test 6 part 2

Question 1

ANEURYSMS Incidence

Answer 1

 European Studies show 460/100,000 Thoracic Aneurysms
         45% Involved Ascending Aorta
         10% Involved Arch
         35% Involved Descending Aorta
         10% Thoracoabdominal

Question 2

ANEURYSMS – CLASSIFICATION BY LOCATION AND ETIOLOGY: Ascending ANEURYSM

Answer 2

 Congenital
 Marfan’s Syndrome
 Post-stenotic dilation
 Secondary to aortic stenosis

Question 3

ANEURYSMS – CLASSIFICATION BY LOCATION AND ETIOLOGY: Arch ANEURYSM

Answer 3

 Isolated

 Atherosclerosis

Question 4

ANEURYSMS – CLASSIFICATION BY LOCATION AND ETIOLOGY: Descending aneurysm

Answer 4

 Atherosclerosis
 Starts as intimal disease
 Major cause

Question 5

ANEURYSMS – CLASSIFICATION BY SHAPE: Fusiform

Answer 5

 Entire circumference of the aortic wall

Question 6

ANEURYSMS – CLASSIFICATION BY SHAPE: Saccular

Answer 6

 Involves only part of the circumference of the aortic wall

 Arch aneurysms are typically saccular because head vessels are supportive

Question 7

ANEURYSM – CRAWFORD CLASSIFICATION (Descending)

Answer 7

 Used to classify Thoracoabdominal Aortic Aneurysms

 Used to describe the extent of the aorta requiring replacement

Question 8

ANEURYSM – CRAWFORD EXTENT I

Answer 8

 Involves most or all of the descending thoracic aorta and upper abdominal aorta.

Question 9

ANEURYSM – CRAWFORD EXTENT II

Answer 9

 Involves most or all of descending thoracic aorta and extends into infrarenal abdominal aorta
- Stops around renals

Question 10

ANEURYSM – CRAWFORD EXTENT III

Answer 10

 Involves the distal ½ or less of descending thoracic aorta and varying portion of abdominal aorta

Question 11

ANEURYSM – CRAWFORD EXTENT IV

Answer 11

 Involves most or all abdominal aorta

Question 12

Natural History of aneurysms

Answer 12

 Progressive dilation
 More than ½ of aortic aneurysms rupture
 Untreated 5 year survival of a thoracoabdominal aortic aneurysm is 13-39%
 Other complications include:
 Mycotic infection
 Atheroembolisation
 Dissection (rare)

Question 13

Predictors of poor prognosis for aneurysms

Answer 13

 Larger size (less than 10cm max transverse diameter)
 Presence of other symptoms
 Associated CV Disease
         CAD
         MI
         CVA

Question 14

DIAGNOSIS of dissections

Answer 14

 Dramatic onset

Question 15

DIAGNOSIS of aneurysms

Answer 15

 Asymptomatic until late in course

 Medical evaluation for unrelated problem or complication of aneurysm

Question 16

DIAGNOSIS for trauma rupture

Answer 16

 If they survive trauma

 Signs/symptoms similar to descending aortic aneurysm