NSG 555 Quiz 2 Module 5 CV Part 1 CAD -
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Terms in this set (42)
carotid stenosis
Carotid artery disease narrowing of extracranial arteries.
more prevalent with HTN and HD
symptomatic carotid focal neuro dysfunction like TIA, ischemic strokep
stenosis
caused by conditions that cause atherosclerotic
plaque:
turbulent flow due to change in vessel caliber
variable shear stress
pathophys carotid artery flow separation
disease increased contact time between particles in the
blood
fatty streak: monocytes that diff. into macrophages
or foam cells-->plaque
contralateral weakness of face/arm or both,
contralateral paresthesia, ipsilateral blindness.
clinical
presentation/exam of STROKE symptoms
carotid artery disease
neck auscultation may elicit a carotid bruit. not
common
duplex ultrasound is first line.
diagnostics carotid artery
can also to CTA
disease
MRA IF duplex can't be obtained, inconclusive
, -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
when is carotid duplex coronary artery or peripheral artery disease
ultrasound indicated? -plaques on retina
-TIAs
stroke in candidate for carotid revascularization
-s/p revascularization
-
CBC, glucose, electrolytes, BUN/Cr, lipids, coag,
Labs for carotid artery
cross/type (transfusion), CK, CK-MB, troponin, EKG,
disease
CXR
What does CK measure? muscle damage. CK-MB is specific to cardio
proteins are released when the heart muscle has
been damaged, such as occurs with a heart attack.
tropin measures 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 any other stroke causes
STOP smoking
Start statin, antiHTN and antipltlt
carotid stenosis
Statin--goal for LDL <100
management
HTN management: keep below 130/80
antiplatelet--aspirin 75-325 mg or plavix. may
benefit from both
HTN management stage 1 thiazide diuretic, CCB, ACEI or ARB
vs stage 2 stage 2 may need combination
incision of artery, evert the plaque, close the hold
with a different veine or something else (Dacron,
bovine pericardium)
carotid endarterectomy can be done for hx TIA or stroke or symptomatic
patient if 70-99% occluded
if no symptoms or not concluded enough no
increased benefic
Questions With A+ Solutions
Save
Terms in this set (42)
carotid stenosis
Carotid artery disease narrowing of extracranial arteries.
more prevalent with HTN and HD
symptomatic carotid focal neuro dysfunction like TIA, ischemic strokep
stenosis
caused by conditions that cause atherosclerotic
plaque:
turbulent flow due to change in vessel caliber
variable shear stress
pathophys carotid artery flow separation
disease increased contact time between particles in the
blood
fatty streak: monocytes that diff. into macrophages
or foam cells-->plaque
contralateral weakness of face/arm or both,
contralateral paresthesia, ipsilateral blindness.
clinical
presentation/exam of STROKE symptoms
carotid artery disease
neck auscultation may elicit a carotid bruit. not
common
duplex ultrasound is first line.
diagnostics carotid artery
can also to CTA
disease
MRA IF duplex can't be obtained, inconclusive
, -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
when is carotid duplex coronary artery or peripheral artery disease
ultrasound indicated? -plaques on retina
-TIAs
stroke in candidate for carotid revascularization
-s/p revascularization
-
CBC, glucose, electrolytes, BUN/Cr, lipids, coag,
Labs for carotid artery
cross/type (transfusion), CK, CK-MB, troponin, EKG,
disease
CXR
What does CK measure? muscle damage. CK-MB is specific to cardio
proteins are released when the heart muscle has
been damaged, such as occurs with a heart attack.
tropin measures 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 any other stroke causes
STOP smoking
Start statin, antiHTN and antipltlt
carotid stenosis
Statin--goal for LDL <100
management
HTN management: keep below 130/80
antiplatelet--aspirin 75-325 mg or plavix. may
benefit from both
HTN management stage 1 thiazide diuretic, CCB, ACEI or ARB
vs stage 2 stage 2 may need combination
incision of artery, evert the plaque, close the hold
with a different veine or something else (Dacron,
bovine pericardium)
carotid endarterectomy can be done for hx TIA or stroke or symptomatic
patient if 70-99% occluded
if no symptoms or not concluded enough no
increased benefic
