur in the {{c1::anterior}} compartment of the leg
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An lateral lower leg incision for fasciotomy has a risk of injury to the {{c1::superficial peroneal}} nerve
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07/07/2024
Loss of pedal pulses with plantar flexion is concerning for {{c1::popliteal entrapment}} syndrome
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07/07/2024
Popliteal entrapment syndrome is treated with resection of the {{c1::medial}} head of the {{c2::gastrocnemius}} muscle
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Adventitial cystic disease is caused by a cyst that forms near an artery and is treated with {{c1::cyst resection}}
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The healing rate is higher for {{c1::above}} the knee amputations
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The chance of walking again is higher for {{c1::below}} the knee amputations
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The mortality rate is higher for {{c1::above}} the knee amputations
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The most common cause of acute arterial emboli is {{c1::atrial fibrillation}}
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07/07/2024
The most common site of peripheral obstruction for an acute arterial embolus is the {{c1::common femoral}} artery
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07/07/2024
The treatment for an acute arterial embolus is {{c1::embolectomy}}
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07/07/2024
Fragments of cholesterol crystals or other debris from atherosclerotic vessels to other arteries is known as {{c1::atheromatous embolism}}
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07/07/2024
The most common site of atheroma emboli is the {{c1::renal}} arteries
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07/07/2024
Blue toe syndrome is most commonly due to atheroma emboli from {{c1::aortoiliac}} disease
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07/07/2024
A patient with a history of claudication is more likely to have acute arterial {{c1::thrombosis}}
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A patient with a history of arrhythmia is more likely to have acute arterial {{c1::embolism}}
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07/07/2024
A limb with loss of sensation or motor function in acute arterial thrombosis is considered a(n) {{c1::threatened}} limb
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Acute arterial thrombosis with a threatened limb is treated with heparin and thromb{{c1::ectomy}}
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Acute arterial thrombosis with a non-threatened limb is treated with angiography and thromb{{c1::olysis}}
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The right renal artery runs {{c1::pos}}terior to the IVC
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Renal atherosclerosis is more common on the {{c2::left}} side, the {{c3::proximal}} 1/3, and in {{c1::men::gender}}
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Fibromuscular dysplasia is more common on the {{c2::right}} side, the {{c3::distal}} 1/3, and in {{c1::women::gender}}
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Fibromuscular dysplasia is treated with PTA {{c1::without}} stenting(with or without)
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Renal atherosclerosis is treated with PTA {{c1::with}} stenting(with or without)
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07/07/2024
Nephrectomy is indicated for renal HTN with an atropic kidney < {{c2::6}} cm in size with persistently high {{c1::renin}} levels
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07/07/2024
The most common site of upper extremity arterial stenosis is the {{c1::subclavian}} artery
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07/07/2024
Subclavian steal syndrome is treated with {{c1::PTA and stenting}}
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07/07/2024
Normally, the subclavian vein passes over the 1st rib {{c1::an}}terior to the anterior scalene muscle
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Normally, the brachial plexus passes over the 1st rib {{c1::pos}}terior to the anterior scalene muscle
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Normally, the subclavian artery passes over the 1st rib {{c1::pos}}terior to the anterior scalene muscle
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07/07/2024
In thoracic outlet syndrome, neurologic involvement is {{c1::more}} common than vascular involvement
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07/07/2024
The most common anatomic abnormality in thoracic outlet syndrome is {{c1::cervical rib}}
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07/07/2024
The most common cause of pain in thoracic outlet syndrome is {{c1::brachial plexus irritation}}
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07/07/2024
Brachial plexus irritation in thoracic outlet syndrome typically causes pain and weakness in the distribution of the {{c1::ulnar}} nerve
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07/07/2024
Treatment of thoracic outlet syndrome involves removal of the {{c2::cervical and 1st ribs}} with division of the {{c1::anterior scalene}} muscle
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07/07/2024
A condition in which thombosis occurs in the deep veins of the upper extremities is known as {{c1::Paget-von Schrötter}} disease
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07/07/2024
Subclavian artery involvement in thoracic outlet syndrome is typically due to {{c2::anterior}} scalene muscle {{c1::hypertrophy}}
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07/07/2024
Mesenteric ischemia usually involves the {{c1::superior mesenteric}} artery
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50% of mesenteric ischemia is due to {{c1::embolic occlusion}}
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07/07/2024
25% of mesenteric ischemia is due to {{c1::thrombotic occlusion}}
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07/07/2024
15% of mesenteric ischemia is due to {{c1::nonocclusive mesenteric ischemia (NOMI)}}
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07/07/2024
5% of mesenteric ischemia is due to {{c1::venous thrombosis}}
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07/07/2024
Superior mesenteric artery embolism most commonly occurs at the {{c1::proximal}} portion of the artery(proximal or distal)
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07/07/2024
Superior mesenteric artery embolism is treated with {{c1::embolectomy}}
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Last Update
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