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PBR 2 > Cardio > Flashcards

Cardio Flashcards

1
Q

Shone complex

A

P arachute mitral valve/supramitral ring
A ortic valve stenosis
C oarctation of aorta
S ubvalvular aortic stenosis

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2
Q

MC cause of severe non ischemic mitral regurgitation

A

Mitral valve prolapse

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3
Q

Rupture of pappilary muscle occurring during the acute phase of MI

A

Acute ischemic Mitral Regurgitation

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4
Q

MC cause of congenital tricuspid regurgitation

A

Ebstein anomaly

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5
Q

Radiograph:
Box shape or globular heart
Normal or decreased vascularity

A

Ebstein anomaly

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6
Q

In cardiac MRI, apical displacement of septal leaflet of ____mm/m2 is cutoff for Ebstein anomaly

A

More than 8

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7
Q

Kind of pulmonary stenosis in TOF?

A

Subvalvular

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8
Q

Obstruction at the level of the main pulmonary artey at its bifurcation will cause what kind of pulmonic stenosis?

A

Supravalvular

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9
Q

Detection of small vegetations and small perforations?

A

TEE

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10
Q

Most common involved valve in rheumatic heart disease

A

Mitral valve

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11
Q

Classic hazy midmyocardial enhancement in LGE MRI?

A

Hypertrophic cardiomyopathy

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12
Q

MC form of HCM?

A

Assymetric septal HCM

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13
Q

SPADE-LIKE configuration of the left ventricle on vertical long axis view of the heart?

A

Apical hypertrophic cardiomyopathy (HCM)

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14
Q

Radiographic Appearance of TAPVR Type 1

A

Snowman or Figure of 8

*only occurs when vertical vein empties into the brachiocephalic vein

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15
Q

Congenital heart anomaly wherein Pulmonary veins empty into a common confluence separated from the left atrium by a partial membrane

A

Cor triatriatum

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16
Q

Normla amount of fluid within the pericardial sac

A

25-5 ml

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17
Q

REQUISITES:
Normal thickness of teh percarddium b/w the sternum and free wall of the RV

A

< 3mm

  • most reliable @ the midventricular level
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18
Q

(REQUISITES)
Allows for detection of freely moving fluid within the pericardial space

A

Phase contrast images

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19
Q

(REQUISITES)
Amount of fluid that can acutely distend the normal adult pericardial space before cardiac tamponade results

A

150-250 cc

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20
Q

Low cardiac-output state wherein the cardiac size in CXR is slightly to markedly enlarged w/ the classic “WATER-BOTTLE” appearance

A

Cardiac tamponade

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21
Q

Differential diagnoses for WATER-BOTTLE appearance

A

Cardiomegaly
Large mediastinal mass
Pericardial effusion (massive)

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22
Q

(REQUISITES)
Infectious agents that cause pericarditis with epricardial effusion

A

Coxsackievirus grp B
Echovirus type 8

*TB pericarditis, common in patients w/ AIDS

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23
Q

(REQUISITES)
MC organisms to cause pericarditis

A

Staph
H. influenzae
N. meningitidis

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24
Q

(REQUISITES)
MCC of pericardial effusion

A

MI w/ left ventricular failure

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25
Q

(REQUISITES)
This is the development of PERICARDIAL and PLEURAL effusions 2-10 weeks post-MI

A

Dressler Syndrome

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26
Q

(REQUISITES)
Modality of Choice in evaluating cardiac masses

A

CARDIAC MRI

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27
Q

(REQUISITES)
Mediastinal dose that will cause radiation pericarditis

A

40 Gy

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28
Q

(REQUISITES)
MC of constrictive pericarditis

A
  1. Viral and tuberculous pericarditis
  2. Uremia w/ pericardial effusion
  3. Surgery
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29
Q

Most reliable sign indicating constriction in contstrictive pericarditis

A

Presence of adhesion

Constrictive pericarditis: wall thickness > 4mm

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30
Q

Pericardium in Restrictive cariomyopathy does NOT calcify, but the absence of calcification does not rule out constriction

A

True

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31
Q

Most common BENIGN PRIMARY CARDIAC TUMOR in infants and children

A

Rhabdomyoma

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32
Q

Most common BENIGN PRIMARY CARDIAC TUMOR overall

A

MYXOMA

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33
Q

SECOND Most common BENIGN PRIMARY CARDIAC TUMOR in infants and children

A

FIBROMA

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34
Q

MC location of congenital absence of the pericardium

A

Left Atrial Appendage adjacent PA

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35
Q

MC locations of Fibroma

A

Left Ventricular wall
INTRAventricular septum

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36
Q

Gorlin Syndrome is also called as

A

basal cell nevus syndrome

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37
Q

MC location of cardiac hemangioma

A

intraMURAL (75%)

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38
Q

MC location of Cardiac Paraganglioma

A

LEFT ATRIUM (left atrial ROOF or POSTERIOR WALL)

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39
Q

Carney Triad

A

Extra adrenal pheochromocytoma
GIST
Pulmonary chordoma

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40
Q

MC cardiac mass in ADULT POPULATION

A

Metastasis

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41
Q

MC Primary MALIGNANT CARDIAC tumor

A

Sarcoma

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42
Q

MC DIFFERENTIATED CARDIAC tumor

A

Angiosarcoma

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43
Q

SECOND MC Sarcoma involving the heart

A

UNdifferentiated Sarcoma

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44
Q

MC Primary CARDIAC malignancy/tumor in CHILDHOOD

A

Rhabdomyosarcoma

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45
Q

only cardiac sarcoma that predominantly arises in the right atrium in the region of the atrioventricular groove

A

Cardiac Angiosarcoma

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46
Q

Anolmalous origin of the Left Main Coronary artery from Pulmonary artery (ALCAPA) is also known as

A

Bland-Garland- White Syndrome

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47
Q

MC indication for coronary CTA

A

coronary artery disease

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48
Q

(REQUISITES)
MC tumors to metastasize to the heart

A

M elanoma
L eukemia
M alignant lymphoma

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49
Q

(REQUISITES)
MC primary tumors to metastasize to the PERICARDIUM

A

Breast
Lung

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50
Q

(REQUISITES)
MC primary malignancy of the PERICARDIUM

A

Pericardial Mesothelioma

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51
Q

Rare variant of mitral annular calcification seen in the POSTERIOR ATRIOVENTRICULAR GROOVE which appears as mass-like calcification and usually misdiagnosed as abscess, infection or tumor

A

CASEOUS CALCIFICATION of the mitral valve

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52
Q

(REQUISITES)
MC location of pericardial cysts

A

Right Cardiophrenic Angle (70%)

53
Q

Gold standard for evaluating CARDIAC VALVES esp. pulmonary and tricuspid valves

A

CARDIAC MRI

54
Q

PRIMARY modality for evaluation of suspected VALVE DISEASE

A

Echocardiography

55
Q

Clinical GOLD STANDARD for non-invasive measurement of blood flow. It is also used to quantify the severity of valvular stenosis or regurgitation.

A

Phase contrast MRI

56
Q

(REQUISITES)
Cardiac mass that has grown through the fossa ovalis and extends into both the right and left atrium

A

DUMBBELL Myxoma

57
Q

(REQUISITES)
Differential dx for dumbbell myxoma involving the interatrial septum with sparing of the fossa ovalis

A

Lipomatous hypertrophy of the interatrial septum

*can produce supraventricular arrythmia

58
Q

(REQUISITES)
MC tumor of the cardiac VALVES w/ sea-anemone-like appearance

A

Papillary Fibroelastoma

*usually small (<1.5 cm)

59
Q

(REQUISITES)
MC location of cardiac papillary fibroelastoma

A

Aortic Valve (aortic side)

2nd MC: Mitral Valve (atrial side of leaflets)

60
Q

(REQUISITES)
MC PRIMARY MALIGNANT tumor of the heart in ADULT

A

Angiosarcoma

*typically right side, often right atrium

61
Q

(REQUISITES)
MRI demonstrates “CAULIFLOWER-LIKE” heterogeneous appearance on T1, w/ hyperintense foci corresponding to hge, hypointense areas of necrosis, and heterogeneous lesions on T2.

A

Angiosarcoma

62
Q

Most common type of SUBAORTIC STENOSIS which results in murmur. It occurs in isolation or part of SHONE COMPLEX

A

Subaortic Membrane

63
Q

(REQUISITES)
MC location of sarcomas that originate from the heart, other than angiosarcoma

A

Left atrium predominance

64
Q

(REQUISITES)
Differential diagnosis of lesions arising from the heart valves

A

Thrombi
Vegetations
Papillary Fibroelastoma

65
Q

(REQUISITES)
Larger, pedunculated masses attached to the valve leaflets are characteristic of

A

Vegetation

66
Q

(REQUISITES)
Non Bacterial vs Infective endocarditis:

Has vegetation that are considerably smaller and frequently occurs BENEATH the CUSPS.

A

Non thrombotic Endocarditis

(Libman-Sacks endocarditis)

67
Q

(REQUISITES)
Non Bacterial vs Infective endocarditis:

Has vegetation that frequently occurs on LINE of CLOSURE of the leaflets.

A

Infective endocarditis

68
Q

(REQUISITES)
Calssic clinical triad of cardiac vegetation

A

Fever
Heart murmur
Positive blood cultures

69
Q

(REQUISITES)
BEST imaging TECHNIQUE to CONFIRM the presence of left vetricular THROMBUS

A

MRI Perfusion study followed by
Delayed enhancement sequence

*thrombus lasck enhancement
*Bright enhancement of the underlying aneurysmal myocardial scar on the delayed enhancement images

70
Q

(REQUISITES)
MCC of DILATED cardiomyopathy

A

ISCHEMIC Disease

71
Q

(REQUISITES)
Criteria for the diagnosis of hypertrophic cardiomyopathy

A

Thickness of 15 mm or more, measured in END DIASTOLE

72
Q

(REQUISITES)
Criteria for the diagnosis of hypertrophic cardiomyopathy

A

Thickness of 15 mm or more, measured in END DIASTOLE

73
Q

(REQUISITES)
MC phenotype of Hypertrophic Cardiomyopathy

A

Asymmetric fetal type

-hypertrophy of the septal wall of the left ventricle

74
Q

MC valve disease

A

aortic disease

75
Q

(REQUISITES)
Most superior coronary sinus

A

Left aortic sinus

76
Q

(REQUISITES)
Most superior coronary sinus

A

Left aortic sinus

77
Q

(REQUISITES)
Non-coronay sinus and inferior most sinus

A

Posterior right aortic snus

78
Q

Conditions associated with Mitral Valve Prolapse

A

MARFAN SYNDROME
ostium secundum and atrial septal defect
Aortic Coarctation

79
Q

Common cardiac manifestation of Patients with SLE

A

Libman-Sacks Nonbacterial endocarditis

*VEGETATIONS are seen the atrial and ventricular side of the MITRAL VALVE

80
Q

Infection of the valve leaflets and prosthetic valves. Increased risk in patients with history of IV DRUG ABUSE

A

Infective endocarditis

81
Q

an acquired cardiac disease that results to SCARRING AND FIBROSIS of cardiac valves

A

Rheumatic heart disease

*autoimmune reaction to infection with GROUP A strep

82
Q

MC Cardiac valve involved in RHEUMATIC HEART DISEASE

A

MITRAL VALVE

**Mitral Valve > Aortic > Tricuspid > Pulmonary

83
Q

Characterized by development of plaque-like, fibrous endocardial thickening involving the heart valves (esp tricuspid and pulmonary)

A

CARCINOID VALVE DISEASE

*first line imaging is TTE
* associated with carcinoid syndrome (midgut carcinoid) and chronic serotonin exposure

84
Q

Imaging Feature of Carcinoid valve disease in TTE

A
  • Thickened valve leaflets/cusps and subvalvular apparatus
  • Retraction and altered motion of the leaflets/cusps
  • Valve regurgitation
85
Q

BRANT:
Combination of Dextrocardia, Bronchiectasis, Sinusitis

A

Kartagener Syndrome

86
Q

BRANT:
Symmetrical mirror image of each other

A

Isomerism

87
Q

BRANT:
Left isomerism is associated with increased incidnec of

A

ASD
Anomalous pulmonary venous return

88
Q

BRANT:
MC forrm of PAPVR,

A

one in w/c a right upper pulmonary vein connects to the RA of SVC.

89
Q

BRANT: Stress induced cardiomyopathy or aka BROKEN HEART SYNDROME which as usually seen in POSTmenopausal women

A

TAKOTSUBO CARDIOMYOPATHY

90
Q

Brant: genetically Heterogenous disease in both PEDIA AND ADULT in which normal morphogenesis of myocardial tissue into compact myocardium is DISRUPTED

A

Left Ventricular Non-Compaction

91
Q

HYPERTRABECULATION of the Left ventricular myocardium and SPARES THE SEPTUM in cardiac MRI

A

left ventricular non- compaction

92
Q

Systemic Inflammatory of the heart that shows presence of NONCASEATING GRANULOMA on endomyocardial biopsy

A

CARDIAC SARCOIDOSIS

93
Q

Brant: Focal inflammation of the myocardium triggered by VIRAL INFECTION.

Acute inflammation of this disease shows T2 hyperintense signal (global or regional) 2x from the skeletal muscle

A

MYOCARDITIS

94
Q

DIAGNOSTIC OF ACUTE MYOCARDITIS

A

Myocardial edema ratio >3.2:1
Global relative enhancement
Delayed pattern enhancement (Patchy nodular and/or linear in subepicardial and midmyocardial

*2out of 3 reliable for the diagnosis

95
Q

BRANT:
MC form of PAPVR associated with sinus venosus ASD

A

Right Upper Pulmonary Vein (darining the irght upper and middle lobes) drains into the RA or SVC

96
Q

BRANT:
Ductus Arteriosum closes functionally

A

First 24H of life

97
Q

BRANT:
Ductus Arteriosum closes anatomically

A

by 10 Days of life

98
Q

BRANT:
Implulse delay in the AV node

A

0.7 sec

99
Q

BRANT:
Time b/w CLOSING of AV valves and OPENING of aortic and pulmonic valves

A

Period of Isovolumetric Contraction

100
Q

BRANT:
Period immediately after ventricular CONTRACTION when aortic and pulmonic valves have CLOSED, BUT the AV valves have NOT yet OPENED

A

Isovolumetric Relaxation

101
Q

BRANT:
INDIRECT signs of LA enlargement

A
  1. Splaying of the carina (>90 deg)
  2. Post displacement of LMB (lat view)
  3. Sup displacement of LMB (AP)
102
Q

BRANT:
Measured @ 2cm above the intersection of the diaphragm and IVC (Lateral view); POSITIVE if the distance from the LA border and post border of IVC is >1.8 cm

A

Hoffman-Rigler Sign

103
Q

BRANT:
Standard view on ECHO useful to evaluate VENTRICULAR size and contractility, as well as assess morhology and function of the mitral and aortic valves

A

Long-axis view, Parasternal Window

104
Q

BRANT:
Useful for vsualization of the 4 cardica chambers including the Apex, EF assessment thru Simpson method, and assessment of mitral valve INFLOW

A

4-Chamber View

105
Q

BRANT:
Useful in assessment of Aortic Stenosis

A

5- Chamber View

106
Q

Focal outpouching in the aortic contour at the ligamentum arteriosum

A

Physiologic Ductus Bump

*difference with traumatic aneurysm
- no history of trauma
- no mediastinal hematoma

107
Q

Acute hemorrhage WITHIN the aortic wall that resulted from rupture of the vasa vasorum within the media, forming a HEMATOMA WITHOUT COMMUNICATION to the aortic lumen

A

INTRAMURAL HEMATOMA

108
Q

Brant: It is characterized by continous often crescentic hyperdense thickening of the aortic wall seen on NCCT. It may also demonstrate an INWARD DISPLACEMENT of atherosclerotic calcifications

A

INTRAMURAL HEMATOMA

Standford classification
TypeA- surgical treatment; higher risk; may extent into the mediastinum or pericardium
TypeB - medical treatment

109
Q

Brant:
Indicative of thin cap atheroma; seen as RIM OF HIGH attenuation SURROUNDING AN AREA OF LOW attenuation, representing an inflamed cap surrounding a necrotic core. Presence is an INDEPENDENT PREDICTOR of future acute coronary event

A

Napkin-ring sign

110
Q

Brant:
Hemodynamically significant Fractional Flow Reserve (FFR)

A

0.8 or lower

111
Q

Indirect sign of Plaque rupture which consist of severe atherosclerotic disease, composed of thick layers diffuse predominantly non calcified atheromatous plaque

A

Complex atheroma

112
Q

Indirect sign of plaque rupture wherein contrast is seen extending between areas of complex plaque. This lesion DO NOT EXTEND BEYOND the lumen of the Aorta into the intima and DELINEATED BY LINEAR WALL CALCIFICATIONS

A

Plaque Ulceration

DDX
PAU: EXTEND BEYOND the intima of the aorta; sign of intimal disruption

113
Q

Brant:
Commonly seen in the left ventricular wall or interventricular septum that is T1 iso, T2 HYPO w/ intense late gad enhancement and central coarse calcification
A. Rhabdomyoma
B. Fibroma
C. Papillay Fibroelastoma
D. Hemangioma

A

Fibroma

(Iso, hypo, intense LGE w/ central coarse calci)

114
Q

Brant:
MC primary cardiac tumor in infant & children associated w/ TS; shows T1 iso, T2 hyper w/ minimal to no enhancement

A. Rhabdomyoma
B. Fibroma
C. Papillay Fibroelastoma
D. Hemangioma

A

Rhabdomyoma

(Iso, hyper, no enhancement)

*assoc w/ TS

115
Q

Brant:
Most often valvular in location (aortic or mitral) showing T1 intermediate, T2 hyper w/ intense LGE; sea anemone appearance

A. Rhabdomyoma
B. Fibroma
C. Papillay Fibroelastoma
D. Hemangioma

A

Papillary Fibroelastoma

(Intermediate, hyper, intense LGE)

*best eval w/ 2D echo
*DDx: vegetation (w/o enhancement within; septic clinically, destruction of valves)

116
Q

Brant:
Associated w/ Kasabach-Merritt syndrome; T1 and T2 hyper w/ intense enhancement

A. Rhabdomyoma
B. Fibroma
C. Papillay Fibroelastoma
D. Hemangioma

A

Hemangioma

*intramural

117
Q

Brant:
Associated w/ Carney triad; MC in the LEFT ATRIAL wall (roof or posterior wall); T1 hypo- iso, T2 EXTREMELY hyper, intense enhancement

A. Rhabdomyoma
B. Paraganglioma
C. Papillay Fibroelastoma
D. Hemangioma

A

Paraganglioma

(Iso/hypo, EXTREMELY hyper, intense enhancement)

118
Q

Brant:
MC in infants and children; within pericardial sac; MC RIGHT side; complex, multilocular cystic mass w/ attachment to aorta via a pedicle

A

Teratoma

119
Q

Aortic arch variant that demonstrates a COMMON ORIGIN of the RIGHT BRACHIOCEPHALIC AND LEFT COMMON CAROTID ARTERY.

A

TWO vessel arch

120
Q

A aortic arch variant in which the LEFT VERTEBRAL ARTERY has an INDEPENDENT ORIGIN from the aortic arch, BETWEEN the left common carotid and left subclavian arteries

A

FOUR VESSEL ARCH

121
Q

Aortic arch variant in which the RIGHT subclavian artery arises distal to the left subclavian artery from the distal aortic arch and travels through the mediastinum behind the esophagus to supply the right upper extremity

A

ABERRANT RIGHT SUBCLAVIAN ARTERY

  • associated with KOMMERELL DIVERTICULUM
  • associated with Vascular ring, only if there is Right ligamentum arteriosum
122
Q

If large, this embryologic remnant of the dorsal aortic arch can cause compressive symptoms of the esophagus

A

DIVERTICULUM OF KOMMERELL

123
Q

Brant:
Fical prominence of the aorta at the ligamentum arteriosum, a normal variant

A

Ductus Diverticulum a.k.a

“Ductus Bump”

124
Q

Brant:
Aneurysm @ tye origin of the aberrant right subclavian artery

A

Diverticulum of Kommerell

*may cause compressive sx on thr esophagus

125
Q

Brant:
Dysphagia secondary to extrinsic compression of the esophagus, may occur due to a vascular ring or diverticulum of Kommerell

A

Dysphagia Lusoria

126
Q

Brant:
MC vascular RINGS

A
  1. Right Aortic Arch w/ aberrant Left SA
  2. Double Aortic Arch
127
Q

Brant:
AAA size with increased risk of rupture of about 14%

A

> 6 cm

128
Q

Brant:
Continuous, often crescentic, hyperdense thickening of the aortic wall; hematoma w/o communication w/ the aortic lumen.

A

Intramural Hematoma

PBR 2 (10 decks)

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