vascular diseases

Question 1

What is normal abdominal aortic diameter?

Answer 1

1.5-2.5 cm; more than twice this size is considered aneurysmal

Question 2

What are some risk factors for AAA?

Answer 2

smoking, family hx, age >55, HTN, atherosclerosis

Question 3

Who needs AAA screening?

Answer 3

one time screening in men 65-75 with a hx of smoking

Question 4

What is the tx for AAA?

Answer 4

If >5.5 cm or that expands more than 0.5 cm in 6 months in diameter or symptomatic, need surgery
If

Question 5

What are the two classifications of aortic dissection?

Answer 5

stanford A: aortic dissection of the ascending aorta

stanford B is distal to the left subclavian

Question 6

What are risk factors for aortic dissection?

Answer 6

HTN, trauma, coarctation of the aorta, syphilis, Ehlers Danlos, Marfan

Question 7

what are some signs and symptoms of aortic dissection?

Answer 7

acute, ripping chest pain, syncope, decr. peripheral pulses, normal or incr BP

Question 8

How is dx of aortic dissection made?

Answer 8

-wide mediastinum on CXR

CT with contrast, echo, MRI, MRA or angiograph for definitive dx

Question 9

How are aortic dissections treated?

Answer 9

stanford A: emergency surger
stanford B: medically unless rupture or occlusion
first stabilize BP if unstable

Question 10

what are complications of aortic dissection?

Answer 10

MI, renal insufficiency, ischemic colitis, stroke, paraplegia

Question 11

What are the lab findings in PAD? What other tests are useful?

Answer 11

ABI index. if

Question 12

what are medical treatments for PAD?

Answer 12

ASA, pentoxifylline, cilostazol to slow occlusion

percutaneous transluminal angioplasty or bypass grafting possible for severe disease

Question 13

What is the treatment for DVT?

Answer 13

leg elevation, lovenox, warfarin for long termmanagement , IVC filter inpts with contraindication to anticoagulation

Question 14

polyarteritis nodosa: what vessels/organs affected, risk factors

Answer 14

inflammation of small or medium arteries causes ischemia affects kidneys, heart GI tract, muscles, nerves, joints, leading to fever, hematuria, anemia, neuropathy, weight loss, ulcers.. risk factors: hep B or C, young and male. often many aneurysms on radiology.

Question 15

How is temporal arteritis treated?

Answer 15

prednison 1-2 mo followed by taper; low dose ASA, vitamin D and Ca supplementation to decr risk of osteoporosis

Question 16

Takayasu arteritis: definition, presentation

Answer 16

inflammation of aorta that can cause stroke and MI. may present with malaise, vertigo, syncope, fever, decr. carotid and limb pulses.

Question 17

takayasu arteritis dx

Answer 17

CT or MRI, biopsy that shows giant cells, fibrosis in affected vessels. tx: steroids, immunosuppression, bypass graft

Question 18

allergic granulomatosis with angitis

Answer 18

aka churg-strauss
-small and medium rteris
hx of asthmatic sx, fatigue, mononeuropathy , erythematous or papular rash with incr eosinophils, incr. ESR, incr p-ANCA

Question 19

What is henoch-schonlein purpura?

Answer 19

IgA immune complex mediated; often have hx of URI, polyarticular arthritis, fever, palpable purpura, abd pain,