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Flashcards in Acute Aortic Syndromes Deck (59)
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1
Q

Free rupture of Aorta often caused by occlusion of coronary Ostia

A

Catastrophic Dissection

2
Q

Sudden onset of severe chest pain w/ back pain, abdominal pain syncope, stroke, and MI

A

Catastrophic dissection

3
Q

Characterized by chest, back, or abdominal pain classified as abrupt onset, severe (10/10) intensity, and a “ripping or tearing” quality

A

Aortic dissection

4
Q

Characterized by pulse deficit, new aortic regurgitation, and hypotension

A

Aortic Dissection

5
Q

Most aortic aneurysms occur in the

A

Infrarenal abdominal aorta

6
Q

By definition is a localized or diffuse dilation of an artery w/ a diameter at least 50% greater than its normal size

A

Aneurysm

7
Q

Over the age of 65, degradation of aortic medial connective tissue due to increased MMP activity causes

A

Aortic Aneurysms

8
Q

Ischemic injury of the media from atherosclerosis or damage to vasa vasorum can cause

A

Aortic aneurysms

9
Q

Under the age of 65, the major reason for aortic aneurysms is

A

Syndromic CT disorders

10
Q

The result of a disorder with fibrillin

A

Marian Syndrome

11
Q

Aneurysmal degeneration that occurs in the thoracic aorta is termed

A

Thoracic Aortic Aneurysm (TAA)

12
Q

A consistently high proportion of patients w/ TAA have family history. What are 3 inherited disease associated w/ TAA

A

Marian syndrome, Ehlers-Danlos, and Turner syndrome

13
Q

Infection that causes small vessel arteritis which can lead to TAA

A

Syphilis

14
Q

An inflammatory condition that can result in TAA

A

Takayasu Arteritis

15
Q

Environmental risk is MORE important as this disease is more likely degenerative

A

Abdominal Aortic Aneurysm

16
Q

Smoking, COPD, prior aneurysm, CAD, and hypertension are all risk factors for

A

Abdominal Aortic Aneurysm

17
Q

Are usually asymptomatic until they rupture

A

Abdominal Aortic Aneurysms (AAA)

18
Q

The typical finding of AAA on physical exam is a

A

Pulsations Abdominal Mass

19
Q

When we see abdominal AND/OR back pain PLUS low BP, we think

A

Ruptured AAA

20
Q

Screening is effective for an

A

AAA

21
Q

What can we use to manage AAA’s of 5.5 cm or greater?

A

Endovascular Stenting

22
Q

The presence of. Flow-limiting lesion in an artery that provides blood supply to the limbs

A

Peripheral Arterial Occlusive Disease

23
Q

At rest, normal blood flow to the extremity muscle groups averages

A

300-400 mm/min

24
Q

Each stenosis segment of an atherosclerotic limb acts to reduce the pressure experienced by

A

Distal muscle groups

25
Q

With exertion, the reduction in pressure produced by the atherosclerotic lesion becomes more significant and the distal pressure is greatly

A

Diminished

26
Q

The most common clinical manifestation of peripheral arterial disease

A

Pain w/ exertion, (claudication)

27
Q

Reproducible ischemic muscle pain that occurs during physical activity and is relieved after a short rest

A

Intermittent claudication

28
Q

Same symptoms as with claudication or tingling, weakness, or clumsiness.

-Relief with sitting or otherwise changing position

A

Spinal Stenosis

29
Q

Pain, weakness, numbness in the legs when walking due to increased metabolic demands of compressed nerve roots

A

Neurogenic claudication

30
Q

W/ neurogenic claudication, the pain is relived when the patient

A

Flexes spine by sitting

31
Q

The most common form of ischemic limb is in the

A

Distal superficial femoral artery

32
Q

This disease in the distal superficial femoral artery causes claudication in the

A

Calf muscle

33
Q

Atherosclerotic disease in the aortoiliac areas can result in

A

Thigh and buttock claudication and male erectile dysfunction

34
Q

Associated w/ increased risk of CAD in younger males

A

ED

35
Q

Pathology of atherosclerotic PAD is identical to

A

CAD

36
Q

40% of patients with PAD have clinically significant

A

CAD

37
Q

Complete cardiovascular exam for PAD will focus on the

A

Lower extremity and pulse evaluation

38
Q

What are two major physical findings consistent w/ chronic arterial insufficiency

A

Thickened toe nails and Dependent rubor

39
Q

Dermal arterioles and capillaries no longer constrict in the presence of increased hydrostatic pressure

-suggestive of severe PAD

A

Dependent Rubor

40
Q

At baseline, a healthy person may have a higher measured ankle pressure than arm pressure. A normal ankle-brachial index is

A

1.0 to 1.4

41
Q

What is a medication that can be used to treat intermittent claudication?

A

Cilostazol

42
Q

An inhibitor of phosphodiesterase 3 used to treat intermittent claudication

A

Cilostazol

43
Q

Critical narrowing or thrombosis will cause

A

Rest pain

44
Q

In the aorta, medial elastin layers decline from

A

Proximal to distal

45
Q

Layer of aorta comprised of endothelial cells overlying the IEL

A

Intima

46
Q

Layer of aorta composed of SMCs and an ECM of collagen and elastic fibers

A

Media

47
Q

Layer of aorta composed of collagen, perivascular nerves, and vasa vasorum

A

Adventitious

48
Q

The presence of elastic lamellae allows the aorta to withstand

A

High pressures

49
Q

A glycoproteins that helps to maintain the structural integrity of the aortic wall and valve leaflets by tethering VSMCs to a matrix of elastin and collagen

A

Fibrillin-1

50
Q

Leads to VSMC detachment from elastin and collagen inducing apoptosis and loss of ECM structural integrity

A

Deficiency of fibrillin-1 (i.e. Marian syndrome and Bicuspid Aortic Valve)

51
Q

As we age, which component of the aorta begins to degrade?

-Leads to stiff aorta

A

Elastic component

52
Q

Usually manifests as a discrete constriction of the aortic isthmus

A

Coarctation of the aorta

53
Q

Associated with other congenital heart defects such as bicuspid aortic valve and Turner syndrome

A

Coarctation of the Aorta

54
Q

Does not cause a hemodynamics problem in utero, as two-thirds of the combined CO flows through the PDA into the descending thoracic aorta

A

Coarctation of the aorta

55
Q

Causes increased afterload and the development of aortic collaterals and hypertension

A

Pathophysiology

56
Q

Development of aortic collaterals can lead to

A

Nothing of the ribs

57
Q

A classic finding of coarctation of the aorta is

A

Radial artery to femoral pulse delay

58
Q

The majority of adult patients w/ coarctation are detected via

A

Incidental hypertension

59
Q

Gives a systolic/holosytolic murmur w/ left paravertebral interscapular area

A

Coarctation of the aorta