ABSITE: VASCULAR QUESTIONS WITH
CORRECT ANSWERS 2025
theMmostMcommonMcongentialMhypercoagulableMdisorderM-MCORRECTMANSWERM-
resistanceMtoMactivatedMproteinMCM(leidenMfactor)
theMmostMcommonMacquiredMhypercoagulableMdisorderM-MCORRECTMANSWERM-smoking
theMmostMcommonMhypercoagMd/o-s:McongenitalMandMacquiredM-MCORRECTMANSWERM-
resistanceMtoMactivatedMproteinMCM(leidenMfactor)MandMsmoking
stagesMofMatherosclerosisM(bigMpicture)M-MCORRECTMANSWERM-(1)MfoamMcellsM--
>M(2)MsmoothMmuscleMcellMproliferationM-->M(3)MintimalMdisruption
stagesMofMatherosclerosisM(details)M-MCORRECTMANSWERM-
(1)MfoamMcellsM=MmacrophagesMthatMhaveMabsorbedMfatMandMlipidsMinMtheMvesselMwall...M(2)MsmoothMmu
scleMcellMproliferationM=McausedMbyMgrowthMfactorsMreleasedMfromMmacrophages,MresultsMinMwallMinjury..
.M(3)MintimalMdisruptionM(fromMsmoothMmuscleMcellMproliferation)M=MleadsMtoMexposureMofMcollagenMinMv
esselMwallMandMeventualMthrombusMformationM(fibrousMplaquesMformMinMthoseMareasMwMunderlyingMathe
romas)
stagesMofMatherosclerosisM(myMwords)M-MCORRECTMANSWERM-fatMandMlipidsMinMvesselMwallM--
>MexposedMandMabsorbedMbyMmacrophagesM(nowMcalledMfoamMcells)M-->MreleaseMgrowthMfactorsM--
>MGFMcauseMsmoothMmuscleMcellMproliferationM-->MwallMinjuryMandMintimalMdisruptionM--
>MexposesMcollageMinMvesselsMwallM--
>MthrombusMformsM(whichMisMfibrousMplaquesMinMtheseMareaMwMunderlyingMatheromas)
riskMfactorsMforMatherosclerosisM-MCORRECTMANSWERM-
smoking,MHTN,Mhypercholesterolemia,MDM,Mhereditary
layersMofMarteryM-MCORRECTMANSWERM-
intima,Mmedia,MadventitiaM(fromMoutMtoMin,McompositionMchangesMdependingMonMtheMartery)
,compositionMofMarteryMlatersM(moreMdetails)M-MCORRECTMANSWERM-
endothelium,Mintima,MinternalMelasticMlamina,MmediaM(containsMsmoothMmuscleMcellsMandMelasticMfibers)
,MadventitiaM(wMvasoMvasorum)
cerebrovascularMdisease:MstrokeMisMtheM___MMCMcauseMofMdeathMinMtheMUSM-MCORRECTMANSWERM-3rd
cerebrovascularMdisease:MmostMimportantMriskMfactorMforMstrokeMisM_____M-MCORRECTMANSWERM-HTN
cerebrovascularMdisease:McarotidsMsupplyM_____%MofMbloodMflowMtoMtheMbrainM-MCORRECTMANSWERM-
85%
cerebrovascularMdisease:MmostMimportantMsiteMofMstenosisMforMCVAMinjuryM-MCORRECTMANSWERM-
carotidMbifurcation
cerebrovascularMdisease:MnormalMinternalMcarotidMarteryM(ICA)MhasM_______M_________MflowM-
MCORRECTMANSWERM-continuousMforwardMflow
cerebrovascularMdisease:M1stMbranchMofMtheMinternalMcarotidM-MCORRECTMANSWERM-ophthalmicMartery
cerebrovascularMdisease:MnormalMexternalMcarotidMarteryM(ECA)MhasM_______M________MflowM-
MCORRECTMANSWERM-triphasic
cerebrovascularMdisease:M1stMbranchMofMeternalMcarotidM-MCORRECTMANSWERM-superiorMthyroidMartery
cerebrovascularMdisease:MnormalMflowMofMICAMvsMECAM-MCORRECTMANSWERM-
continuousMforwardMvsMtriphasic
cerebrovascularMdisease:M1stMbranchMofMICAMvsMECAM-MCORRECTMANSWERM-
ophthalmicMvsMsuperiorMthyroidMartery
cerebrovascularMdisease:McommunicationMbetweenMICAMandMECAMisMviaM-MCORRECTMANSWERM-
ophthalmicM(offMICA)MandMinternalMmaxillaryMarteryM(offMECA)
,cerebrovascularMdisease:MMCMdiseaseMintracranialMarteryM-MCORRECTMANSWERM-middleMcerebralMartery
cerebrovascularMdisease:MMCM(andM2ndMMC)McauseMofMcerebralMischemicMeventsM-MCORRECTMANSWERM-
fromMarterialMembolizationM(NOTMthrombis)MfromMtheMICAM(canMalsoMbeM2/2MlowMflowMstateMthroughMse
verelyMstenoticMlesion)...MheartMisMtheM2ndMMCMsourceMofMcerebralMemboli
cerebrovascularMdisease:MmanifestationMofManteriorMcerebralMarteryMeventsM-MCORRECTMANSWERM-
mentalMstatusMchanges,Mrelease,Mslowing
cerebrovascularMdisease:MmanifestationMofMmiddleMcerebralMarteryMeventsM-MCORRECTMANSWERM-
contralateralMmotorMandMspeechM(ifMdominantMside),McontralateralMfacialMdroop
cerebrovascularMdisease:MmanifestationMofMposteriorMcerebralMarteryMeventsM-MCORRECTMANSWERM-
vertigo,Mtinnitus,MdropMattacks,Mincoordination
cerebrovascularMdisease:MmanifestationMofManteriorMvsMmiddleMvsMposteriorMcerebralMarteryMeventsM-
MCORRECTMANSWERM-
anteriorM=MmentalMstatusMchanges,Mrelease,Mslowing....MmiddleM=McontralateralMmotorMandMspeechM(ifMd
ominantMside),McontralateralMfacialMdroop...MposteriorM=Mvertigo,Mtinnitus,MdropMattacks,Mincoordination
cerebrovascularMdisease:MdefineMamaurosisMfugaxM-MCORRECTMANSWERM-
occlusionMofMtheMophthalmicMbranchMofMtheMICAM(visualMchangesM--
>MshadeMcomingMdownMoverMeyes),MvisualMchangesMareMtransient...MyouMwillMseeMHollenhorstMplaquesMo
nMopthoMexam
cerebrovascularMdisease:MmgmtMofMcarotidMinjuryMwMmajorMfixedMdeficitM-MCORRECTMANSWERM-
mgmtMplanMdependsMonMoccludedMvsMnotMoccluded...MifMoccludedMthenMNOMrepairM(b/cMcanMexacerbate
Minjury)....MifMnotMoccludedMthenMrepairMwMcarotidMstentMorMopenMprocedure
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)MrepairMindicationsM-MCORRECTMANSWERM-
symptomaticMwM>70%Mstenosis,Ma-sxMwM>80%Mstenosis
, cerebrovascularMdisease:McarotidMendarterectomyM(CEA)MtimingMifMrecentMstrokeM-MCORRECTMANSWERM-
waitM4-6MweeksMafterMstrokeMthenMdoMCEAM(ifMcriteriaMmetM-MsymptomaticMwM>70%Mstenosis,Ma-
sxMwM>80%Mstenosis),MifMdoMitMearlierMthenMriskMofMbleeding
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-MwhenMisMitManMemergency?M-
MCORRECTMANSWERM-
mayMbeMdoneMemergentlyMifM(1)MfluctuatingMneuroMsxMorM(2)Mcrescendo/evolvingMTIAs
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-MwhenMisMaMshuntMused?M-
MCORRECTMANSWERM-(1)MstumpMPM<50,M(2)McontralateralMsideMisMtight
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)MrepairMorderM-MCORRECTMANSWERM-
dependsMonMtheMrelativeMtightnessMofMtheMsides....repairMtheMtightestMsideMfirstMifMtheMptMhasMb/lMstenos
isMvsMdominantMsideMfirstMifMequallyMtightMb/l
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-McomplicationsMfromMrepairM(overview)M-
MCORRECTMANSWERM-
(9)....MvagusMnerve,MhypoglossalMnerve,MglossopharyngealMnerve,MansaMcervicalis,MmandibularMbranchMof
MfacialMnerve,MbackMtoMORMtoMcheckMforMflapMorMthrombosisM(acuteMeventsMpostMop),Mpseudoaneurysm,M
HTNM(20%),MMI
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-McomplicationsMfromMrepair,MvagusMnerveM-
MCORRECTMANSWERM-
mostMcommonMcranialMnerveMinjuryMwMCEA,M2/2MvascularMclampingMduringMendarterectomy...Mp/wMhoar
senessM(b/cMrecurrentMlaryngealMnerveMbranchesMoffMofMvagus)
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-
McomplicationsMfromMrepair,MhypoglossalMnerveM-MCORRECTMANSWERM-
tongueMgoesMTOWARDMsideMofMinjury,Mp/wMspeechMandMchewingMdifficulties
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-
McomplicationsMfromMrepairM,MglossopharyngealMnerveM-MCORRECTMANSWERM-
rare,MoccursMwMreallyMhighMcarotidMdissection,Mp/wMdifficultyMswallowing
CORRECT ANSWERS 2025
theMmostMcommonMcongentialMhypercoagulableMdisorderM-MCORRECTMANSWERM-
resistanceMtoMactivatedMproteinMCM(leidenMfactor)
theMmostMcommonMacquiredMhypercoagulableMdisorderM-MCORRECTMANSWERM-smoking
theMmostMcommonMhypercoagMd/o-s:McongenitalMandMacquiredM-MCORRECTMANSWERM-
resistanceMtoMactivatedMproteinMCM(leidenMfactor)MandMsmoking
stagesMofMatherosclerosisM(bigMpicture)M-MCORRECTMANSWERM-(1)MfoamMcellsM--
>M(2)MsmoothMmuscleMcellMproliferationM-->M(3)MintimalMdisruption
stagesMofMatherosclerosisM(details)M-MCORRECTMANSWERM-
(1)MfoamMcellsM=MmacrophagesMthatMhaveMabsorbedMfatMandMlipidsMinMtheMvesselMwall...M(2)MsmoothMmu
scleMcellMproliferationM=McausedMbyMgrowthMfactorsMreleasedMfromMmacrophages,MresultsMinMwallMinjury..
.M(3)MintimalMdisruptionM(fromMsmoothMmuscleMcellMproliferation)M=MleadsMtoMexposureMofMcollagenMinMv
esselMwallMandMeventualMthrombusMformationM(fibrousMplaquesMformMinMthoseMareasMwMunderlyingMathe
romas)
stagesMofMatherosclerosisM(myMwords)M-MCORRECTMANSWERM-fatMandMlipidsMinMvesselMwallM--
>MexposedMandMabsorbedMbyMmacrophagesM(nowMcalledMfoamMcells)M-->MreleaseMgrowthMfactorsM--
>MGFMcauseMsmoothMmuscleMcellMproliferationM-->MwallMinjuryMandMintimalMdisruptionM--
>MexposesMcollageMinMvesselsMwallM--
>MthrombusMformsM(whichMisMfibrousMplaquesMinMtheseMareaMwMunderlyingMatheromas)
riskMfactorsMforMatherosclerosisM-MCORRECTMANSWERM-
smoking,MHTN,Mhypercholesterolemia,MDM,Mhereditary
layersMofMarteryM-MCORRECTMANSWERM-
intima,Mmedia,MadventitiaM(fromMoutMtoMin,McompositionMchangesMdependingMonMtheMartery)
,compositionMofMarteryMlatersM(moreMdetails)M-MCORRECTMANSWERM-
endothelium,Mintima,MinternalMelasticMlamina,MmediaM(containsMsmoothMmuscleMcellsMandMelasticMfibers)
,MadventitiaM(wMvasoMvasorum)
cerebrovascularMdisease:MstrokeMisMtheM___MMCMcauseMofMdeathMinMtheMUSM-MCORRECTMANSWERM-3rd
cerebrovascularMdisease:MmostMimportantMriskMfactorMforMstrokeMisM_____M-MCORRECTMANSWERM-HTN
cerebrovascularMdisease:McarotidsMsupplyM_____%MofMbloodMflowMtoMtheMbrainM-MCORRECTMANSWERM-
85%
cerebrovascularMdisease:MmostMimportantMsiteMofMstenosisMforMCVAMinjuryM-MCORRECTMANSWERM-
carotidMbifurcation
cerebrovascularMdisease:MnormalMinternalMcarotidMarteryM(ICA)MhasM_______M_________MflowM-
MCORRECTMANSWERM-continuousMforwardMflow
cerebrovascularMdisease:M1stMbranchMofMtheMinternalMcarotidM-MCORRECTMANSWERM-ophthalmicMartery
cerebrovascularMdisease:MnormalMexternalMcarotidMarteryM(ECA)MhasM_______M________MflowM-
MCORRECTMANSWERM-triphasic
cerebrovascularMdisease:M1stMbranchMofMeternalMcarotidM-MCORRECTMANSWERM-superiorMthyroidMartery
cerebrovascularMdisease:MnormalMflowMofMICAMvsMECAM-MCORRECTMANSWERM-
continuousMforwardMvsMtriphasic
cerebrovascularMdisease:M1stMbranchMofMICAMvsMECAM-MCORRECTMANSWERM-
ophthalmicMvsMsuperiorMthyroidMartery
cerebrovascularMdisease:McommunicationMbetweenMICAMandMECAMisMviaM-MCORRECTMANSWERM-
ophthalmicM(offMICA)MandMinternalMmaxillaryMarteryM(offMECA)
,cerebrovascularMdisease:MMCMdiseaseMintracranialMarteryM-MCORRECTMANSWERM-middleMcerebralMartery
cerebrovascularMdisease:MMCM(andM2ndMMC)McauseMofMcerebralMischemicMeventsM-MCORRECTMANSWERM-
fromMarterialMembolizationM(NOTMthrombis)MfromMtheMICAM(canMalsoMbeM2/2MlowMflowMstateMthroughMse
verelyMstenoticMlesion)...MheartMisMtheM2ndMMCMsourceMofMcerebralMemboli
cerebrovascularMdisease:MmanifestationMofManteriorMcerebralMarteryMeventsM-MCORRECTMANSWERM-
mentalMstatusMchanges,Mrelease,Mslowing
cerebrovascularMdisease:MmanifestationMofMmiddleMcerebralMarteryMeventsM-MCORRECTMANSWERM-
contralateralMmotorMandMspeechM(ifMdominantMside),McontralateralMfacialMdroop
cerebrovascularMdisease:MmanifestationMofMposteriorMcerebralMarteryMeventsM-MCORRECTMANSWERM-
vertigo,Mtinnitus,MdropMattacks,Mincoordination
cerebrovascularMdisease:MmanifestationMofManteriorMvsMmiddleMvsMposteriorMcerebralMarteryMeventsM-
MCORRECTMANSWERM-
anteriorM=MmentalMstatusMchanges,Mrelease,Mslowing....MmiddleM=McontralateralMmotorMandMspeechM(ifMd
ominantMside),McontralateralMfacialMdroop...MposteriorM=Mvertigo,Mtinnitus,MdropMattacks,Mincoordination
cerebrovascularMdisease:MdefineMamaurosisMfugaxM-MCORRECTMANSWERM-
occlusionMofMtheMophthalmicMbranchMofMtheMICAM(visualMchangesM--
>MshadeMcomingMdownMoverMeyes),MvisualMchangesMareMtransient...MyouMwillMseeMHollenhorstMplaquesMo
nMopthoMexam
cerebrovascularMdisease:MmgmtMofMcarotidMinjuryMwMmajorMfixedMdeficitM-MCORRECTMANSWERM-
mgmtMplanMdependsMonMoccludedMvsMnotMoccluded...MifMoccludedMthenMNOMrepairM(b/cMcanMexacerbate
Minjury)....MifMnotMoccludedMthenMrepairMwMcarotidMstentMorMopenMprocedure
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)MrepairMindicationsM-MCORRECTMANSWERM-
symptomaticMwM>70%Mstenosis,Ma-sxMwM>80%Mstenosis
, cerebrovascularMdisease:McarotidMendarterectomyM(CEA)MtimingMifMrecentMstrokeM-MCORRECTMANSWERM-
waitM4-6MweeksMafterMstrokeMthenMdoMCEAM(ifMcriteriaMmetM-MsymptomaticMwM>70%Mstenosis,Ma-
sxMwM>80%Mstenosis),MifMdoMitMearlierMthenMriskMofMbleeding
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-MwhenMisMitManMemergency?M-
MCORRECTMANSWERM-
mayMbeMdoneMemergentlyMifM(1)MfluctuatingMneuroMsxMorM(2)Mcrescendo/evolvingMTIAs
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-MwhenMisMaMshuntMused?M-
MCORRECTMANSWERM-(1)MstumpMPM<50,M(2)McontralateralMsideMisMtight
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)MrepairMorderM-MCORRECTMANSWERM-
dependsMonMtheMrelativeMtightnessMofMtheMsides....repairMtheMtightestMsideMfirstMifMtheMptMhasMb/lMstenos
isMvsMdominantMsideMfirstMifMequallyMtightMb/l
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-McomplicationsMfromMrepairM(overview)M-
MCORRECTMANSWERM-
(9)....MvagusMnerve,MhypoglossalMnerve,MglossopharyngealMnerve,MansaMcervicalis,MmandibularMbranchMof
MfacialMnerve,MbackMtoMORMtoMcheckMforMflapMorMthrombosisM(acuteMeventsMpostMop),Mpseudoaneurysm,M
HTNM(20%),MMI
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-McomplicationsMfromMrepair,MvagusMnerveM-
MCORRECTMANSWERM-
mostMcommonMcranialMnerveMinjuryMwMCEA,M2/2MvascularMclampingMduringMendarterectomy...Mp/wMhoar
senessM(b/cMrecurrentMlaryngealMnerveMbranchesMoffMofMvagus)
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-
McomplicationsMfromMrepair,MhypoglossalMnerveM-MCORRECTMANSWERM-
tongueMgoesMTOWARDMsideMofMinjury,Mp/wMspeechMandMchewingMdifficulties
cerebrovascularMdisease:McarotidMendarterectomyM(CEA)M-
McomplicationsMfromMrepairM,MglossopharyngealMnerveM-MCORRECTMANSWERM-
rare,MoccursMwMreallyMhighMcarotidMdissection,Mp/wMdifficultyMswallowing