Ch 9. Aneurysms Flashcards
What is the difference between a vulnerable and stable plaque?
A stable one has a thick layer of fibrous cap while a vulnerable is thin
What is an arterial dissection
When blood enters the arterial wall
Difference between a saccular and fusiform aneurysm
Saccular-unilateral bulging
Fusiform- bilateral bulging
What are the MC locations for an aneurysm
Abdominal aorta
Iliac arteries
Aortic arch
What makes it a true AAA
Aorta dilated by 50% or more
Greater than 5cm
Risks of getting AAA
Males older than 50, smokers, Caucasian, familial history of HTN, Marian’s syndrome
A abdominal aortic aneurysm is a
Contraindication to adjusting
Chance of an AAA rupturing
4-5 cm= 1%
5-6cm= 11%
> 6cm = 25%
What percent of AAA ruptures are fatal?
50%
Aortic dissection MC affects
Males 40-60 years old
HTN is major risk 90% of cases
What causes an early onset of aortic dissections
Connective tissue disorder
Marian, ehlers-danios, Wilson
Where does pain project from an aortic dissection
Between shoulder blades
Tearing or stabbing pain
Possible confusion with heart attack
Which type of aortic dissection is MC
Type A= ascending aorta, most severe, MC
Type B- distal, sublcavian artery, less common
What is Wilson disease
Abnormal copper ion transportation
Is Wilson diseased autosomal recessive or dominant
Recessive!
> 300 mutations
Kayser-Fleischer rings are from what disease
Wilson disease
Found in the eyes
What causes vasculitis
Immune mediated aka lupus PAN etc.
Type III hypersensitive
Penicillin
What is giant cell arthritis
Aka Temporal arteritis
What is the MC vasculitis found in the elderly >50
Temporal arteritis
Autoimmune, arteries of head, patch
What are symptoms of temporal arteritis
Facial pain, diplopia/ sudden blindness,fever
Ophthalmic artery makes up what % of temporal arteritis
50%
What is Takayuki Arteritis
Aka pulseless disease
Autoimmune
Narrowing of the aortic arch, decreases pulse
Who edges takayasu arteritis MC affect
Young adults <50 years old
Symptoms of takayasu arteritis
Fatigue, fever, weight loss,
Forms granulomas
What is polyarteritis Nodosa
Systemic autoimmune vasculitis
Small/ medium sized arteries most affected
What are the MC areas of polyarteritis Nodosa
Kidneys, heart, liver, GI (spares pulmonary arteries
What are features of polyarteritis Nodosa
Episodic and widespread
Weight loss, fatigue,fever, malaise
Polyarteritis Nodosa is MC in
Young adult
2/3 ARE IDIOPATHIC, autoimmune
1/3 are post. Hepatitis B infections
True or False
Polyarteritis Nodosa is fatal if untreated
True
Tx. Corticosteroids 90% cure
What are symptoms of polyarteritis nodosa in the G.I. Arteries
Abdominal pain, bloody stools
Polyarteritis Nodosa and Kawasaki disease both have
Fibrinoid necrosis
WHo does Kawasaki disease affect
80% children younger than 4 yrs old
Aka pediatric vasculitis
What percent of Kawasaki disease cases result in heart attack
1%
Is acute onset and self limiting
Whawhat is the hallmark of Kawasaki disease
Acute/persistent fever
What percentage of Kawasaki aneursyms resolve in __ years
50%, 2 years
Who does Kawasaki effect
Asian males
What disease is associated with a strawberry like tongue
Kawasaki disease
No response to ibuprofen
What causes conjunctivitis,swollen extremities and cervical lymphadenopathy, oral erythema
Kawasaki disease
Tx. Aspirin, corticosteroids, CABG surgery
What is Reye syndrome
Idiopathic swelling of liver and brain following exposures to
- aspirin
- Viral infection (ex. Flu, chicken pox)
Who is most at risk of Reye syndrome
Ages 4-12
Can result in confusion, siezures, behavioral change, loss of consciousness, rash, diarrhea, vomiting
True or False
Reye syndrome is a medical emergency
TRUE
May be rapidly fatal
What is Wegener Granulomatosis
Necrotizing vasculitis of kidneys and respiratory tract
What type of hypersensitivity is Wegener granulomatiosis
Type IV
Wegener Granulomatosis MC affects
Middle aged males 40yrs old
80% lethal in 1 year if untreated
Tx. Immunosuppresion
What is a symptoms of Wegener Granulomatosis
Bilateral pneumonitis (95%)
Chronic sinusitis (90)%
Renal disease (80)%- hematureia, proteinuria, possible renal failure
Nasopharyngeal inflammation/ulcers (75)%-rhinitis, nose bleeds
What is thromboangitis Obliterans
Aka Buerger Disease
Vasculitis in heavy tobacco smokers
What does thromboangiitis obliterans mc affect
The hands and feet, aka cold feet/hands
Males 25-35 3x more likely
What is raynaud phenomenon
Pallor and cyanosis
Exaggerated arteriovenous vasoconstriction
Raynaud phenomenon mc affects
Fingers and toes
More common in adolescent and young adults females more at risk
What is pallor
White finger tips
What is cyanosis
Blue finger tips
What is Takotsubo Cardiomyopathy
Aka broken heart syndrome
Stress induced cardiomyopathy
Surge of catecholamines
