Pathology of Vascular Disorders

Question 1

Syphilitic aneurysms are a rare complication of tertiary syphilis. What is the pathogenesis of the disorder?

Answer 1

Infection of the vasa vasorum (blood supply for the aortic wall) by T. pallidum

Question 2

What symptoms generally present due to a thoracic aortic aneurysm?

Answer 2

Respiratory difficulties, difficulty swallowing, cough

Question 3

What are the risk factors for a thoracic aortic aneurysm?

Answer 3

Hypertension or Marfan’s syndrome (these are the same risk factors for a dissecting aneurysm)

Question 4

Berry aneurysms are often associated with what disorder?

Answer 4

Polycystic kidney disease

Question 5

What is Homan sign?

Answer 5

Pain with forced dorsiflexion - associated with deep vein thrombosis

Question 6

What is stasis dermatitis?

Answer 6

An area of darkened and firm skin due to ischemia caused by varicose veins

Question 7

What is the most serious complication of deep vein thrombosis?

Answer 7

Pulmonary embolism

Question 8

What is the diagnosis?

Answer 8

Syphilitic aortitis (“tree bark” apperance)

Question 9

Recurring nose-bleeds (epistaxis) is most associated with what peripheral vascular disorder?

Answer 9

Osler-Weber-Rendu Disease

Question 10

What is a common location for a berry aneurysm?

Answer 10

Circle of Willis - often at the junction of the communicating branches with the ACA (lacks elastic lamina and smooth muscle)

Question 11

Inferior vena cava syndrome causes lower extremity edema and distended abdominal veins. What neoplasms are most likely to invade the IVC?

Answer 11

Renal and hepatic carcinomas

Question 12

What are major risk factors for peripheral vascular disease?

Answer 12

Cigarettes, hyperlipemia, diabetes, hypertension

Question 13

What symptoms often present with a ruptured abdominal aorta aneurysm?

Answer 13

Sudden, severe back pain, hypotension, pulsatile mass

Question 14

What is the cause of varicose veins?

Answer 14

Loss of vein wall support and valve incompetence with standing

Question 15

What is the cause of Osler-Weber-Rendu disease?

Answer 15

Malformed dilated capillaries and veins

Question 16

What is the most common cause of peripheral vascular disease?

Answer 16

Atherosclerosis

Question 17

The risk of abdominal aorta aneurysm rupture increases significantly after what size?

Answer 17

> 5cm

Question 18

What symptoms often present clinically with peripheral vascular disease?

Answer 18

Claudication that improves with rest, weak pulses in the extremities, gangrene, poor wound healing, cold extremities

Question 19

What is the most common cause of an abdominal aortic aneurysm?

Answer 19

Atherosclerosis

Question 20

What is the most important risk factor for development of a deep vein thrombosis?

Answer 20

Prolonged immobilization

Question 21

What are the most common clinical findings associated with an abdominal aortic aneurysm?

Answer 21

Abdominal bruit or pulsatile mass

Question 22

A saddle embolism occurs when an embolus straddles the pulmonary artery bifurcation. What symptoms may present?

Answer 22

Acute right-sided heart failure, sudden jugular distension, severe dyspnea