Surgical Aspects of Vasc. Disease Flashcards Preview

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Flashcards in Surgical Aspects of Vasc. Disease Deck (23)
1

what are some symptoms of peripheral artery disease (PAD)?

intermittent claudication
rest pain
erectile dysfunction

2

what are some signs of PAD?

absent pulses
bruits
muscular atrophy
decreased hair growth
thick toenails
tissue necrosis/ulcer/infection

3

what's the diff between PAD ulcer and venous stasis ulcer?

PAD: ulcer on toes/foot (distal)
venous stasis: medial malleolus ulcer

4

risk factors for atherosclerosis?

SMOKING
htn
DM
fam hx
obesity
high cholesterol
sedentary lifestyle

5

indications for surgical treatment in PAD?

"STIR"
-severe claudication refractory to conservative tx
-tissue necrosis
-infection
-rest pain

6

what is rest pain?

pain in the foot (over distal metatarsals)
-pain at rest (duh)
-typically arises at night and resolves with hanging foot over bed (gravity=extra flow)

7

indication for amputation?

irreversible tissue ischemia (no hope with bypass)
-necrotic tissue
-severe infection
-severe pain w/out bypassable vessels

8

what are the 6 P's of acute arterial occlusion?

-pain
-pallor
-paralysis
-paresthesia
-polar/poikilothermia (cold)
-pulselessness

9

indication for CEA in asymptomatic pts?

carotid artery stenosis>60%

10

indication for CEA in symptomatic pts?

carotid stenosis>50%

11

what are symptoms of carotid artery stenosis?

amaurosis fugax (look it up!)
TIA
RIND - reversible ischemic neurologic deficit
CVA

12

what's one of the worse complications of a CEA?

STROKE

13

what are some other post op complications for CEA?

-stroke
-MI
-hematoma
-infection
-hemorrhage
-htn or hypotension
-thrombosis
-vagus/hypoglossal n. injury
-intracranial hemorrhage

14

what's the mortality rate after CEA?

about 1%

15

what med do you give post op after CEA?

ASA

16

what's the most common cause of death after CEA?

MI

17

indications for surgical tx of varicose veins?

-persistent or debilitating pain
-recurrent superficial thrombophlebitis
-erosion of overlying skin with bleeding
-manifestations of ven. insuffic.

18

how are varicose veins removed?

stab that shiz!
-stab incisions made
-hooks loop vein and you rip it out

19

primary tx of DVT?

systemic anticoagulation

20

for surgical patients, what is the risk of post op DVT?

-20-25% of gen surg pts
-50-60% in knee or hip arthroplasty
basically DVT prophy is super important (stockings, pneumatic compression, heparin or LMWH)

21

what's the indication for surgical tx of venous insufficiency?

-non healing ulcers
-disabling s/s refractory to conservative tx

22

procedures to tx venous insufficiency?

-ablative procedures of superficial veins
-antireflux procedures
-bypass operations for obstruction

23

indication for IVC filter?

in pts with proximal DVT who can't be anticoagulated for some reason
Reason? prevention of pulm. emboli