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Surgery > Vascular 2 > Flashcards

Vascular 2 Flashcards

1
Q

An arterial aneurysm is defined by a > ___% increase in normal diameter.

A

> 50%

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2
Q

What aneurysm morphology type is at a higher risk for rupture?

A

Saccular

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3
Q

What aneurysm type is the most commonly seen?

A

fusiform

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4
Q

An arterial aneurysm is involves full-thickness dilation of ___ layers of the artery.

A

3 layers

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5
Q

Which is the most common aortic aneurysm location?

A

abdominal (AAA)

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6
Q

Where is the most common site of a THORACIC aortic aneurysm?

A

ascending aortic aneurysm

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7
Q

Where is the most common site of a ABDOMINAL aortic aneurysm?

A

infrarenal

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8
Q

What is the only type of abdominal aortic aneurysm that you CAN stent?

a. suprarenal
b. pararenal
c. juxtarenal
d. infrarenal

A

d. infrarenal

* MOST COMMON LOCATION OF AAA AS WELL*

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9
Q

Cystic medial necrosis is commonly associated with these 3 inherited or developmental collagen vascular disorders.

cystic medial necrosis is term for degenerative disease for artery

A
  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Biscupid aortic valve
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10
Q

Hoarseness, chest pain, dyspnea are symptoms more consistent with what type of aortic aneurysm?

A

thoracic

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11
Q

deep abdominal pain or discomfort, pulsating feeling near navel are symptoms more consistent with what type of aneurysm?

A

abdominal

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12
Q

What is the diagnostic criteria for AAA?

A

diameter > 3cm or > 50% expected

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13
Q

Cystic medial necrosis is most common in what type of thoracic aortic aneurysm?

A

ascending aortic aneurysms

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14
Q

Atherosclerosis is most common in what type of thoracic aortic aneurysms?

A

aneurysms of the aortic arch and descending thoracic aorta

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15
Q

What are the 3 classic signs and symptoms of an AAA rupture?

A
  • hypotension
  • flank/back pain
  • pulsatile mass
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16
Q

what is the imaging test of choice for SCREENING for AAA?

A

abdominal ultrasound (AAA)

17
Q

what imaging test is required for a patient going to the OR for an AAA rupture?

A

CT with contrast

she said angiogram is better choice

18
Q

What are the 4 indications for AAA screening?

A
  • men 65-75 yo with smoking Hx
  • anyone with 1st degree relative with an aneurysm
  • anyone with another aneurysm (e.g. popliteal)
  • patients with hyper-mobility syndromes
19
Q

What is the treatment for ASYMPTOMATIC aneurysms?

A
  • serial imaging with ultrasound
20
Q

Based on the following ultrasound findings what is the recommended surveillance/treatment protocol?

a. aneurysm of 3.0-3.9
b. aneurysm 4.0-4.9
c. 5-5.4
d. >5.5

A

a. aneurysm of 3.0-3.9 = screening every 3 years
b. aneurysm 4.0-4.9 = screening every 12 months
c. 5-5.4 = screening every 6 months
d. >5.5 = FIX

21
Q

What is the most important determinant of aneurysm rupture and complication?

A

aneurysm size (diameter)

22
Q

What are the size indication for repair of an asymptomatic aneurysm in the following locations:

a. ascending TAA
b. descending TAA
c. AAA
d. femoral artery aneurysm
e. popliteal artery aneurysm

A

a. ascending TAA = >5.5cm
b. descending TAA = >5.5cm
c. AAA = >5.5cm
d. femoral artery aneurysm = >3cm
e. popliteal artery aneurysm = > 3cm

23
Q

Which of the following aneurysm locations are most at risk for thrombosis?

a. ascending TAA
b. descending TAA
c. AAA
d. femoral artery aneurysm
e. popliteal artery aneurysm

A

e. popliteal artery aneurysm

24
Q

What are the 3 surgical indications for aortic aneurysm treatment?

(this includes both TAA and AAA)

A
  • AAA growth > 0.5 cm in 6 months
  • TAA growth > 0.5 cm in a year
  • symptomatic aneurysms
25
Q

What is an aortic dissection?

A

tear in the aortic INTIMA that leaves to the creation of a false lumen

26
Q

The major modifiable risk factor for aortic dissection is what?

A

systemic hypertension

27
Q

Sudden onset of severe sharp or “tearing” chest pain in posterior chest or back and a wide pulse pressure is a common presentation of this diagnosis.

A

aortic dissection

28
Q

The classic clinical triad for presentation of aortic dissection includes:

A
  • sudden onset thoracic or abdominal pain
  • widened mediastinum on chest radiograph
  • variations in pulse or BP
29
Q

D-Dimer is a great test to rule ____ aortic dissection.

A

rule out

30
Q

What is the diagnostic study of choice for aortic dissection?

A

CT scan

31
Q

Acute aortic regurgitation may develop in this arterial condition.

A

aortic dissection

32
Q

Based on the Stanford classification for aortic dissection, what is the difference between Type A and B? How does treatment differ based on the Type?

A
  • Type A = arises in the ascending aorta SURGICAL EMERGENCY
  • Type B = arises distal (below) the left subclavian MANAGE MEDICALLY
33
Q

What does the long term management of an aortic dissection consist of?

A
  • lifelong beta blocker + avoid strenuous activity
  • serial imaging 3, 6, 12 months, then every 1-2 years
  • reoperation when indicated

Surgery (7 decks)

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