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Vascular Disorders > Vessel Aneurysms > Flashcards

Vessel Aneurysms Flashcards

1
Q

Define a vessel aneurysm.

A

Weakening of vessel wall, followed by dilation due to increased wall stress

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2
Q

What is the most common vessel aneurysm?

A

Abdominal aortic aneurysm

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3
Q

Is an abdominal aortic aneurysm usually located above or below renal artery orifices?

A

Below

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4
Q

How do abdominal aortic aneurysms form?

A

Atherosclerosis weakens the vessel wall

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5
Q

What is the law of Laplace?

A

The larger the vessel radius, the larger the wall tension required to withstand a given internal fluid pressure.
For a cylindrical vessel: T=r*P

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6
Q

Aside from atherosclerosis, what other factors cause abdominal aortic aneurysms?

A

Connective tissue disorders, absence of vasa vasorum

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7
Q

Abdominal aortic aneurysms are usually asymptomatic, how might such an aneurysms effect distal extremities?

A

Atherosclerotic plaques can chip off and embolize

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8
Q

What is the most common complication of an AAA?

A

Rupture

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9
Q

What is the AAA rupture triad?

A

Sudden onset of flank pain
hypotension
Pulsatile mass on PE

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10
Q

What is the greatest predictor of rupture?

A

Diameter of aneurysm

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11
Q

How do you diagnose an AAA?

A

US

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12
Q

A pulsatile mass is found behind the knee, what is your diagnosis?

A

Popliteal artery aneurysm

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13
Q

Define a mycotic aneurysm

A

Vessel wall weakening due to an infection

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14
Q

What fungi commonly cause mycotic aneurysms?

A

Aspergillus, Candida

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15
Q

What bacteria commonly cause mycotic aneurysms?

A

Staphylococcus spp, Salmonella spp

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16
Q

Are mycotic aneurysms caused more commonly by fungi or bacteria?

A

Bacteria

17
Q

What is the most common site of a saccular aneurysm?

A

Junction of anterior communicating artery and anterior cerebral artery

18
Q

What is the most common complication of a saccular aneurysm?

A

Rupture

19
Q

What are risk factors for developing a saccular aneurysm?

A

ADPKD, Ehlers Danlos, HTN, coarctation of aorta

20
Q

What symptom is classic for a ruptured saccular aneurysm?

A

“Worst headache of my life”

21
Q

Aside from subarachnoid hemorrhage, what are other risks of saccular aneurysm rupture?

A

Neurologic defects and meningeal fibrosis can obstruct CSF flow

22
Q

How is the diagnosis of a ruptured saccular aneurysm made?

A

CT

23
Q

Detail the pathogenesis of a syphilitic aneurysm.

A

T. pallidum infects vasa vasorum of ascending and transverse portions of aortic arch- vessel iscehmia of medial tissue weakness the wall and leads to dilation of aorta and aortic valve

24
Q

What is the vasculitis caused by syphilis referred to as?

A

Obliterating endarteritis

25
Q

What murmur could you hear due to syphilitic aortitis?

A

Diastolic murmur- AV regurgitation

26
Q

Aortic dissection is common in men with a mean age of 40-60 years. When is this condition commonly seen in young people?

A

Connective tissue disease- Marfan or Ehlers-Danlos

27
Q

What is the classic presentation of an aortic dissection?

A

Acute retrosternal chest pain radiating to the back

28
Q

Where does pain radiate in an acute MI?

A

Down the inner arm

29
Q

What are the 2 types of aortic dissections?

A

Stanford type A- ascending aorta, and can progress to transverse/descending aorta (Tx: surgery)
Stanford type B- does not involve ascending aorta (Tx: beta blockers and vasodilators)

30
Q

What is the most common cause of death in a patient with a ruptured aortic aneurysm?

A

Cardiac tamponade

31
Q

Ehlers Danlos syndrome is due to a defect in what protein?

A

Collagen

32
Q

Marfan syndrome is due to a defect in what protein?

A

Fibrillin- forms elastic fibers

33
Q

What is the inheritance of Marfan syndrome?

A

AD

34
Q

What is the most common valvular defect in a patient with Marfan syndrome?

A

Mitral valve prolapse

35
Q

Why can patients with Marfan syndrome have dislocation of their lens?

A

Suspensory ligament that holds the lens in composed of elastic tissue

36
Q

Dissection of the aorta can result in what findings when checking pulses?

A

Loss of pulse

37
Q

In a patient with an aortic dissection, what findings do you expect on CT?

A

True and false lumen

Vascular Disorders (8 decks)

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