Buergers disease (thromboangitis obliterans)

there is often thrombophlebitis migrans

affects peripheral distal arteries

card2brain.ch

Hypercoagulable state (or thrombophilia)

it can be only inherited

it can be only acquired

the former include deficiencies in protein C, protein S, and antithrombin and activated protein C resistance of presence of factor V Leiden

A, C

it can be only inherited

it can be only acquired

the former include deficiencies in protein C, protein S, and antithrombin and activated protein C resistance of presence of factor V Leiden

A, C

The most common cause of secondary HT is

phaechromocytoma

renovascular disease

renal parenchymal HT

primary aldosteronism

phaechromocytoma

renovascular disease

renal parenchymal HT

primary aldosteronism

Most common cause of thrombophilia in Western population is

protein S deficiency

antithrombin deficiency

factor V Leiden

protein C deficiency

protein S deficiency

antithrombin deficiency

factor V Leiden

protein C deficiency

We performed usually arterigraphy in patients

with critical with ischemia

intermittent claudication

acute limb ischemia

correct answears are A, B, C

with critical with ischemia

intermittent claudication

acute limb ischemia

correct answears are A, B, C

We should consider in patients of critical limb ischemia

the management of risk factors such as hyperlipidemia

pharamcotherapy (prostanoids, antiplatelet drugs)

A, B

all of the above

the management of risk factors such as hyperlipidemia

pharamcotherapy (prostanoids, antiplatelet drugs)

A, B

all of the above

Which sentence is false

Buerger disease usually begins with ischemia of the distal small arteries and veins

as Buergers disease progress, it may involve more proximal arteries

involvement of the large arteries is typical for Buerger disease

inlvolvement of the large arteries is unusual for Buerger disease and rarely occurs as in the absence of occlusive disease

Buerger disease usually begins with ischemia of the distal small arteries and veins

as Buergers disease progress, it may involve more proximal arteries

involvement of the large arteries is typical for Buerger disease

inlvolvement of the large arteries is unusual for Buerger disease and rarely occurs as in the absence of occlusive disease

Charactersitc features of Takayasu arterites are 1. HT 2. Blindness 3.Stroke 4. GN 5. A? fungus. Correct answears are

1, 2, 3, 5

1, 3, 4, 5

2, 3, 4, 5

1, 2, 3, 4

1, 2, 3, 5

1, 3, 4, 5

2, 3, 4, 5

1, 2, 3, 4

Which of gollowing factors does increase the risk for ulceration in diabetic patients?

PAD

Longer durations of diabetes

History of foot ulcerations

Correct answears are A, B, C

PAD

Longer durations of diabetes

History of foot ulcerations

Correct answears are A, B, C

Treatment of acute ischemia indluce

surgical procedure, fibrinolysis, and/or heparin

Antibiotics and fibrinolysis

Alprostadil and aspirin

Correct are A, B

surgical procedure, fibrinolysis, and/or heparin

Antibiotics and fibrinolysis

Alprostadil and aspirin

Correct are A, B

One statement regarding venous ulceration is false, which one?

the most common form of leg ulcers (is responsible for more than half of lower extremities)

It is characterized by high recurrence risk

duration of the disease is almost wlays short

venous ulcers can affect large area of calf

the most common form of leg ulcers (is responsible for more than half of lower extremities)

It is characterized by high recurrence risk

duration of the disease is almost wlays short

venous ulcers can affect large area of calf

Which of the following treatmetn can be appropriate in patients with confirmed or suspected ASP (antiphospholipid syndrome)

plasmaphoresis

Glicorticosteroids and NSAIDs

Heparin or warfarin

antibiotic active against T pallidum

plasmaphoresis

Glicorticosteroids and NSAIDs

Heparin or warfarin

antibiotic active against T pallidum

Which of the following is associated with a greater risk for development of varicose veins?

being a male

normal body mass index

occupational standing

vigorous exercise

being a male

normal body mass index

occupational standing

vigorous exercise

A 46 year old active man is suspected of having upper extremity DVT. Which of the following diagnostic test is considered as first to confirm the diagnosis?

D-dimer

ABI

Compression USG

Conventional phlebography

D-dimer

ABI

Compression USG

Conventional phlebography

Distal type of obstruction occurs in following disorders

CVI

Buergers disease

DM

Correct answears are A & C

CVI

Buergers disease

DM

Correct answears are A & C

In Buergers disease we recommend=

complete discontinuation of significant smoking ....?

aspirin 75-150mg daily

warfarin

correct answears are A & B

complete discontinuation of significant smoking ....?

aspirin 75-150mg daily

warfarin

correct answears are A & B

What are symptoms of eosinophilic granulomatosis with polyangitis

asthma

hypereosinophilia?

pulmonaryinfiltrate

correct are A, B, C

asthma

hypereosinophilia?

pulmonaryinfiltrate

correct are A, B, C

Treatment of critical limb ischemia comprisesM

control of pain

foot care

treatment of life-threatening coexisitng disease

correct are A, B, C

control of pain

foot care

treatment of life-threatening coexisitng disease

correct are A, B, C

What examination to routinely perfomed in patients with intermittent claudication?

ankle-brachial index

angiography

MRA

correct are B & C

ankle-brachial index

angiography

MRA

correct are B & C

Pain in critical limb ischemia

is less severe during leg eleation

is more severe in rest position

is less severe in rest position

correct are A & C

is less severe during leg eleation

is more severe in rest position

is less severe in rest position

correct are A & C

What is the recommended hypertensive treatment for most patients with HT and chronic kidney disease?

Angiotensin-converting enzyme inhibitors

Calcium antagonists

Angiotensin receptor antagonists + calcium antagonsts + diuretics

Angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists

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Angiotensin-converting enzyme inhibitors

Calcium antagonists

Angiotensin receptor antagonists + calcium antagonsts + diuretics

Angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists

Which statement regarding the risk for VTE in hospitalized patients it TURE?

Most hospitalized patients have 1 or more risk factors for VTE

Risk factors for VTE are cumulative

Approximately 10% of hospital deaths are PE

All of above

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Most hospitalized patients have 1 or more risk factors for VTE

Risk factors for VTE are cumulative

Approximately 10% of hospital deaths are PE

All of above

Key recommendations of treatment DVT include all of the following EXCEPT

In acute DVT, it is recommended that initial treatment be with LMWH or UFH for 5 days

For patients with a high clinical suspicion of DVT, treatment with anticoagulants while awaiting the outcome of diagnostic tests is recommended

Treatment with a vit K antagonist is not recommended for patients with first episode of idiopathic DVT

all of the above are included in the key recommendations

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In acute DVT, it is recommended that initial treatment be with LMWH or UFH for 5 days

For patients with a high clinical suspicion of DVT, treatment with anticoagulants while awaiting the outcome of diagnostic tests is recommended

Treatment with a vit K antagonist is not recommended for patients with first episode of idiopathic DVT

all of the above are included in the key recommendations

Current AHA guidlines state that therapeutic tarhet in lowering blood pressure in most patients is

<150/80 mmHg

<120/75 mmHg

<140/90 mmHg

<130/80 mmHg

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<150/80 mmHg

<120/75 mmHg

<140/90 mmHg

<130/80 mmHg

In patients with critical limb ischemia the most important is

Interventional/surgical treatment

Pharmacotherapy (prostanoids, antiplatelet drugs)

management of risk factors such as hyperlipidemia

Correct answears are B + C

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Interventional/surgical treatment

Pharmacotherapy (prostanoids, antiplatelet drugs)

management of risk factors such as hyperlipidemia

Correct answears are B + C

Risk factors of DVT related to other disease 1. stroke, 2. malignancy, 3. nephrotic syndrome 4. anemia 5. HT

Correct answears are

2,3,4

1,2,3

3,4,5

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2,3,4

1,2,3

3,4,5

HT is diagnosed in patients with blood pressure except;

160/100mmHg

150/80 mmHg

130/80 mmHg

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160/100mmHg

150/80 mmHg

130/80 mmHg

Physiologically, systolic BP at the ankle should be

nearly equal to or higher than that of the arm

lower than that of the arm

40mmHg higher than that of the arm

40mmHg lower than that of the arm

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nearly equal to or higher than that of the arm

lower than that of the arm

40mmHg higher than that of the arm

40mmHg lower than that of the arm

Treatment goals for patients with venous indufficiency include each of the following;

reduction of edema

prevention of recurrence

alleviation of pain

correct answears are A, B, C

reduction of edema

prevention of recurrence

alleviation of pain

correct answears are A, B, C

Subclavian steal syndrome

may occur when there is significant stenosis or complete obstruction of the subclavian artery

collateral flow develops cia the vertebral arteris

classically exercising the left arm "steals blood" from the area normally supplied by the vertebral arteries producing appropriate neurological symptoms and signs

correct answears are A, B, C

may occur when there is significant stenosis or complete obstruction of the subclavian artery

collateral flow develops cia the vertebral arteris

classically exercising the left arm "steals blood" from the area normally supplied by the vertebral arteries producing appropriate neurological symptoms and signs

correct answears are A, B, C

Claudication

has by usage come to mean a pain or discomfort associated with exercise (walking)

Lesions in the femoral, popliteal or tibial arteries often associated with a sensation of weakness in the hip, buttocks or calves

more proximal occlusive lesions usually produce a cramping pain only in the calf muscles

correct answears are A, B, C

has by usage come to mean a pain or discomfort associated with exercise (walking)

Lesions in the femoral, popliteal or tibial arteries often associated with a sensation of weakness in the hip, buttocks or calves

more proximal occlusive lesions usually produce a cramping pain only in the calf muscles

correct answears are A, B, C

Neuropathic foot ulcer

is painless

always coexists with absent pulses

is often located on the sole or edge foot

correct answears are A & c

is painless

always coexists with absent pulses

is often located on the sole or edge foot

correct answears are A & c

On physical examination of patient with critical lumb ischemia we observe

atrophy of the calf muscle

Hyperpigmentation

sometimes ankle and foot edema caused by leg dependency at night

correct answears are A & C

atrophy of the calf muscle

Hyperpigmentation

sometimes ankle and foot edema caused by leg dependency at night

correct answears are A & C

In most patients with the first episode of DVT treatment with VKA (vit K antagonist) is recommended

for 5 days

for 3-12 weeks

for at least 3 months

all of the above are incorrect

for 5 days

for 3-12 weeks

for at least 3 months

all of the above are incorrect

Etiology of thoracic outlet syndrone

Hypertrophy of the muscles

Cervical rib

Dropping shoulders (middle age women)

all of above

Hypertrophy of the muscles

Cervical rib

Dropping shoulders (middle age women)

all of above

28 yo woman presents with a history of 2 first-trimester miscarriage and no live births. She is considering trying to become pregnant but is concerned about her risk for another miscarriage. Otherwise, her medical history is negaitve. You consider wether this woman has antiphospholipid syndrome/APS. Which of the following is part of the Sappore criteria for the diagnosis of APS?

One or more miscarriages after 10th week of gestation or at least 3 or more miscarriges before 10th week

persistently (12 weeks apart) positive antibodies against phospholipid

history of arterial thrombosis

all of the above

One or more miscarriages after 10th week of gestation or at least 3 or more miscarriges before 10th week

persistently (12 weeks apart) positive antibodies against phospholipid

history of arterial thrombosis

all of the above

Which sentence concerning D-dimer plasma level is false?

D-dimer plasma C can be elevated postoperative period, infarction, sepsis, cancer and pneumonia

Increased D-dimer plasma level is 90% sensitive for the presence of DVT or/and PE (90% people with positive test have thrombosis)

Increased D-dimer plasma level is sufficient to establish diagnosis of PE with any accessory investigations

all answears are false

D-dimer plasma C can be elevated postoperative period, infarction, sepsis, cancer and pneumonia

Increased D-dimer plasma level is 90% sensitive for the presence of DVT or/and PE (90% people with positive test have thrombosis)

Increased D-dimer plasma level is sufficient to establish diagnosis of PE with any accessory investigations

all answears are false

While talking with a patient who has been diagnosed with hyperkalemia about currect medications, which of the wollowing is most likely to cause elevated serum potassium?

loop diuretics

ACEI or ARB

thiazide diuretic

all of above

loop diuretics

ACEI or ARB

thiazide diuretic

all of above