Diseases of the Aorta Flashcards Preview

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Flashcards in Diseases of the Aorta Deck (42)
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1
Q

This type of aneurysm is when theres localized abnormal dilation of a blood vessel that involves an intact weakened arterial wall

A

True aneurysm

2
Q

In a false aneurysm, there is a defect in the vascular wall, leading to the formation of what?

A

Extravascular hematoma

3
Q

This condition rresults when blood splays apart the laminar planes of the media to form a blood filled channel within the aortic wall

A

Arterial dissection

4
Q

How many sides of the vessel wall is buldging with a saccular aneurysm?

A

1

5
Q

How many sides of the vessel wall is buldging with a fusiform aneurysm?

A

2

6
Q

What are the 2 most important disordeers that predispose u to aortic aneurysms?

A

Atherosclerosis and HTN

7
Q

However, atherosclerosis has a greeater instance of aortic aneurysms in which part of teh aorta?

A

Abdominal aorta

8
Q

HTN has a greater instance of aortic aneurysms in which part of teh aorta?

A

Ascending aorta

9
Q

This condition is from the defective synthesis of fibrillin, leading to weakening of the elastic tissue in the aorta.

A

Marfan syndrome

10
Q

This condition is from muttations in TGF-B receptors, leading to abnormalities and collagen I and IIa

A

Loeys-Dietz syndrome

11
Q

This syndrome results in a weak vessel wall due to defective type III collagen synthesis

A

Ehlers Danlos syndrome

12
Q

This is the molecule that;s produced by macrophages in response to vasculitis by atherosclerotic plaques.

A

MMP (matrix metalloproteinase)

13
Q

What is the action of MMP on the aterial wall?

A

Degrades the shit outta everything

14
Q

Which layer of the vessel wall is ischemic due to diffusion problems with atheroscleoric thickening?

A

Media

15
Q

Systemic HTN can cause outer medial ischemic by causing narrowing of which arteries that supply that part of the vessel?

A

Vasa vasorum

16
Q

This type of AAA is characterized by dense perioaortic fibrosis with many macrophages and often giant cells.

A

Inflammatory AAA

17
Q

This type of AAA is when lesions become infected by the lodging of circulating bugs in the GI (typically salmonella).

A

Mycotic AAA

18
Q

What is the serious (fatal) complication to AAA’s?

A

Rupture and quick death.

“ticking time-bomb”

19
Q

What is the clinical presentation of a AAA?

A

pulsating abdominal mass. kinda looks like a tumor. but it’s not.

20
Q

Which condition is AAA’s associated with, again?

A

Atherosclerosis

21
Q

Which condition is thoractic aortic aneurysms (TAA)’s assocaited with?

A

HTN

22
Q

Why can u have respiratory and swallowing difficulties with TAA’s?

A

compression of the airways and esophagus

coughing due to recurrent laryngeal n.

23
Q

What is the major risk factor for aortic dissections?

A

HTN

24
Q

What are the 2 mechansims to cause diminished flow through the vasa vasorum to cause aortic dissections?

A
  1. medial hypertrophy

2. loss of smooth muscle cells of the vasa vasorum

25
Q

Where is the name of the pattern of the degeneration to cause aortic degeneration?

A

cystic medial degeneration

26
Q

True or False: in aortic dissections, inflammation is characteristically absent.

A

True!

27
Q

What tears in aortic dissections?

A

Intima

28
Q

Where in the aortic arch are aortic dissections usually found?

A

ascending aorta, ~10cm from the aortic valve

29
Q

True or False: aortic dissections occur at 1 location and do not spread along the vessel wall.

A

False! It can extend retrograde or distally

30
Q

What happens if the aortic dissection ruptures through the adventitia?

A

massive hemorrhage or cardiac tamponade

31
Q

Is the paid sudden or gradual in aortic dissections?

A

Sudden

like RIPPPPPPPPPPPP

32
Q

Where does the pain radiate in aortic dissections from the anterior chest?

A

to the back between the scapulae

33
Q

This type of lesion involves either both the ascending and descending aorta or just the ascending aorta.

A

Proximal lesion (type A)

34
Q

This type of lesion involves parts of the aorta usually beginning distal to the subclavian artery and NEVER the ascending aorta.

A

Distal lesions (type B)

35
Q

How big must the aortic dissection be in the ascending aorta to do surgical repair?

A

> 5.5-6 cm

36
Q

How big must the aortic dissection be in the thoracic aorta to do surgical repair?

A

> 6.5-7 cm

37
Q

How big must the aortic dissection be in the abdominal aorta to do surgical repair?

A

> 5.5cm

38
Q

What is the immediate goal to reduce of acute aortic dissection?

A

Reduce systolic BP

39
Q

Which drugs can u give for the acute management of aortic dissections to reduce LV contractile force?

A

β-blockers

40
Q

In type A dissections, what is the treatment of choice?

A

Surgery (it’s close to the heart)

41
Q

In uncomplicated type B dissections, what is the treatment of choice?

A

Medical therapy

42
Q

So when do u do surgery in pts with type B dissections?

A

clinical evidence of propogation of the dissection, compromist of majoy aortic branches, impending ruoture, continued pain