Vascular Disease
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Questions and Answers

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
  • $>$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?

    <p>Known CAD</p> Signup and view all the answers

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

    <p>Endothelial damage due to hemodynamic shear stress</p> Signup and view all the answers

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

    <p>Cigarette smoking</p> Signup and view all the answers

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

    <p>Raynaud's</p> Signup and view all the answers

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

    <p>Accumulation of calcium in arteries</p> Signup and view all the answers

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

    <p>Proinflammatory cytokines</p> Signup and view all the answers

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

    <p>Bisoprolol</p> Signup and view all the answers

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

    <p>Atenolol</p> Signup and view all the answers

    Which condition does Clonidine help reduce in vascular surgery patients?

    <p>Myocardial ischemia</p> Signup and view all the answers

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

    <p>&gt; 12 months</p> Signup and view all the answers

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

    <p>Statins</p> Signup and view all the answers

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

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

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

    <p>Thoracic dissection</p> Signup and view all the answers

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

    <p>(AD) Aortic Dissection</p> Signup and view all the answers

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

    <p>Mean Arterial Pressure (MAP)</p> Signup and view all the answers

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

    <p>Overall complication rate by the surgeon and institution</p> Signup and view all the answers

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

    <p>17% reduction in stroke</p> Signup and view all the answers

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

    <p>It ensures rapid emergence for neurologic assessment</p> Signup and view all the answers

    What is the likely consequence of aortic clamping on hemodynamics?

    <p>Increased afterload</p> Signup and view all the answers

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

    <p>It further compromises perfusion pressure distal to the clamp</p> Signup and view all the answers

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

    <p>Watershed areas with compromised blood supply</p> Signup and view all the answers

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

    <p>Dyspnea</p> Signup and view all the answers

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

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

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

    <p>Hypotension, back pain, pulsatile abdominal mass</p> Signup and view all the answers

    What are common signs and symptoms of peripheral arterial disease?

    <p>Decreased pulses and hair loss</p> Signup and view all the answers

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

    <p>Avoiding hyperdynamic response to intubation</p> Signup and view all the answers

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

    <p>False</p> Signup and view all the answers

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

    <p>False</p> Signup and view all the answers

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

    <p>True</p> 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.

    <p>True</p> Signup and view all the answers

    Postoperative hypertension after carotid endarterectomy increases the potential for bleeding.

    <p>True</p> Signup and view all the answers

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