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 (A)</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 (D)</p> Signup and view all the answers

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

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

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

<p>Raynaud's (A)</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 (B)</p> Signup and view all the answers

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

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

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

<p>Bisoprolol (C)</p> Signup and view all the answers

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

<p>Atenolol (C)</p> Signup and view all the answers

Which condition does Clonidine help reduce in vascular surgery patients?

<p>Myocardial ischemia (D)</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 (C)</p> Signup and view all the answers

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

<p>Statins (A)</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. (C)</p> Signup and view all the answers

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

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

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

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

What is the likely consequence of aortic clamping on hemodynamics?

<p>Increased afterload (C)</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 (A)</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 (C)</p> Signup and view all the answers

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

<p>Dyspnea (A)</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 (B)</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 (D)</p> Signup and view all the answers

What are common signs and symptoms of peripheral arterial disease?

<p>Decreased pulses and hair loss (B)</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 (C)</p> Signup and view all the answers

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

<p>False (B)</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 (B)</p> Signup and view all the answers

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

<p>True (A)</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 (A)</p> Signup and view all the answers

Postoperative hypertension after carotid endarterectomy increases the potential for bleeding.

<p>True (A)</p> Signup and view all the answers

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