Vascular Pathology Test 1

Question 0

What is a true aneurysm?

Answer 0

involves all three layers of the aorta

Question 1

what do you most likely have if you see the SMA arising stright up instead of parallel?

Answer 1

lymphadenopathy

Question 2

What percent of abd Ao aneurysm are infrarenal?

Answer 2

below the renal arteries

95%

this has to be documented

Question 3

what is a murual aneurysm?

Answer 3

common with larger aneurysm

hangs around the edges of the vessel

Question 4

What kind of aneurysm results from an infection?

Answer 4

mycotic aneurysm

Question 5

What is present in a Mural thrombus?

Answer 5

Atherosclerosis with tortuosity, folding.

Question 6

When is surgery considered for an Abd Ao aneurysm?

Answer 6

When an aneurysm in > 5CM

Question 7

What kind of aneurysm is the result of trauma?

Answer 7

Aortic pseudoaneurysm

Question 8

What does an aneurysm do to the vessel?

Answer 8

consistent dilation of the vessel

Question 9

What is aortic ectasia?

Answer 9

characterized by aortic root dilatation

dilatation associated with HTN and aging, resulting in aortic regurgitation

not an aneurysm

Question 10

What does AAA stand for?

Answer 10

Abdominal Aortic Aneurysm

Question 11

What is the size of the Ao to be considered an aneurysm?

Answer 11

increase in diameter of greater than 1.5 times normal

Normal is < 3cm and tapers

Question 12

How is an AA found?

Answer 12

often made by physical exam by palpating a pulsatile mass

Abd bruit (tumultuous sounds through stethoscope)

Question 13

Where is an AAA most commonly found?

Answer 13

Infrarenal

Question 14

What affects the likelihood of AAA?

Answer 14

age

gender

blood pressure

Question 15

Where do you measure an AAA

Answer 15

At the largest diameter AP but not long

Question 16

What is present when thrombus is found?

Answer 16

multiple echoes

Question 17

What are risk factors for AAA?

Answer 17

age over 60

smoking

HTN

Vascular disease

COPD

family history

diabetes

these all weaken the arterial wall

Question 18

What is the most common reason for the thrombus resulting in AAA?

Answer 18

Arteriosclerosis

atherosclerosis _ most common cause - lipid deposits, plaque

trauma

congenital

syphilis (bacterial sexually transmitted infection)

Question 19

What are some factors for AAA?

Answer 19

Mycosis infection
cystic medial Necrosis _ marfan

increased pressure

inflammation

volume overload - severe reguritation

Question 20

What is Marfan’s Syndrome?

Answer 20

Autosomal Dominant Connective Tissue Disorder

may be diagnosed at birth or not recognized until late in life

will be monitored because it could rupture

Question 21

What is the one main reason for AAA?

Answer 21

atherosclerosis

Question 22

What are some causes of AAA?

Answer 22

inflammation of media and adventitia (ex: rheumatic fever, polychondritis, ankylosing spondylitis)

increased pressure (ex: systemic hypertension, aortic valve stenosis)

abnormal volume load (reguritation)

Question 23

What are clinical symptoms of AAA?

Answer 23

Asymptomatic mostly

symptoms results from rupture or vessel expansion that affects other organs

palpable abd mass

back or abd pain

abd bruit

drop in hematocrit (rupture)

Question 24

What is a hematocrit drop indicate??

Answer 24

something is bleeding somewhere or trauma

Question 25

When is an AAA considered high risk?

Answer 25

greater than 6 cm

Question 26

When do you follow an AA every 6 months?

Answer 26

< 4cm

Question 27

When is surgical intervention for AA considered?

Answer 27

> 4cm

Question 28

What affects the growth rate of an AA?

Answer 28

cardiac disease blood pressure lowering medication (beta blocker)

Question 29

Do you also measure the lumen when measuring an AA?

Answer 29

Yes Get AP measurement of entire vessel and then just the lumen

Question 30

What happens to the tensile strength of the aortic wall when a true aneurysm develops?

Answer 30

the tensile strength decreases

Question 31

What are the different shapes of AAA?

Answer 31

SAccular - sudden fusiform - most common, infrarenal, gradual enlargement

Question 32

what is a psuedoaneurysm?

Answer 32

pulsatile hematoma

Question 33

What is a pulsatile hematoma?

Answer 33

leakage of blood into the soft tissue abutting the punctures artery

Question 34

What can cause a psuedoaneurysm?

Answer 34

Cardiac cath or angiography so pseudoaneurysm would be found in the groin where the cath is startedmost common complications: hemmorrhage, torsion knicked vessel causes this...dr mistake

Question 35

on US what do you see on the blood flow picture?

Answer 35

a little neck attached to the vessel

Question 36

How do you fix a pseudoaneurysm?

Answer 36

surgical repair compression technique thrombin injection

Question 37

What is the compression technique for fixing a pseudoaneurysm?

Answer 37

You compress the bubble of the psuedoaneurysm with the transducer in hope of popping the bubble. not very successful

Question 38

What is a thrombin injection for psuedoanurysm?

Answer 38

a needle is inserted in to the psuedoaneurysm with clotting medicine. the bubble clots and closes off.

Question 39

What is an Ao dissection?

Answer 39

it's a line found in the vessel on the ultrasound a tear in the wall of the Ao - creates a dissection flap

Question 40

What are the symptoms of a Aortic Dissection?

Answer 40

intense chest pain hypertension abdominal pain neurologic symptoms

Question 41

What is the deBakey model?

Answer 41

a model that describes the different types of Ao dissections closer to the heart is more dangerous

Question 42

What are the symptoms of a ruptured AAA?

Answer 42

Excruciating pain shock organ displacement compression greater than 6cm

Question 43

What are the clinical symptoms of AAA rupture?

Answer 43

intense back pain decrease in hematocrit hypotension nausea vomiting

Question 44

What test would be done if AAA rupture?

Answer 44

CT is the method of choice esp in a surgical emergency

Question 45

What is AAA stent graft repair?

Answer 45

put into a patient with AAA to repair it a hollow tube inserted into the vessel make sure the flow is in the tube and the tube is intact will see the tube on US

Question 46

What is a pseudo pulsatile abd. mass?

Answer 46

something palpated but not an AAA tumor fibroid uterus (so large felt in abd) horseshoe kidneys (connected across Ao) para-aortic nodes (lymphnodes) pancreatic cancer

Question 47

What is an arteriovenous fistula?

Answer 47

acquired secondary to trauma communication between and artery and a vein

Question 48

What is a clinical sign of an Arteriovenous fistula?

Answer 48

Pain pulsatile mass Massive swelling of lower extremities dilated IVC

Question 49

What are the IVC tumors?

Answer 49

Renal cell carcinoma wilm's tumor

Question 50

What is IVC thrombosis

Answer 50

pulmonary emboli from lower extremities fixed with filter

Question 51

What are the symptoms of a renal vein obstruction?

Answer 51

flank pain hematuria proteinuria

Question 52

What is renal vein thrombosis related to?

Answer 52

thrombosis in the IVC

Question 53

What causes renal artery stenosis?

Answer 53

clinical HTN

Question 54

What are some IVC abnormalities?

Answer 54

Congenital: Double IVC Infrahelpatic interruption of the IVC

Question 55

What kind of IVC abnormality do you have if your hepatic veins empty directly into the right atrium?

Answer 55

Infrahepatic interruption of the IVC

Question 56

When might you find a renal vein obstruction in infants and adults?

Answer 56

Seen in dehydrated infants adults with kidney abnormalities

Question 57

Can you see thrombi in the renal vein?

Answer 57

Yes

Question 58

What are some symptoms of renal vein thrombosis?

Answer 58

Pain Hematuria nephromegaly decreased flow

Question 59

How can you detect renal artery stenosis?

Answer 59

Doppler