Vascular Pathology Ch9

Question 1

Normal diameter of the aorta is less than ____cm

Answer 1

3

Question 2

an increase in aorta diameter greater than 1.5 times the normal diameter

Answer 2

abdominal aortic aneurysm

Question 3

factors that determine aorta size

Answer 3

• age
• gender
• blood pressure

Question 4

most common location for aneurysm

Answer 4

infrarenal

Question 5

risk factors include**

Answer 5

• over age 60

- **smoke, hypertension, vascular disease, COPD, and positive family history of AAA

Question 6

most common two causes of AAA

Answer 6

arteriosclerosis and atherosclerosis

Question 7

disease of the arterial vessels which cause thickening, hardening and loss of elasticity in arterial walls. can involve aorta and iliacs

Answer 7

arteriosclerosis

Question 8

the aortic wall becomes irregular from plaque formation

Answer 8

atherosclerosis

Question 9

other cause of AAA

Answer 9

-trauma, congenital defects, sypilis, mycosis, and **cystic medial necrosis (Marfan’s syndrome)*

Question 10

most patients with AAA are ________

Answer 10

asymptomatic

Question 11

___% of illiac aneurysms rupture

Answer 11

50

Question 12

three different types of aneurysms**

Answer 12

-true, false (pseudoaneurysm), and dissecting

Question 13

most common, gradual dilatation of vascular lumen often extends into the iliac vessels

Answer 13

fusiform aneurysm**

Question 14

type of aneurysm that has a sharp jusction between normal and abnormal

Answer 14

blulbous aneurysm**

Question 15

type of aneurysm that is spherical and larger than fusiform (5-10cm) is connected to the lumen by mouth that varies in size

Answer 15

saccular aneurysm**

Question 16

pulsatile hematoma that results from leakage of blood into the soft tissue next to punctured artery

Answer 16

pseudoaneurysm

Question 17

normal iliac arteries should measure less than ___ cm in diameter

Answer 17

1

Question 18

infected aneurysm

Answer 18

mycotic

Question 19

weakening of the media (severe)

Answer 19

atherosclerotic

Question 20

small saccular commonly located in the brain

Answer 20

berry

Question 21

symptoms of ruptured AA

Answer 21

excruciating abd pain, shock, and expanding mass.

most common site is lateral wall below renals

Question 22

operative mortality rate _____%

Answer 22

40-60

Question 23

**largest risk for rupture is ______, NOT ______

Answer 23

size, location

Question 24

thrombus within an aneurysm is seen as _______ level echos

Answer 24

medium to low

Question 25

amount of ______ has no relation to the risk of aneurysm rupture

Answer 25

thrombus

Question 26

4-5cm AAA

Answer 26

followed every 6 months

Question 27

5-6cm AAA

Answer 27

may benefit from surgical repair

Question 28

6-7cm AAA

Answer 28

considered high risk

Question 29

Most aortic dissection are idiopathic, but may be associated with:**

Answer 29

- cystic medial necrosis - chronic hypertension - inherited Marfan's syndrome - trauma

Question 30

aortic dissection involving the ascending aorta and aortic arch. high incidence of mortality

Answer 30

type I and II aortic dissection

Question 31

descending aorta at a lever inferior to the left subclavian artery. lower mortality rate

Answer 31

type III aortic dissection

Question 32

aortic dissection is more common in _____ and patients are usually ____ years old and hypertensive

Answer 32

males, 40-60

Question 33

aortic dissection will present as _______ excruciating chest pain radiating to the back. occurs with an intimal tear from the _____ of wall

Answer 33

acute, media**

Question 34

aortic dissection usually originates at the _______ in the thorax

Answer 34

aortic arch**

Question 35

masses that mimic a AAA

Answer 35

- retroperitoneal sarcoma - huge fibroid uterus - lymphadenopathy - pancreatic CA (because the mass is adjacent to the aorta, pulsations are transmitted from the aorta to the mass)

Question 36

- occurs mostly secondary to trauma/surgery | - some may develop as a complication of arteriosclerotic aortic aneurysms

Answer 36

arteriovenous fistulas

Question 37

If there is leg and lower trunk edema and a dilated IVC, an___________ should be suspected**

Answer 37

** arterivenous fistula

Question 38

- failure of union of the hepatic veins and the right subcardinal vein - hepatics don't drain into IVC because of obstruction - 30-40 years old with portal ypertension

Answer 38

infrahepatic interruption of IVC

Question 39

does not collapse with expiration. **present with with right ventricular heart failure

Answer 39

IVC dilataion

Question 40

single or multiple echogenic nodules are seen along the wall. IVC may be distended and filled with the tumor

Answer 40

IVC tumor

Question 41

most common tumor to invade IVC, usually from the right kidney

Answer 41

renal cell CA

Question 42

**-leg edema -low back and pelvic pain -GI complaints -renal and liver abnormalities complete is life threatening

Answer 42

IVC thrombosis

Question 43

The preferred location for IVC filters

Answer 43

iliac bifurcation below the renal veins

Question 44

symptoms of renal vein obstruction

Answer 44

flank pain, hematuria, flank mass, and proteinuria. associate with maternal diabetes and hypertension

Question 45

- renal vein dilation proximal to the point of occlusion - enlarged kidneys in acute stage (loss of normal structure) - decreased or no flow shown on doppler

Answer 45

renal vein thrombosis**

Question 46

symptoms of renal vein thrombosis**

Answer 46

pain, nephromegaly, hematuria, or thromboembolic phenomena elsewhere in the body

Question 47

thrombus of the hepatic veins, rare, most are idiopathic

Answer 47

Chiari syndrome**

Question 48

intestinal ischemia secondary to the compression of the proximal celiac axis by the median arcuate ligament of the diaphragm

Answer 48

arcuate ligament syndrome**

Question 49

symptoms of arcuate ligament syndrome

Answer 49

- epigastric pain, weight loss, and abdominal bruit with inspiration - typically the stenosis disappears with inspiration

Question 50

high diastolic component and supply organs that need constant perfusion such as ICA, HA and RA

Answer 50

nonresistive

Question 51

very little or even reversed flow in diastole and supply organs that do no need a constant blood supply, such as the ECA, iliac and brachial arteries

Answer 51

resistive

Question 52

peak systole - peak diastole / peak systole

Answer 52

Resistive index