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abdomen > Vascular Pathology Test 1 > Flashcards

Vascular Pathology Test 1 Flashcards

0
Q

What is a true aneurysm?

A

involves all three layers of the aorta

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1
Q

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

A

lymphadenopathy

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2
Q

What percent of abd Ao aneurysm are infrarenal?

A

below the renal arteries

95%

this has to be documented

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3
Q

what is a murual aneurysm?

A

common with larger aneurysm

hangs around the edges of the vessel

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4
Q

What kind of aneurysm results from an infection?

A

mycotic aneurysm

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5
Q

What is present in a Mural thrombus?

A

Atherosclerosis with tortuosity, folding.

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6
Q

When is surgery considered for an Abd Ao aneurysm?

A

When an aneurysm in > 5CM

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7
Q

What kind of aneurysm is the result of trauma?

A

Aortic pseudoaneurysm

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8
Q

What does an aneurysm do to the vessel?

A

consistent dilation of the vessel

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9
Q

What is aortic ectasia?

A

characterized by aortic root dilatation

dilatation associated with HTN and aging, resulting in aortic regurgitation

not an aneurysm

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10
Q

What does AAA stand for?

A

Abdominal Aortic Aneurysm

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11
Q

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

A

increase in diameter of greater than 1.5 times normal

Normal is < 3cm and tapers

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12
Q

How is an AA found?

A

often made by physical exam by palpating a pulsatile mass

Abd bruit (tumultuous sounds through stethoscope)

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13
Q

Where is an AAA most commonly found?

A

Infrarenal

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14
Q

What affects the likelihood of AAA?

A

age

gender

blood pressure

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15
Q

Where do you measure an AAA

A

At the largest diameter AP but not long

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16
Q

What is present when thrombus is found?

A

multiple echoes

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17
Q

What are risk factors for AAA?

A

age over 60

smoking

HTN

Vascular disease

COPD

family history

diabetes

these all weaken the arterial wall

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18
Q

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

A

Arteriosclerosis

atherosclerosis _ most common cause - lipid deposits, plaque

trauma

congenital

syphilis (bacterial sexually transmitted infection)

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19
Q

What are some factors for AAA?

A

Mycosis infection
cystic medial Necrosis _ marfan

increased pressure

inflammation

volume overload - severe reguritation

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20
Q

What is Marfan’s Syndrome?

A

Autosomal Dominant Connective Tissue Disorder

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

will be monitored because it could rupture

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21
Q

What is the one main reason for AAA?

A

atherosclerosis

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22
Q

What are some causes of AAA?

A

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

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

abnormal volume load (reguritation)

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23
Q

What are clinical symptoms of AAA?

A

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)

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24
Q

What is a hematocrit drop indicate??

A

something is bleeding somewhere

or trauma

25
Q

When is an AAA considered high risk?

A

greater than 6 cm

26
Q

When do you follow an AA every 6 months?

A

< 4cm

27
Q

When is surgical intervention for AA considered?

A

> 4cm

28
Q

What affects the growth rate of an AA?

A

cardiac disease

blood pressure lowering medication (beta blocker)

29
Q

Do you also measure the lumen when measuring an AA?

A

Yes

Get AP measurement of entire vessel and then just the lumen

30
Q

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

A

the tensile strength decreases

31
Q

What are the different shapes of AAA?

A

SAccular - sudden

fusiform - most common, infrarenal, gradual enlargement

32
Q

what is a psuedoaneurysm?

A

pulsatile hematoma

33
Q

What is a pulsatile hematoma?

A

leakage of blood into the soft tissue abutting the punctures artery

34
Q

What can cause a psuedoaneurysm?

A

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

35
Q

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

A

a little neck attached to the vessel

36
Q

How do you fix a pseudoaneurysm?

A

surgical repair

compression technique

thrombin injection

37
Q

What is the compression technique for fixing a pseudoaneurysm?

A

You compress the bubble of the psuedoaneurysm with the transducer in hope of popping the bubble.

not very successful

38
Q

What is a thrombin injection for psuedoanurysm?

A

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

39
Q

What is an Ao dissection?

A

it’s a line found in the vessel on the ultrasound

a tear in the wall of the Ao - creates a dissection flap

40
Q

What are the symptoms of a Aortic Dissection?

A

intense chest pain

hypertension

abdominal pain

neurologic symptoms

41
Q

What is the deBakey model?

A

a model that describes the different types of Ao dissections

closer to the heart is more dangerous

42
Q

What are the symptoms of a ruptured AAA?

A

Excruciating pain

shock

organ displacement

compression

greater than 6cm

43
Q

What are the clinical symptoms of AAA rupture?

A

intense back pain

decrease in hematocrit

hypotension

nausea

vomiting

44
Q

What test would be done if AAA rupture?

A

CT is the method of choice esp in a surgical emergency

45
Q

What is AAA stent graft repair?

A

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

46
Q

What is a pseudo pulsatile abd. mass?

A

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

47
Q

What is an arteriovenous fistula?

A

acquired secondary to trauma

communication between and artery and a vein

48
Q

What is a clinical sign of an Arteriovenous fistula?

A

Pain

pulsatile mass

Massive swelling of lower extremities

dilated IVC

49
Q

What are the IVC tumors?

A

Renal cell carcinoma

wilm’s tumor

50
Q

What is IVC thrombosis

A

pulmonary emboli from lower extremities

fixed with filter

51
Q

What are the symptoms of a renal vein obstruction?

A

flank pain

hematuria

proteinuria

52
Q

What is renal vein thrombosis related to?

A

thrombosis in the IVC

53
Q

What causes renal artery stenosis?

A

clinical HTN

54
Q

What are some IVC abnormalities?

A

Congenital:

Double IVC

Infrahelpatic interruption of the IVC

55
Q

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

A

Infrahepatic interruption of the IVC

56
Q

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

A

Seen in dehydrated infants

adults with kidney abnormalities

57
Q

Can you see thrombi in the renal vein?

A

Yes

58
Q

What are some symptoms of renal vein thrombosis?

A

Pain

Hematuria

nephromegaly

decreased flow

59
Q

How can you detect renal artery stenosis?

A

Doppler

abdomen (11 decks)

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