Vascular

Question 1

Between which layers does a dissection occur?

Answer 1

blood passes through an intimal tear into the space between the intima and media layers

Question 2

Where do the majority of thoracic aortic intimal tears leading to aneurysms?

Answer 2

65% of intimal tears occur at the sinotubular junction of the ascending aorta and extends to involve the remaining thoarcic aorta
-another 30% originate close to the area where the L subclavian artery branches off the aorta

Question 3

What are the most common pathogens responsible for mycotic aneurysm?

Answer 3

-S. aureus (28%)
-Salmonella spp (15%)
-Pseudomonas aeruginosa (10%)
this is in the US, in SE Asia Salmonella is most common

Question 4

When is a CABG the correct option to address coronary artery disease?

Answer 4

-left main disease (this is starred in Osler)
-3v disease
-2v disease and 1 is the LAD
-low EF +/- DM