EXAM #2: DISEASES OF THE AORTA

Question 1

What is a key element of the physical with a suspected aortic dissection?

Answer 1

BP and pulses bilaterally

Question 2

What is the risk of rupture for a aortic aneurysm less than 4.0cm?

Answer 2

0.3%

Question 3

What is the risk of rupture for a aortic aneurysm between 4.0 - 4.9cm?

Answer 3

1.5%

Question 4

What is the risk of rupture for a aortic aneurysm between 5.0-5.9cm?

Answer 4

6.5%

Question 5

What is the risk of rupture for a aortic aneurysm between 6.0- 6.9cm?

Answer 5

10%

Question 6

What is the risk of rupture for a aortic aneurysm greater than 7.0cm?

Answer 6

33%

Question 7

What CXR finding is associated with aortic aneurysm?

Answer 7

Widened mediastinum

Question 8

What is the classic triad for AAA rupture?

Answer 8

1) Pain
2) Hypotension
3) Pulsatile abdominal mass

Question 9

What is the best imaging modality for aortic aneursym?

Answer 9

Helical CT

Question 10

What are the medical treatments for aortic aneurysm?

Answer 10

1) Smoking cessation
2) Lipid control
3) BP control, dP/dt

+

1) ASA
2) Beta-blocker
3) ACEI

Question 11

When is surgery indicated for an aortic aneurysm?

Answer 11

GRRAS

• Growth
• Rupture
• Rapid expansion (more than half a cm in half a year)
• ## Absolute Size= 5.5cm in males or 5.0cm in female

Question 12

Who needs to be screened for AAA? What is the modality used for screening?

Answer 12

• 65-75
• Ever smoked

*Screen with US

Question 13

In someone that is asymptomatic, when do they need to be screened if stable AAA that is less than 4.0cm? 4.0-4.5cm?

Answer 13

4. 0= every 2 years

4. 0-5.4= 6-12 months

Question 14

Is thoracic aneurysm more common the ascending or descending aorta?

Answer 14

Ascending b/c of higher pressures

Question 15

Aside from the connective tissue disorders, what congenital disorder should be monitored for a throacic aortic aneurysm?

Answer 15

Bicuspid aortic valve

Question 16

In a patient with a genetic disorder that has a throacic aneurysm that is greater than 5.5cm, what do you need to do?

Answer 16

Urgent surgery

Question 17

What is a DeBakey I aortic dissection?

Answer 17

Ascending and descending

*Also called Stanford A

Question 18

What is a DeBakey II aortic dissection?

Answer 18

Ascending only

*Also called Stanford A

Question 19

What is a DeBakey III aortic dissection?

Answer 19

Descending only

*Also called Stanford B

Question 20

How is the pain in aortic dissection described?

Answer 20

Severe, ripping, acute onset

*No pain= no dissection

Question 21

What is the preferred management for acute aortic dissection?

Answer 21

IV beta-blockers

Question 22

What is the most crucial part of follow-up in patients with known but stable aortic dissection ?

Answer 22

Imaging at:

• 1
• 3
• 6
• 12 months