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Flashcards in Vascular Pathology Test 1 Deck (60):
0

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

lymphadenopathy

1

What is a true aneurysm?

involves all three layers of the aorta

2

What percent of abd Ao aneurysm are infrarenal?

below the renal arteries

95%

this has to be documented

3

what is a murual aneurysm?

common with larger aneurysm

hangs around the edges of the vessel

4

What kind of aneurysm results from an infection?

mycotic aneurysm

5

What is present in a Mural thrombus?

Atherosclerosis with tortuosity, folding.

6

When is surgery considered for an Abd Ao aneurysm?

When an aneurysm in > 5CM

7

What kind of aneurysm is the result of trauma?

Aortic pseudoaneurysm

8

What does an aneurysm do to the vessel?

consistent dilation of the vessel

9

What is aortic ectasia?

characterized by aortic root dilatation

dilatation associated with HTN and aging, resulting in aortic regurgitation

not an aneurysm

10

What does AAA stand for?

Abdominal Aortic Aneurysm

11

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

increase in diameter of greater than 1.5 times normal

(Normal is < 3cm and tapers)

12

How is an AA found?

often made by physical exam by palpating a pulsatile mass

Abd bruit (tumultuous sounds through stethoscope)

13

Where is an AAA most commonly found?

Infrarenal

14

What affects the likelihood of AAA?

age

gender

blood pressure

15

Where do you measure an AAA

At the largest diameter AP but not long

16

What is present when thrombus is found?

multiple echoes

17

What are risk factors for AAA?

age over 60

smoking

HTN

Vascular disease

COPD

family history

diabetes

these all weaken the arterial wall

18

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

Arteriosclerosis

atherosclerosis _ most common cause - lipid deposits, plaque

trauma

congenital

syphilis (bacterial sexually transmitted infection)

19

What are some factors for AAA?

Mycosis infection
cystic medial Necrosis _ marfan

increased pressure

inflammation

volume overload - severe reguritation

20

What is Marfan's Syndrome?

Autosomal Dominant Connective Tissue Disorder

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

will be monitored because it could rupture


21

What is the one main reason for AAA?

atherosclerosis

22

What are some causes of AAA?

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

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

abnormal volume load (reguritation)


23

What are clinical symptoms of AAA?

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)

24

What is a hematocrit drop indicate??

something is bleeding somewhere

or trauma

25

When is an AAA considered high risk?



greater than 6 cm

26

When do you follow an AA every 6 months?

< 4cm

27

When is surgical intervention for AA considered?

> 4cm

28

What affects the growth rate of an AA?

cardiac disease

blood pressure lowering medication (beta blocker)

29

Do you also measure the lumen when measuring an AA?

Yes

Get AP measurement of entire vessel and then just the lumen

30

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

the tensile strength decreases

31

What are the different shapes of AAA?

SAccular - sudden

fusiform - most common, infrarenal, gradual enlargement

32

what is a psuedoaneurysm?

pulsatile hematoma

33

What is a pulsatile hematoma?

leakage of blood into the soft tissue abutting the punctures artery

34

What can cause a psuedoaneurysm?

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

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

a little neck attached to the vessel

36

How do you fix a pseudoaneurysm?

surgical repair

compression technique

thrombin injection

37

What is the compression technique for fixing a pseudoaneurysm?

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

not very successful

38

What is a thrombin injection for psuedoanurysm?

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

39

What is an Ao dissection?

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

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

40

What are the symptoms of a Aortic Dissection?

intense chest pain

hypertension

abdominal pain

neurologic symptoms

41

What is the deBakey model?

a model that describes the different types of Ao dissections

closer to the heart is more dangerous

42

What are the symptoms of a ruptured AAA?

Excruciating pain

shock

organ displacement

compression

greater than 6cm

43

What are the clinical symptoms of AAA rupture?

intense back pain

decrease in hematocrit

hypotension

nausea

vomiting

44

What test would be done if AAA rupture?

CT is the method of choice esp in a surgical emergency

45

What is AAA stent graft repair?

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

What is a pseudo pulsatile abd. mass?

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

What is an arteriovenous fistula?

acquired secondary to trauma

communication between and artery and a vein

48

What is a clinical sign of an Arteriovenous fistula?

Pain

pulsatile mass

Massive swelling of lower extremities

dilated IVC

49

What are the IVC tumors?

Renal cell carcinoma

wilm's tumor

50

What is IVC thrombosis

pulmonary emboli from lower extremities

fixed with filter

51

What are the symptoms of a renal vein obstruction?

flank pain

hematuria

proteinuria

52

What is renal vein thrombosis related to?

thrombosis in the IVC

53

What causes renal artery stenosis?

clinical HTN

54

What are some IVC abnormalities?

Congenital:

Double IVC

Infrahelpatic interruption of the IVC

55

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

Infrahepatic interruption of the IVC

56

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

Seen in dehydrated infants

adults with kidney abnormalities

57

Can you see thrombi in the renal vein?

Yes

58

What are some symptoms of renal vein thrombosis?

Pain

Hematuria

nephromegaly

decreased flow

59

How can you detect renal artery stenosis?

Doppler