vascular enlargement

Question 1

types of aneurysms

Answer 1

Question 2

a true aneurysm is

Answer 2

an abnormally dilated artery that is bound by all three layers of the arterial wall

Question 3

a pseudoanurysm is

Answer 3

a extrvascular hematoma adjacent to an injured arterial wall with a persistant communiction with the arterial lumen

Question 4

an arterial dissection is

Answer 4

a seperation of the layers of the vascular wall
typically a seperation of the tunica intima from the tunica medi by hemaatomaa

Question 5

false aneurysm is also called a

Answer 5

pseudoanaeeurysm

Question 6

aortic dissection is

Answer 6

a tear in the inner layer of the aorta that leads to a progressively growing hematoma in the intimate-media space

Question 7

at what age do patients get aortic dissection

Answer 7

peak incidence 60-80
in patients with connective tissue disease: peak incidence 30-50

Question 8

localisation of aortic disection

Answer 8

ascending aorta is 65% of casees
or may be in
descending aorta
aortic arch
abdominal aorta

Question 9

aetiology of aortic dissection

Answer 9

hypertension
trauma eg. deceleration injury
or iatrogenic injury during valve replacements or graft surgery
vasculitis with aortic involvement eg. syphilis
use of amphetamines and cocaine
third trimester prganancy
atherosclerosis
congenital: mrfans, enlers danlos, bicuspid aortic valve, coarctation of the aorta

Question 10

clinical features of aortic dissection

Answer 10

sudden severe tearing/ripping pain, migrates as the dissceted wll propogates caudally
hypertension or hypotension
assymetrical blood pressure and pulse readings between limbs
wide pulse pressure
syncope, diaphoresis, confusion or agitation

Question 11

approach for the patient with suspected dissection

Answer 11

ECG
troponin, lactate
CT angiogram chest, aabdomen, pelvis - double lumen is highly siuggestive of dissection
CXR - may see widened mediastinum, does not rule out dissection