Cardiac/Vascular Flashcards

1
Q

Most common primary malignant cardiac tumour in adults and features?

A

Angiosarcoma

**Right atrium **and involve more than one chamber

Broad based attachment

Can encase the Coronary

Present - septic emboli or invasion into pericardium = effusion/tamponade

Heterogeneously high signal on T1 and T2-weighted images with heterogeneous enhancement

Undifferentiated sarcoma mostly arises in the left atrium, although they can also involve the cardiac valve

DDx
Lymphoma
- Primary cardiac lymphomas
- Right atrium, with frequent involvement of more than one chamber and
invasion of the pericardium
-isointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images

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2
Q

Most common benign cardiac tumour in adults?

A

Atrial Myxoma

LA and stalk attached to interatrial septum.
Prolapse through MV
Enhance with Gd (thrombus will not)

Associated with
Carneys syndrome (myxoma, facial/buccal blue neavi, sertoli tumours testes)

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3
Q

Most common fetal cardiac tumour?

A

Rhabdomyoma

LV. Associated with TS

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4
Q

Most common aortic arch anomaly

A

Left arch aberrant right subclavian artery

Posterior indentation of oesophagus.
If symptomatic = Dysphagia lusoria

Indentation both oesophagus ‘reverse S’

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5
Q

Posterior indention and anterior indentation of the trachea?

A

Double aortic arch

Most common vascular ring

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6
Q

What is pulmonary artery sling

A

Aberrant left pulmonary artery

Anomalies origin of the left pulmonary artery from the right pulmonary artery.

passes above the right main bronchus and in between the trachea and oesophagus
anterior indentation of the oesophagus and posterior trachea

Only vascular ring to between the oesophagus and trachea

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7
Q

Follow up for AAA ?

A

3 - 4.4 cm (small) = 12 month US

4.5 - 5.4 cm (medium) = 3 month US

> 5.5cm (large) = Vascular ref and CT if Sx candidate

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8
Q

Hydronephrosis, retroperitoneal fibrosis, anuerymsal abdominal aneurysm, soft tissue thickening of wall?

A

Inflammatory aortic aneurysm

More fusiform shape.
Extend to distal aorta and iliacs
assoicated with other ig4-related diseases

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9
Q

Rapidly growing lobulated saccular aneurysm arising eccentrically from abdominal aortic wall. Adjacent periaortic soft tissues sweeling and gas locules?

A

Mycotic aneurysm

Bacterial. Look for adjacent Psoas abscess or vertebral infection.

DDx Syphilitic aortitis shows curvilinear calcifications

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10
Q

Smoker, young, arterial occlusion with corkscrew collaterals in hands and feet ?

A

Buerger

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11
Q

Soft tissue swelling in lower limb, varicose veins, port wine stain ?

A

Kippel - trenaunay - weber

Classic triad
Bone and soft tissue hypertrophy
Cutaneous capillary malformation (port-wine stain)
Congenital lymphatic and venous malformations (slow flow)

Soft tissues of the right leg diffusely enlarged . Soft tissue enlargement is secondary to multiple low-flow vascular malformations and fat hypertrophy.
A phlebolith is present within 1 of the venous malformations.

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12
Q

May-thurner?

A

obstruction of the left common iliac vein by compression right common iliac artery

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13
Q

Describe Cystic advential degeneration

A

Mucus cysts on wall of popliteal artery.
High T2 and T1 (depending on mucin present)

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14
Q

Popliteal artery entrapment syndrome

A

Anomalous insertion of the medial gastrocnemius

claudication in young fit people

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15
Q

Types of endoleaks ?

A

Type 1 = proximal or distal graft attachment site
Type 2 = Retrograde filling of sac from persistent collateral
Type 3 = mechanical problem with endograft (fabric tear/graft disruption)
Type 4 = Porous graft material
Type 5 = Endotension

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16
Q

What type of vascuilitis is Takasayau and what does MRI/CT show?

A

Large vessel vasculitis
Young, female
**High STIR signal in wall = oedema

CT mural thickening, mural enhancement and aneurysmal dilatation, pseudoaneurysm +/- large vessel occlusion

17
Q

what type of vasculitis is PAN and what condition strongly assoiciated with?

A

Medium vessel vasculitis
Branches of aorta

Associated with Hep B

Multiple 1-5 mm peripheral aneurysms , Occlusions , Irregular stenoses
Diffuse wall thickening of medium-sized arteries

Kidneys (70-80%)
GI tract, peripheral nerves, and skin (50%)
Skeletal muscles and mesentry (30%)

18
Q

What condition in children assoaicted with Coronary artery aneurysm?

A

Kawaski

19
Q

Lung features in Granulomatosis With Polyangiitis (Wegener)

A

**Multiple lung nodules or masses ± cavitation
GGO ( pulmonary hemorrhage)

Severe chronic rhinosinusitis septal cartilaginous and osseous destruction

Tracheal wall thickening Circumferential (involvement of posterior membranous trachea)
** Spared in relapsing polychondritis
C- ANCA

20
Q

Transient, peripheral consolidation in patient with asthma and positive p-ANCA

A

Eosinophilic Granulomatosis With Polyangiitis (churg struss)

Peripheral, transient consolidations
Mimics eosinophilic pneumonia

21
Q

Microscopic polyangitis

A

Consider MPA in patients with alveolar hemorrhage (i.e., ground-glass opacities &/or consolidation) and concomitant renal disease (i.e., glomerulonephritis)

also P-ANCA

Angio vessels affected are too small unlike PAN etc

22
Q

Bechets

A

Consider multiple pulmonary artery aneurysms, particularly young men of Mediterranean, Middle Eastern, or Asian ethnicity

Oral and genital mucosal ulcers, uveitis
Involves distal ileum and closely mimics Crohn disease or malignancy

23
Q

Hodgkins vs NHL

A

Hodgkins
-spread is contiguous
-anterior mediastinal nodes
- Thorax predominantly
- abdo involvement ~ 4 %

NHL
-spread is non-contiguous
- Abdomen predominantly
- posterior mediastinal nodes
- thorax involvement in ~50%

24
Q

Classification of aortic dissection?

A

see picture