Vascular Surgery Overview
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Questions and Answers

Which symptom is NOT associated with acute limb artery occlusion?

  • Poikilothermia
  • Pallor
  • Pitting edema (correct)
  • Pain

    • Which statement about thrombolytic therapy for limb artery occlusive disease is incorrect?

  • Using a catheter is more effective than intravenous injection.
  • Recent heart valve surgery is a contraindication.
  • It remains effective when used within four weeks of occlusion.
  • Pregnant women are suitable candidates for this treatment. (correct)

    • What is incorrect regarding inferior vena cava (IVC) filters?

  • They can be used in high-risk trauma patients.
  • They are considered when anticoagulant therapy fails.
  • They are used in patients contraindicated for anticoagulants.
  • They ensure the inferior vena cava remains completely patent post-insertion. (correct)

    • Which statement about the treatment of ruptured abdominal aortic aneurysm is false?

    <p>It prevents abdominal compartment syndrome effectively.</p> Signup and view all the answers

    In patients with thoracic aortic aneurysm near the left subclavian artery, which statement is correct?

    <p>It should be preserved whenever feasible.</p> Signup and view all the answers

    What defines an aneurysm based on diameter increase?

    <p>Exceeding 2 times the normal artery diameter.</p> Signup and view all the answers

    What is the appropriate management for patients who develop limb ischemia after a subclavian artery sacrifice?

    <p>Performing an urgent bypass graft.</p> Signup and view all the answers

    Which condition is a potential complication following IVC filter placement?

    <p>Thrombosis of the inferior vena cava.</p> Signup and view all the answers

    Which of the following diseases is treated with thrombolytic therapy?

    <p>Limb artery occlusion</p> Signup and view all the answers

    What complication needs regular monitoring after endovascular repair of abdominal aortic aneurysm?

    <p>Re-formation of the aneurysm.</p> Signup and view all the answers

    Where is the most commonly affected site for acute traumatic aortic transection?

    <p>Aortic isthmus</p> Signup and view all the answers

    Which of the following symptoms is inaccurately described for complete acute arterial obstruction in the leg?

    <p>Intermittent claudication</p> Signup and view all the answers

    Which of the following is not a risk factor for peripheral artery stenosis?

    <p>Alcohol abuse</p> Signup and view all the answers

    Which statement is incorrect regarding surgical considerations for patients with abdominal aortic aneurysms?

    <p>Surgery is necessary regardless of size if the aneurysm is rapidly growing but less than 4 cm</p> Signup and view all the answers

    Which of the following does not relate to the indications for surgical intervention in abdominal aortic aneurysms?

    <p>Aneurysm larger than 5 cm, life expectancy less than 1 year</p> Signup and view all the answers

    What is the most common cause of acute embolic occlusion of the leg arteries?

    <p>Atrial fibrillation</p> Signup and view all the answers

    Which option is not appropriate management for acute deep vein thrombosis in the leg?

    <p>Immediate surgical intervention if feasible</p> Signup and view all the answers

    Which condition is primarily characterized by pain and pallor in the affected limb?

    <p>Acute arterial occlusion</p> Signup and view all the answers

    Which of the following best describes a condition that does not require surgery for abdominal aortic aneurysm?

    <p>Size under 4 cm with significant symptoms</p> Signup and view all the answers

    Which condition is NOT associated with chronic arterial occlusion?

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

    What symptom characterizes the fourth stage of the Fontaine classification?

    <p>Ulcers and gangrene</p> Signup and view all the answers

    Which patient condition is least suitable for revascularization surgery in acute limb ischemia?

    <p>Loss of motor function in the affected limb</p> Signup and view all the answers

    Which imaging modality has the highest specificity and sensitivity for aortic dissection?

    <p>Transesophageal echocardiography</p> Signup and view all the answers

    What is the best treatment for acute pulmonary embolism with cardiac arrest?

    <p>Extracorporeal life support</p> Signup and view all the answers

    According to the Blunt cerebrovascular injury grading scale, which finding is classified as grade four?

    <p>Luminal irregularity with dissection</p> Signup and view all the answers

    Which of the following is a possible consequence of chronic venous insufficiency?

    <p>Stasis dermatitis</p> Signup and view all the answers

    What is the primary cause of venous varicosities?

    <p>Venous valve incompetence</p> Signup and view all the answers

    Which statement about the risk factors for vascular dissection following balloon angioplasty is incorrect?

    <p>Immediate use of a high-pressure balloon is recommended if dissection occurs.</p> Signup and view all the answers

    What is a common feature of graft infection complications?

    <p>Vancomycin is ineffective for graft infections.</p> Signup and view all the answers

    Which statement regarding traumatic injury to the thoracic aorta is false?

    <p>Penetrating trauma accounts for less than 90% of injuries.</p> Signup and view all the answers

    Which description regarding abdominal aortic aneurysms is incorrect?

    <p>Smoking is not considered a significant risk factor.</p> Signup and view all the answers

    In the context of dialysis access steal syndrome, which statement is false?

    <p>Excessive flow through the fistula is necessary for distal ischemia.</p> Signup and view all the answers

    Which statement about chronic venous disease's CEAP classification is inaccurate for C3?

    <p>CEAP classifications are not used for chronic venous disease.</p> Signup and view all the answers

    Which statement regarding graft infections is misleading?

    <p>Infection occurs only in contaminated surgeries.</p> Signup and view all the answers

    Which option is NOT a method for treating dialysis access steal syndrome?

    <p>Insertion of a new fistula.</p> Signup and view all the answers

    What statement regarding traumatic aortic injuries is incorrect?

    <p>Conservative treatment is only an option for non-traumatic dissections.</p> Signup and view all the answers

    Which statement regarding the treatment of abdominal aortic aneurysms is incorrect?

    <p>Patients can safely ignore untreated aneurysms under 5 cm.</p> Signup and view all the answers

    Study Notes

    Acute Traumatic Aortic Transection

    • Most common location for injury: Aortic isthmus.

    Acute Arterial Occlusion of the Lower Extremities

    • Symptoms of complete blockage include:
      • Pain at rest.
      • Affected limb turning pale.
      • Absence of distal pulses.
      • Limb paralysis.
      • Incorrect symptom: Intermittent claudication.

    Risk Factors for Peripheral Arterial Disease

    • Non-risk factor: Alcohol abuse.
    • Other risk factors include:
      • Advanced age.
      • Hypertension.
      • Smoking.
      • Diabetes.

    Surgical Considerations for Abdominal Aortic Aneurysm

    • Criteria for surgery based on rupture risk and operative risk comparison.
    • Aneurysms ≥5 cm in asymptomatic patients over two years old warrant surgical intervention.
    • Surgical intervention necessary if aneurysm grows >0.5 cm in 6 months, even at 4-5 cm.
    • Incorrect consideration: No need for surgery on rapidly enlarging aneurysms <4 cm.

    Indications for Surgery in Abdominal Aortic Aneurysms

    • Common indications include:
      • Aneurysms >5 cm with a life expectancy of <1 year are not an indication.
      • Aneurysms >6-7 cm, especially in high-risk patients.
      • Rapidly enlarging aneurysms causing pain.

    Acute Limb Ischemia Causes

    • Most common cause: Atrial fibrillation.

    Management of Acute Deep Vein Thrombosis

    • Incorrect management option: Always perform surgery first before considering drugs.

    Symptoms of Acute Limb Arterial Occlusion

    • Symptoms include:
      • Pain.
      • Temperature abnormalities (poikilothermia).
      • Pallor.
      • Paralysis.
      • Incorrect symptom: Pitting edema.

    Thrombolytic Therapy in Limb Arterial Disease

    • Correct statement: Thrombolytic agent infusion via catheter more effective than IV.
    • Unfavorable conditions for treatment:
      • Recent heart valve surgery.
      • Pregnant women.
      • Recent upper gastrointestinal bleeding.
    • Incorrect statement: Effective even if occlusion duration is >2 weeks but <4 weeks.

    Inferior Vena Cava Filters

    • Considered when anticoagulant therapy is ineffective or contraindicated.
    • Suitable for high-risk trauma patients.
    • Incorrect statement: IVC filters maintain complete patency post-insertion.

    Treatment of Ruptured Abdominal Aortic Aneurysm

    • Ideal pre-operative management includes maintaining low blood pressure (70-80 mmHg).
    • Endovascular stenting is becoming the mainstream treatment.
    • Regular follow-up with CT scanning needed post-stenting.

    Aortic Aneurysm Stenting

    • Stenting near the left subclavian artery may require specific surgical techniques.
    • Incorrect statement: No significant function from the left subclavian artery and can be sacrificed.

    Definition of An Aneurysm

    • Defined as a diameter increase to ≥50% of the normal artery diameter.

    Balloon Angioplasty Complications

    • Major risk factors include severe arterial calcification and oversizing the balloon.
    • Wrong approach: Use high-pressure balloon immediately upon dissection occurrence.

    Graft Infection Descriptions

    • Prophylactic antibiotics recommended even for clean surgeries.
    • Common pathogens include Staphylococcus epidermidis.
    • CT scans are best for diagnosing suspected infections.

    Chest Aortic Injury Diagnosis

    • Risk factors for injury include clavicle and first rib fractures.
    • CT scans are essential for diagnosis.
    • Majority of injuries are from penetrating trauma.

    Acute Limb Ischemia Revascularization Criteria

    • Not suitable for patients with lost limb function.

    Imaging for Aortic Dissection

    • MRI offers the highest specificity and sensitivity.

    Treatment for Cardiac Arrest with Pulmonary Embolism

    • Best treatment: Extracorporeal life support.

    Blunt Cerebrovascular Injury Grading

    • Understand levels based on the grading scale, with higher grades indicating more severe injury.

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    Description

    This quiz covers essential topics in vascular surgery, including acute aortic injuries, peripheral arterial disease risk factors, and surgical indications for abdominal aortic aneurysms. Test your knowledge on common clinical presentations and surgical considerations in these conditions.

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