40 Questions
What is the primary cause of endothelial damage leading to atherosclerosis?
Hemodynamic shear stress
Which stage of atherosclerosis is characterized by the formation of a fibrous plaque?
Fibrous plaque
What is the term for the abnormal lipid profile that is a predisposing risk factor for atherosclerosis?
Atherogenic dyslipidemia
Which of the following is NOT a major risk factor for atherosclerosis?
Insulin resistance
What is the term for the increased tendency to form blood clots that is a predisposing risk factor for atherosclerosis?
Prothrombotic state
What is the result of the destructive effects of oxidized LDLs on the arterial wall?
Endothelial dysfunction
What is the term for the abnormal accumulation of fat in the arterial wall that is the initial lesion of atherosclerosis?
Fatty streak
Which of the following is a common consequence of the progression of atherosclerosis?
Impaired endothelial function
What is the most common site of atherosclerotic lesions in the coronary arteries?
Branch points
What is the estimated risk of MI or cardiac-related death in patients undergoing carotid endarterectomy?
1-5%
What is the primary benefit of administering perioperative beta blockade in patients at risk for coronary disease?
Decreasing mortality and the incidence of cardiovascular complications
What type of patients are most likely to require vascular surgery and have atherosclerotic lesions at multiple locations?
Generally sick people
What is the name of the study that investigated the administration of Atenolol in patients at risk for coronary disease?
Mangano Study
What is the primary location of atherosclerotic lesions in the abdominal aorta?
Along the outer surfaces of arterial curves
What is the estimated risk of MI or cardiac-related death in patients undergoing peripheral vascular surgery?
5% or greater
What is the duration of the benefit of administering perioperative beta blockade in patients at risk for coronary disease?
For as long as 2 years following surgery
What is the effect of perioperative bisoprolol on short- and long-term cardiac death and MI?
Significantly reduced
What is the recommended duration of beta-blocker treatment before surgery?
At least 30 days
What is the effect of high-dose beta-blockade on cardiac outcomes?
Increased risk of cardiac death
In which patient subgroup should beta-blockade be introduced according to the 2009 Guidelines?
All of the above
What is the effect of beta-blockade on non-fatal stroke according to the recent meta-analysis?
27% increase
Which beta-blocker is preferred for perioperative beta-blockade?
Bisoprolol
What is the effect of beta-blockade on MACE in patients with anemia?
Marked increase
What is the recommended approach to transfusion in beta-blocked patients with anemia?
Higher transfusion threshold
What is the primary indication for surgery in an abdominal aortic aneurysm?
Diameter > 5 cm
What is the typical location of an abdominal aortic aneurysm rupture?
Left retroperitoneum
What is the role of fluid resuscitation in the management of an abdominal aortic aneurysm rupture?
Deferred fluid resuscitation until the aorta is controlled
What is the benefit of combined general anesthetic with epidural analgesia in elective AAA repair?
Improved postoperative course
What is the primary cause of intermittent claudication in peripheral arterial disease?
Metabolic demands exceeding oxygen delivery during exercise
What is the characteristic ankle-brachial index in patients with rest pain?
< 0.4
What is the risk factor shared by peripheral arterial disease and coronary artery disease?
Similar to CAD
What is the benefit of neuraxial analgesia in peripheral arterial disease?
Very useful for pain management
What is the primary cause of mortality in patients with atherosclerosis?
Cardiovascular ischemic events
Which of the following is a sign of peripheral artery disease?
Dependent rubor
What is the primary indication for surgical intervention in peripheral artery disease?
All of the above
What is the primary risk of peripheral artery disease surgery?
Ischemic heart disease
What is the management of Raynaud's phenomenon in anesthesia?
All of the above
What is the most common etiology of carotid artery disease?
Embolic problem
What is the primary correlate of surgical outcome in carotid endarterectomy?
All of the above
What is the ranking of carotid artery disease in terms of cause of disability in the U.S.?
1st
Test your knowledge of vascular disease pathophysiology, including the causes of atherosclerosis, such as endothelial damage, inflammation, and hypercoagulability, and the three stages of its progression. Learn about the role of oxidized LDLs and understand how it affects the arterial tree.
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