Week 14
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Quiz 14 Context:
A 68-year-old female presents for routine follow-up of her hypertension and hyperlipidemia. During the history, she reports the recent experience of visual changes described as the sudden loss of vision in her right eye. The episode is described as "having a curtain pulled down over my eye." There was no associated pain. Vision returned after about 6 minutes.
Physical examination is most signficant for normal vision (with corrective lenses in place) by Snellen chart. Examination of the fundi suggests the presence of Hollenhorst plaques on the right side. Cardiovascular examination reveals a regular rate and rhythm, no cardiac murmurs, and the presence of a right cervical bruit.
An arterial
angiogram is performed and is shown above.
Sorry, that is not the most likely answer. Try Again.
b. Excellent!
This image reveals a significant plaque, most likely atherosclerotic, which is located at the distal common carotid artery. It extends into the origin of the internal carotid artery.
You have correctly identified this week's Image of the Week. Now test your knowledge of other aspects of peripheral vascular disease. Do you know…
…the relationship between different values of the ankle-brachial index (ABI) and the severity of peripheral arterial disease (PAD)? And do you know the prevalence of PAD in the primary care setting when an ABI of less than 0.90 is used to identify the disease?
...the two most important risk factors associated with the development of PAD and the influence each has upon the progression of the disease?
…the recommendations concerning surgical intervention for symptomatic patients with carotid stenosis from the North American Symptomatic Carotid Endarterectomy Trial (NASCET) guidelines (1991) and the cutoff value for perioperative stroke risk at which surgical benefits are realized?
The answers to these questions and a concise review of the pathogenesis, diagnosis, and treatment of peripheral vascular disease can be found here within the Disease Management Project.
This finding is most consistent with which of the following?
- Carotid artery dissection
- Carotid artery plaque
- Temporal arteritis
- Vertebrobasilar occlusion
- Subclavian
steal syndrome
