what exactly causes the occlusive vascular disease of thromboangiitis obliterans? - Answers aka
Buerger's disease
inflammatory thrombi affecting the medium and small vessels (nonatherosclerosis)
polymorphonuclear leukocytes, microabscesses, and multinucleated giant cells may be presen
Treatment options for thromboangiitis obliterans? - Answers smoking cessation most important!
cilostazol (PDE 3 inhibitor) has vasodilator properties (alleviated symptoms)
if raynauds also present, CCB (nifedipine)
what heart failure treatment provides a benefit of reduction in morbidity and mortality? - Answers ACE
inhibitors
beta blockers can also reduce M&M
diuretics have no reduction in mortality
how would you manage a patient with a MI in the setting of cocaine use? - Answers benzodiazepine
early
no beta blockers
If PCI cannot be done for a STEMI patient within 120 minutes, what should be done? - Answers fibrolytic
therapy
then do PCI & coronary angiography when it can be done
ideally PCI is done within 90 minutes
fibrolytic therapy can be used up to 12 hours of symptoms
, If you suspect an acute limb ischemia due to arterial embolism, what imaging should you get? - Answers
catheter-based arteriography (digital subtraction arteriography) provides the most useful information.
can also help with treatment
can help distinguish between thrombosis and embolus
where are arterial emboli often found? - Answers lower extremities more common than upper
extremities
The common femoral, common iliac, and popliteal artery bifurcations are frequent locations
majority originate in the heart
fun fact: Compared with thromboemboli, atheroemboli are less likely to produce symptoms of acute
limb ischemia
how would you work up a patient with treatment resistant hypertension that you suspect a secondary
cause? - Answers 24-hour ambulatory monitoring (to ensure not white coat)
medical hx (assess adherence to meds, other meds)
physical exam (look for abominal/renal bruits)
labs (electrolytes, glucose, creatinine, UA)
If pheo suspected: measure fractionated metanephrines and catecholamines in a 24-hour urine
collection
other than atherosclerosis leading to renal artery stenosis and secondary HTN, what is another causes of
a renal-associated secondary HTN? - Answers fibromuscular dysplasia (usually in a young pt)
most important modifable risk factor for AAA? - Answers smoking cessation!
when is it okay to do screening survelliance for AAA rather than repair and how often should you
screen? - Answers if AAA is <5.5 cm then annual screening with US is recommended. may need every 6
months if rapidly expanding or other concerns