Vascular Disease

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What is the preferred beta-blocker for perioperative use based on the text?

Atenolol

Metoprolol

Propranolol

Bisoprolol (correct)

When should beta-blockade ideally be introduced before surgery? (2 answers)

Immediately before surgery

At least 30 days before surgery (correct)

1 day before surgery

At least 7 days before surgery

What is the recommended heart rate range to titrate beta-blockers to before surgery?

$>$100 beats/min

$<$80 beats/min (correct)

$<$60 beats/min

Which cardiac condition would prompt the consideration of introducing beta-blockade according to the 2009 guidelines?

Known CAD Signup and view all the answers

What are the probable causes of the generalized inflammatory disorder of the arterial tree mentioned in the text?

Endothelial damage due to hemodynamic shear stress Signup and view all the answers

What is a major predisposing risk factor for atherosclerosis mentioned in the text?

Cigarette smoking Signup and view all the answers

Which condition is associated with peripheral arterial disease according to the text?

Raynaud's Signup and view all the answers

What factor can lead to the progression of fatty streaks in atherosclerosis?

Accumulation of calcium in arteries Signup and view all the answers

Which component is associated with hypercoagulability leading to thrombosis in the pathophysiology mentioned?

Proinflammatory cytokines Signup and view all the answers

Which beta-blocker shows the most benefit in perioperative settings?

Bisoprolol Signup and view all the answers

Which drug is recommended for typical preoperative treatment 7-30 days before surgery?

Atenolol Signup and view all the answers

Which condition does Clonidine help reduce in vascular surgery patients?

Myocardial ischemia Signup and view all the answers

What is the suggested duration for DAPT following stent placement with a drug-eluting stent (1st generation)?

> 12 months Signup and view all the answers

Which therapy has shown a significant reduction in mortality perioperatively with vascular surgery?

Statins Signup and view all the answers

What does the CARP trial suggest regarding coronary revascularization before vascular surgery?

It is not beneficial unless indicated for acute coronary syndrome. Signup and view all the answers

'DeBakey Type I' and 'Stanford Type A' are classifications related to which condition?

Thoracic dissection Signup and view all the answers

'Marfan's syndrome' and 'Ehlers-Danlos syndrome' are genetic predispositions to which condition?

(AD) Aortic Dissection Signup and view all the answers

Which cardiovascular variable experiences the highest percentage change by level of aortic occlusion?

Mean Arterial Pressure (MAP) Signup and view all the answers

What is a crucial factor to consider when determining if asymptomatic patients should undergo carotid endarterectomy?

Overall complication rate by the surgeon and institution Signup and view all the answers

What is a significant benefit observed in cases where regional anesthesia was used for carotid endarterectomy? (2 answers)

17% reduction in stroke Signup and view all the answers

Why should maintenance of anesthesia during carotid endarterectomy be kept at a 'light' level?

It ensures rapid emergence for neurologic assessment Signup and view all the answers

What is the likely consequence of aortic clamping on hemodynamics?

Increased afterload Signup and view all the answers

Why is pharmacologic reduction in preload and afterload not recommended during aortic clamping?

It further compromises perfusion pressure distal to the clamp Signup and view all the answers

What is a potential complication of resecting or excluding the Artery of Adamkiewicz during aortic cross-clamping?

Watershed areas with compromised blood supply Signup and view all the answers

In thoracic aortic aneurysm, what symptom is directly associated with compression of the trachea?

Dyspnea Signup and view all the answers

What is an indication for elective surgery in abdominal aortic aneurysm?

Asymptomatic, pulsatile abdominal mass with a diameter greater than 5 cm Signup and view all the answers

What is the classic triad of symptoms seen in ruptured abdominal aortic aneurysm?

Hypotension, back pain, pulsatile abdominal mass Signup and view all the answers

What are common signs and symptoms of peripheral arterial disease?

Decreased pulses and hair loss Signup and view all the answers

Which action is advantageous with regional anesthesia in the management of peripheral arterial disease?

Avoiding hyperdynamic response to intubation Signup and view all the answers

Carotid endarterectomy is more effective in reducing stroke in asymptomatic patients compared to symptomatic patients.

False Signup and view all the answers

Regional anesthesia for carotid endarterectomy results in a higher incidence of stroke compared to general anesthesia.

False Signup and view all the answers

Carotid endarterectomy correlates include age, diabetes, and history of stroke among others.

True Signup and view all the answers

The composite incidence of stroke, death, or cardiac event is lower in cases where carotid endarterectomy is done using regional anesthesia.

True Signup and view all the answers

Postoperative hypertension after carotid endarterectomy increases the potential for bleeding.

True Signup and view all the answers

Vascular Disease

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Questions and Answers

What is the preferred beta-blocker for perioperative use based on the text?

When should beta-blockade ideally be introduced before surgery? (2 answers)

What is the recommended heart rate range to titrate beta-blockers to before surgery?

Which cardiac condition would prompt the consideration of introducing beta-blockade according to the 2009 guidelines?

What are the probable causes of the generalized inflammatory disorder of the arterial tree mentioned in the text?

What is a major predisposing risk factor for atherosclerosis mentioned in the text?

Which condition is associated with peripheral arterial disease according to the text?

What factor can lead to the progression of fatty streaks in atherosclerosis?

Which component is associated with hypercoagulability leading to thrombosis in the pathophysiology mentioned?

Which beta-blocker shows the most benefit in perioperative settings?

Which drug is recommended for typical preoperative treatment 7-30 days before surgery?

Which condition does Clonidine help reduce in vascular surgery patients?

What is the suggested duration for DAPT following stent placement with a drug-eluting stent (1st generation)?

Which therapy has shown a significant reduction in mortality perioperatively with vascular surgery?

What does the CARP trial suggest regarding coronary revascularization before vascular surgery?

'DeBakey Type I' and 'Stanford Type A' are classifications related to which condition?

'Marfan's syndrome' and 'Ehlers-Danlos syndrome' are genetic predispositions to which condition?

Which cardiovascular variable experiences the highest percentage change by level of aortic occlusion?

What is a crucial factor to consider when determining if asymptomatic patients should undergo carotid endarterectomy?

What is a significant benefit observed in cases where regional anesthesia was used for carotid endarterectomy? (2 answers)

Why should maintenance of anesthesia during carotid endarterectomy be kept at a 'light' level?

What is the likely consequence of aortic clamping on hemodynamics?

Why is pharmacologic reduction in preload and afterload not recommended during aortic clamping?

What is a potential complication of resecting or excluding the Artery of Adamkiewicz during aortic cross-clamping?

In thoracic aortic aneurysm, what symptom is directly associated with compression of the trachea?

What is an indication for elective surgery in abdominal aortic aneurysm?

What is the classic triad of symptoms seen in ruptured abdominal aortic aneurysm?

What are common signs and symptoms of peripheral arterial disease?

Which action is advantageous with regional anesthesia in the management of peripheral arterial disease?

Carotid endarterectomy is more effective in reducing stroke in asymptomatic patients compared to symptomatic patients.

Regional anesthesia for carotid endarterectomy results in a higher incidence of stroke compared to general anesthesia.

Carotid endarterectomy correlates include age, diabetes, and history of stroke among others.

The composite incidence of stroke, death, or cardiac event is lower in cases where carotid endarterectomy is done using regional anesthesia.

Postoperative hypertension after carotid endarterectomy increases the potential for bleeding.

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