UPDATED ACTUAL Exam Questions and
CORECT Answers
Carotid artery disease - CORRECT ANSWER - carotid stenosis
narrowing of extracranial arteries.
more prevalent with HTN and HD
symptomatic carotid stenosis - CORRECT ANSWER - focal neuro dysfunction like TIA,
ischemic strokep
pathophys carotid artery disease - CORRECT ANSWER - caused by conditions that cause
atherosclerotic plaque:
turbulent flow due to change in vessel caliber
variable shear stress
flow separation
increased contact time between particles in the blood
fatty streak: monocytes that diff. into macrophages or foam cells-->plaque
clinical presentation/exam of carotid artery disease - CORRECT ANSWER - contralateral
weakness of face/arm or both, contralateral paresthesia, ipsilateral blindness.
STROKE symptoms
neck auscultation may elicit a carotid bruit. not common
diagnostics carotid artery disease - CORRECT ANSWER - duplex ultrasound is first line.
, can also to CTA
MRA IF duplex can't be obtained, inconclusive
when is carotid duplex ultrasound indicated? - CORRECT ANSWER - -if known stenosis
in asymptomatic patients
-vascular assessment in patients with risk factors for atherosclerosis: HTN, HLD, tobacco, family
history
-stroke risk assessment in pt with symptomatic coronary artery or peripheral artery disease
-plaques on retina
-TIAs
stroke in candidate for carotid revascularization
-s/p revascularization
-
Labs for carotid artery disease - CORRECT ANSWER - CBC, glucose, electrolytes,
BUN/Cr, lipids, coag, cross/type (transfusion), CK, CK-MB, troponin, EKG, CXR
What does CK measure? - CORRECT ANSWER - muscle damage. CK-MB is specific to
cardio
tropin measures - CORRECT ANSWER - proteins are released when the heart muscle has
been damaged, such as occurs with a heart attack. The more damage there is to the heart, the
greater the amount of troponin T and I there will be in the blood.
dif dx carotid stenosis - CORRECT ANSWER - any other stroke causes
carotid stenosis management - CORRECT ANSWER - STOP smoking
Start statin, antiHTN and antipltlt
Statin--goal for LDL <100