Aneurysms and dissection

Question 1

False aneurysm/hematoma

Answer 1

Defect in the vascular wall leading to an extravascular hematoma that freely communicates with the intravascular space

Question 2

Arises when blood enters a defect in the arterial wall and tunnels between its layers

Answer 2

Arterial dissection

Question 3

2 most important causes of aortic aneurysms

Answer 3

Atherosclerosis
HTN

Question 4

Spherical outpouchings involving only a portion of the vessel wall

Answer 4

Saccular aneurysms

Question 5

Diffuse, circumferential dilations of a long vascular segment. Vary in diameter and in length

Answer 5

Fusiform aneurysms

Question 6

Causes of aneurysms by a intrinsic poor quality of the vascular wall CT

Answer 6

Marfan
EDS
Loeys-Dietz syndrome
Scurvy

Question 7

Causes of aneurysms due to an alteration in the balance of collagen degradation and synthesis altered by inflammation and associated proteases

Answer 7

Increase matrix metalloproteinases
Decreased expression of TIMPs
Nature of local inflammatory response

Question 8

Common locations of abdominal aortic aneurysms

Answer 8

Below renal As
Above aortic bifurcation

Question 9

Triad of abdominal aortic aneurysm rupture

Answer 9

Pain
Hypotension
Pulsatile abdominal mass

Question 10

Histology of abdominal aortic aneurysm

Answer 10

Bland, laminated, poorly organized, mural thrombus

Question 11

Complications of abdominal aortic aneurysm

Answer 11

Rupture leading to shuck
Mural thrombus embolizing

Question 12

Most common cause of abdominal aortic aneurysms

Answer 12

Atherosclerosis

Question 13

Most common cause of thoracic aortic aneurysms

Answer 13

HTN

Question 14

Possible complications of embolization of mural thrombus in abdominal aortic aneurysm

Answer 14

Impotence
Claudication
Livedo reticularis
Blue toe syndrome (arterial occlusion)

Question 15

Most common peripheral A aneurysm

Answer 15

Popliteal A aneurysm

Question 16

Vessel wall weakens due to infection

Answer 16

Mycotic aneurysm

Question 17

Fungal causes of mycotic aneurysm

Answer 17

Mucor
Aspergillus
Candida

Question 18

Bacterial causes of mycotic aneurysm

Answer 18

Bacteroides fragilis
Pseudomonas aeruginosa
Salmonella

Question 19

Can infect vasa vasorum of ascending and transverse aortic arch causing vasculitis leading to endarteritis obliterans. Aortic valve dilation occurs due to medial wall ischemia leading to aortic regurgitation.

Answer 19

Syphilitic aneurysm

Question 20

Tree barking of aorta in syphilitic aneurysm

Answer 20

Irregular intimal wrinkling due to scarring from inflammation and repair

Question 21

Blood separates the laminar planes of the media to form a blood-filled channel within the aortic wall.

Answer 21

Aortic dissection

Question 22

Most frequent pre-existing histologically detectable lesion before aortic dissection

Answer 22

Cystic medial degeneration

Question 23

More common and more dangerous type of aortic dissection, occurring proximal to the subclavian A

Answer 23

Stanford type A

Question 24

CXR finding in aortic dissection

Answer 24

Mediastinal widening

Question 25

Complications of aortic dissection

Answer 25

Aortic regurgitation Ischemia/infarct due to interrupted blood supply Cardiac tamponade Death

Question 26

CTA finding in aortic dissection

Answer 26

Intimal flap

Question 27

Most common location for traumatic aortic rupture

Answer 27

Aortic isthmus

Question 28

What is the aortic isthmus?

Answer 28

Proximal descending aorta just distal to the origin of the L subclavian A