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Jan 3, 2013 AHD

08:00-09:00 PGY 1 Tut TR #4   
08:00-09:00 PO 3 TR #1   
08:00-09:00 PO 5 TR #2   
08:15-08:45 RCR Conf. Rm M-197   
09:00-10:00 GR Amphitheatre   
10:00-11:00 M&M Amphitheatre     
11:00-13:00 CCFP-EM: Vaillancourt - CVS - Peripheral vascular: Arterial & Venous      
1330:-16:30 CC Sim Sim Centre  

Reading & Objectives

Message from Dr. Vaillancourt:
Residents often find this session is jammed packed

The objectives are roughly the mirror of the Table of Contents from Rosen's.
I’m sure you can find similar chapters in Tintinalli.
Some questions are better answered by a quick Google search.


Peripheral venous and arterial diseases

January 3rd, 2013
Moderator: Dr. Christian Vaillancourt

Questions:
Pulmonary embolism
1) List/organize common risk factors and medical conditions causing PE
2) % of PE cases with peripheral DVT seen on imaging?
3) % of above and below knee DVTs embolising to lung? Other sources?
4) Describe 4 non-thromboembolic sources of PE (e.g. what other material?)
5) Describe hemodynamic and physiologic changes resulting from PE
6) What % of the pulmonary tree needs to be involved to cause pulmonary HTN
7) Briefly describe and critique the PERC rule (Dr. Kline)
8) Briefly describe and critique the Wells criteria
9) Describe potential findings on ECG, CXR, ABG, PFT, cardiac echo
10) Compare V/Q with CT-angio with angiography (advantages, indications)
11) Give indications for thrombolytis, embolectomy, thoracotomy
12) Discuss the role of s/c heparin, stockings, pneumatic compression, IVC filter

Peripheral phlebitis
13) Describe Virchow’s triad
14) Describe natural mechanisms preventing DVT (anatomy, function)
15) List 5 different imaging modalities used to investigate DVTs
16) What is phlegmasia cerulea dolens? Mondor’s disease?
17) What are the clinical features of post-phlebitic syndrome
18) Any indication to thrombolyse DVTs?

Abdominal aneurysm
19) Compare true and false aneurysm
20) What is the likelihood of finding a AAA (in %) if the following are present: a)femoral or popliteal aneurysm b)brother has AAA c)perif. vasculopathy
21) What is the mortality rate for patients requiring emergent surgery?
22) Discuss the management of ruptured AAA in the ED
23) List 3 late complications of surgical AAA repair

Aortic dissection
24) List 10 risk factors for thoracic aortic dissections 
25) List 10 findings of aortic dissection on CXR. % abnormal in dissection?
26) Describe De Bakey and Stanford classifications. Which one would you use?
27) List as many physical manifestations as you can (list by organ)
28) Give pro/con of TTE, TEE, CT-contrast, angiography, MRI
29) Describe the medical management of aortic dissection

Peripheral arterial diseases
30) What are the 5 Ps of acute arterial obstruction?
31) What is phlegmasia cerulea alba?
32) How is compartment syndrome different from acute arterial obstruction?
33) Define: atherosclerosis, thromboembolism, atheroembolism
34) What is Leriche syndrome? Buerger disease?
35) Compare Raynaud disease and Raynaud phenomenon?
36) Draw a line between diseases and their appropriate artery sizes:
Temporal arteritis___ ___small
Takayashu___ ___medium+large
HSPurpura___ ___medium+small
Kawasaki, and     ___ ___large
Polyarteritis nodosum

Only if there’s time
37) Describe causes of thoracic outlet syndrome
38) Associate clinical manifestations with structures potentially compressed
39) How would you unblock a central venous catheter?
40) Describe manifestations of superior vena cava syndrome

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