Vascular 1

Question 1

Aneurysm is…

Answer 1

Abnormal stretching or dilation of the wall of an artery, a vein, or the heart

Question 2

Amount of stretching to be considered aneurysm:
__% > normal

Answer 2

50%
(Dilating to greater than 50% of diameter)

Question 3

How are aneurysms named?

Answer 3

According to site of formation

Question 4

Stretching, as happens with aneurysm, produces expansion and eventually a ____ and ____ wall

Answer 4

Weak and thin

Question 5

Are aneurysms more common in men women or equal?

Answer 5

Men (4x)

Question 6

Most common type of aneurysm?

Answer 6

Triple A: Abdominals Aortic Aneurysm, more than 95% of them happen here

Question 7

10% of aneurysms happen in _____ area, can be life threatening. Associated with hoarseness. Hypertensive men in 40s

Answer 7

Thoracic area

Question 8

Most common site for an arterial aneurysm is the ____

Answer 8

Aorta

Question 9

> 95% of AAA are located below ____ ____ and cause what type of pain?

Answer 9

Below the renal arteries
Cause low back pain

Question 10

Aneurysm: Saccular

Answer 10

Unilateral outpouching of one side of vessel affects all layers

Question 11

Aneurysm: Fusiform

Answer 11

Bilateral outpouching

Question 12

Aneurysm: Dissecting

Answer 12

Bilateral outpouching but does not affect all layers

Question 13

Aneurysm: False aneurysm

Answer 13

Wall ruptures and a blood clot is retained in an outpouching of tissues

Question 14

Saccular, fusiform, dissecting, are ___ aneurysms.

Answer 14

True aneurysms

Question 15

____can be caused by smoking, alcohol, HTN, genetics, atherosclerosis, infection, and trauma.

Answer 15

Aneurysm

Question 16

Diagnosis of aneurysm can be via

Answer 16

CT scan, ultrasound, MRI, endocardiography

Question 17

What is this?
Chest pain, palpable pulsating mass, abdominal heart beat felt by client when laying down, dull ache in mid abdominal, left flank, LBP, Groin or leg pain, weakness or transient paralysis

Answer 17

Clinical signs and symptoms of AAA - Aneurysm (non ruptured)

Question 18

What is this?
Sudden, severe chest pain with tearing sensation. Pain my extended to neck, shoulder, low back or abdomen but rarely joints and arm which distinguishes it from MI. Systolic BP <100mmHg. Ecchyomosis (purple discoloration). Lightheadedness and nausea (syncope). More life threatening, tachycardia.

Answer 18

Clinical signs and symptoms - AAA (Ruptured Aneurysm)

Question 19

Peripheral vascular disease is the broad term for

Answer 19

Both arterial and venous blood vessels diseases

Question 20

How is peripheral vascular diseases organized?

Answer 20

based on underlying pathological finding (inflammatory, arterial occlusive, venous, or vasomotor disorders)

Question 21

Peripheral vascular diseases are more common in UE or LE

Answer 21

LE (although UE involvement is not uncommon)

Question 22

Peripheral vascular diseases affects approximately how many Americans over the age of 60

Answer 22

8 million

Question 23

Peripheral vascular diseases can be categorized into 4 disorder categories which are…

Answer 23

Inflammatory, venous, arterial, vasomotor disorders

Question 24

What is Vasculitis

Answer 24

Group of auto-immune multi-system diseases that can affect all ages, from infants up to elderly patients

Question 25

Vasculitis is characterized by

Answer 25

Leukocytic inflammation of the vascular walls

Question 26

Vasculitis: -Pathogenesis is _____ - ____ _____ of any size, type, location, or system - Acute or chronic - Irregular and segmental - Affects what part of the nervous system?

Answer 26

- Unknown - Blood vessels - Can affect the PNS and CNS

Question 27

What is Polyarteritis Nodosa

Answer 27

Multiple sites (poly) of inflammation and destructive lesions in the arterial system (arteritis)

Question 28

Polyarteritis nodosa - Affects ____ and ______ sized blood vessels - Manifestations depend on the ___ - What organs can it affect?

Answer 28

- small and medium sized - site - any organ in the body

Question 29

While Polyarteritis nodosa cause is unknown, what are the things it is associated with?

Answer 29

-IV drug use - Hep B, C - HIV

Question 30

Clinical manifestations of Polyarteritis nodosa

Answer 30

Typical onset of inflammatory response (fever, chills, tachycardia, arthralgia, myositis) (abdominal pain, nausea, vomiting) (Paresthesias, neuropathies, pain, weakness)

Question 31

What is management of polyarteritis nodosa? Improved 5 year survival rate to what percentage?

Answer 31

- Prolonged use of steroid therapy - Immunosuppressant - 90%

Question 32

Arteritis (Giant Cell Arteritis) is considered a what?

Answer 32

Vasculitis

Question 33

Giant cell arteritis typically involved what arteries?

Answer 33

Temporal and cranial arteries (large vessels)

Question 34

Etiology and pathology of giant cell arteritis? Most commonly affects who?

Answer 34

Unknown Most common affects older people, and women

Question 35

In giant cell arteritis, what layer becomes inflamed?

Answer 35

Middle layer (tunica media)

Question 36

Clinical manifestation of giant cell arteritis: - Sudden or gradual? - Continuous, __ilateral throbbing headache in _______ area - may radiate to eye, face, side of neck - Visual disturbances due to injury to ____ - ____ sensitivity with chewing, talking, swallowing

Answer 36

- Sudden - Bilateral; Temporal area - Ophthalmic artery - Scalp

Question 37

- Medical management for giant cell arteritis - Relief of symptoms in how many days? - Resolved within how many months?

Answer 37

- Corticosteroids - 3-5 days - 6-12 months

Question 38

- Allergic or Hypersensitivity angiitis is a type of…. - Commonly affect who?

Answer 38

- Vasculitis - Children and young adults

Question 39

In allergic or hypersensitivity angiitis, the etiology is unknown but follows what type of infection and people with what sensitivities?

Answer 39

Upper respiratory infection in people with allergy and drug sensitivity issues

Question 40

Allergic or hypersensitivity angiitis has a classic triad of symptoms including

Answer 40

1. Purpura (purplish spots under the skin) 2. Arthritis 3. Abdominal pain

Question 41

Kawasaki’s Disease aka

Answer 41

mucotaneous lymph node syndrome

Question 42

Kawasaki’s Disease - affects what type arteries? - Can occur in any ethnic group but prevalent in what populations? - __% are children. __% develop cardiac complications

Answer 42

- Small and medium - Asians - 80%; 20%

Question 43

Kawasaki’s Disease etiology

Answer 43

Unknown

Question 44

Kawasaki’s Disease vast majority of cases occur in <__ years

Answer 44

<5 years

Question 45

Kawasaki’s Disease clinical manifestations - Fever >__ days, _____ inflammation - Conjunctivitis, cervical _____ - Rash: erythema of ___/___ - Abdominal pain/nausea/vomiting - Complication: - Tongue has what appearance?

Answer 45

- >5 days; mucocutaneous - Cervical lymphadenopathy - palms/soles - coronary aneurysm and cardiomyopathy - Strawberry tongue

Question 46

Describe Clinical manifestations, timeline, phases of Kawasaki’s Disease

Answer 46

3 phases Acute - Sudden high fever, unresponsive to antibiotics and antipyretics. Extreme irritability Subacute - Possible fever but irritability persists. Rash develops on trunk and extremities with skin desquamation (peeling), conjunctivitis, and oral mucosal changes. At risk for cardiac involvement. Convalescent - 6-8 weeks after onset all clinical signs/symptoms should resolve with blood values returned to normal

Question 47

Medical management of Kawasaki’s Disease Prognosis?

Answer 47

High does intravenous gamma-globulin (antibodies) and salicylates therapy to reduce fever and control inflammation Prognosis is for full recovery of function if no aneurysm develops