Ch 9. Aneurysms

Question 1

What is the difference between a vulnerable and stable plaque?

Answer 1

A stable one has a thick layer of fibrous cap while a vulnerable is thin

Question 2

What is an arterial dissection

Answer 2

When blood enters the arterial wall

Question 3

Difference between a saccular and fusiform aneurysm

Answer 3

Saccular-unilateral bulging

Fusiform- bilateral bulging

Question 4

What are the MC locations for an aneurysm

Answer 4

Abdominal aorta
Iliac arteries
Aortic arch

Question 5

What makes it a true AAA

Answer 5

Aorta dilated by 50% or more

Greater than 5cm

Question 6

Risks of getting AAA

Answer 6

Males older than 50, smokers, Caucasian, familial history of HTN, Marian’s syndrome

Question 7

A abdominal aortic aneurysm is a

Answer 7

Contraindication to adjusting

Question 8

Chance of an AAA rupturing

Answer 8

4-5 cm= 1%

5-6cm= 11%

> 6cm = 25%

Question 9

What percent of AAA ruptures are fatal?

Answer 9

50%

Question 10

Aortic dissection MC affects

Answer 10

Males 40-60 years old

HTN is major risk 90% of cases

Question 11

What causes an early onset of aortic dissections

Answer 11

Connective tissue disorder

Marian, ehlers-danios, Wilson

Question 12

Where does pain project from an aortic dissection

Answer 12

Between shoulder blades

Tearing or stabbing pain

Possible confusion with heart attack

Question 13

Which type of aortic dissection is MC

Answer 13

Type A= ascending aorta, most severe, MC

Type B- distal, sublcavian artery, less common

Question 14

What is Wilson disease

Answer 14

Abnormal copper ion transportation

Question 15

Is Wilson diseased autosomal recessive or dominant

Answer 15

Recessive!

> 300 mutations

Question 16

Kayser-Fleischer rings are from what disease

Answer 16

Wilson disease

Found in the eyes

Question 17

What causes vasculitis

Answer 17

Immune mediated aka lupus PAN etc.

Type III hypersensitive

Penicillin

Question 18

What is giant cell arthritis

Answer 18

Aka Temporal arteritis

Question 19

What is the MC vasculitis found in the elderly >50

Answer 19

Temporal arteritis

Autoimmune, arteries of head, patch

Question 20

What are symptoms of temporal arteritis

Answer 20

Facial pain, diplopia/ sudden blindness,fever

Question 21

Ophthalmic artery makes up what % of temporal arteritis

Answer 21

50%

Question 22

What is Takayuki Arteritis

Answer 22

Aka pulseless disease

Autoimmune

Narrowing of the aortic arch, decreases pulse

Question 23

Who edges takayasu arteritis MC affect

Answer 23

Young adults <50 years old

Question 24

Symptoms of takayasu arteritis

Answer 24

Fatigue, fever, weight loss,

Forms granulomas

Question 25

What is polyarteritis Nodosa

Answer 25

Systemic autoimmune vasculitis Small/ medium sized arteries most affected

Question 26

What are the MC areas of polyarteritis Nodosa

Answer 26

Kidneys, heart, liver, GI (spares pulmonary arteries

Question 27

What are features of polyarteritis Nodosa

Answer 27

Episodic and widespread Weight loss, fatigue,fever, malaise

Question 28

Polyarteritis Nodosa is MC in

Answer 28

Young adult 2/3 ARE IDIOPATHIC, autoimmune 1/3 are post. Hepatitis B infections

Question 29

True or False Polyarteritis Nodosa is fatal if untreated

Answer 29

True Tx. Corticosteroids 90% cure

Question 30

What are symptoms of polyarteritis nodosa in the G.I. Arteries

Answer 30

Abdominal pain, bloody stools

Question 31

Polyarteritis Nodosa and Kawasaki disease both have

Answer 31

Fibrinoid necrosis

Question 32

WHo does Kawasaki disease affect

Answer 32

80% children younger than 4 yrs old Aka pediatric vasculitis

Question 33

What percent of Kawasaki disease cases result in heart attack

Answer 33

1% Is acute onset and self limiting

Question 34

Whawhat is the hallmark of Kawasaki disease

Answer 34

Acute/persistent fever

Question 35

What percentage of Kawasaki aneursyms resolve in __ years

Answer 35

50%, 2 years

Question 36

Who does Kawasaki effect

Answer 36

Asian males

Question 37

What disease is associated with a strawberry like tongue

Answer 37

Kawasaki disease No response to ibuprofen

Question 38

What causes conjunctivitis,swollen extremities and cervical lymphadenopathy, oral erythema

Answer 38

Kawasaki disease Tx. Aspirin, corticosteroids, CABG surgery

Question 39

What is Reye syndrome

Answer 39

Idiopathic swelling of liver and brain following exposures to 1. aspirin 2. Viral infection (ex. Flu, chicken pox)

Question 40

Who is most at risk of Reye syndrome

Answer 40

Ages 4-12 Can result in confusion, siezures, behavioral change, loss of consciousness, rash, diarrhea, vomiting

Question 41

True or False Reye syndrome is a medical emergency

Answer 41

TRUE May be rapidly fatal

Question 42

What is Wegener Granulomatosis

Answer 42

Necrotizing vasculitis of kidneys and respiratory tract

Question 43

What type of hypersensitivity is Wegener granulomatiosis

Answer 43

Type IV

Question 44

Wegener Granulomatosis MC affects

Answer 44

Middle aged males 40yrs old 80% lethal in 1 year if untreated Tx. Immunosuppresion

Question 45

What is a symptoms of Wegener Granulomatosis

Answer 45

Bilateral pneumonitis (95%) Chronic sinusitis (90)% Renal disease (80)%- hematureia, proteinuria, possible renal failure Nasopharyngeal inflammation/ulcers (75)%-rhinitis, nose bleeds

Question 46

What is thromboangitis Obliterans

Answer 46

Aka Buerger Disease Vasculitis in heavy tobacco smokers

Question 47

What does thromboangiitis obliterans mc affect

Answer 47

The hands and feet, aka cold feet/hands Males 25-35 3x more likely

Question 48

What is raynaud phenomenon

Answer 48

Pallor and cyanosis Exaggerated arteriovenous vasoconstriction

Question 49

Raynaud phenomenon mc affects

Answer 49

Fingers and toes More common in adolescent and young adults females more at risk

Question 50

What is pallor

Answer 50

White finger tips

Question 51

What is cyanosis

Answer 51

Blue finger tips

Question 52

What is Takotsubo Cardiomyopathy

Answer 52

Aka broken heart syndrome Stress induced cardiomyopathy Surge of catecholamines