Vascular Surgery Week 3 Quiz

Which of the following is TRUE of the development of thoracic aortic aneurysms?

• Atherosclerosis is an important etiologic factor in their development.

• They are rarely associated with underlying connective tissue conditions like Marfan's.

• Hypertension plays a role in the development of abdominal but not thoracic aortic aneurysms.

• The pathophysiology involves the breakdown of the elastic fibers within the tunica media and the dysfunction of the smooth muscle cells.

CT angiogram of the chest is showing an aortic dissection extending from the aortic valve, around the arch and down into the abdomen This dissection is best classified as:

• A DeBakey type I and a Stanford type A dissection

• A DeBakey type II and a Stanford type A dissection

• A DeBakey type III dissection and a Stanford type B dissection

• Only a Stanford type B dissection

A 47-year-old man is found to have an acute thoracic aortic dissection involving the descending thoracic aorta. He was admitted with chest pain, which has resolved. His vital signs are heart rate 92, blood pressure 143/78, respiratory rate 19, and O2 saturation 95% on room air. Which of the following is the next best step in managing his condition?

• Intravenous fluids to improve perfusion.

• Beta-blockers to reduce blood pressure and heart rate.

• Endovascular stenting over the area of the tear.

• Open resection and replacement of the involved aorta.

Which of the following is TRUE about the risk of rupture of abdominal aortic aneurysms?

• The risk of rupture is higher for men than women.

• Overall mortality following rupture is 70-80%.

• The risk of rupture is related to the aneurysm's overall size but not its rate of growth.

• Rupture is rare in aneurysms less that 6.5 cm in diameter.

Which of the following is TRUE of giant cell arteritis?

• It rarely resolves.

• It may be diagnosed by temporal artery biopsy.

• Aortic aneurysms and dissections are common complications of the disease.

• Steroids and NSAIDs worsen disease outcomes.

Which of the following is NOT a complication of abdominal aortic aneurysms?

• Leriche syndrome

• Rupture

• Thrombosis

• Limb ischemia

A 47-year-old man is found to have an acute thoracic aortic dissection . All of the following are true of this condition EXCEPT:

• The false lumen may compress the true lumen and impair perfusion.

• The false lumen is typically smaller than the true lumen.

• Pressures in the false lumen may create a re-entry tear, allowing perfusion through both the false and the true lumens.

• The false lumen does not fill as quickly with contrast and therefore often appears darker than the true lumen on CT angiography.

Which of the following is LEAST likely to increase risk of aortic dissection?

• Cystic medial degeneration

• Hypertension

• Diabetes mellitus

• Existing aneurysm

A 34-year-old heavy smoker is found to have an inflammatory vasculitis of the small vessels of the lower extremities. This is most likely which of the following?

• Giant cell arteritis

• Takayasu's arteritis

• Kawasaki's disease

• Buerger's disease

A 56-year-old male presents with abdominal pain and is found to have a 6.2-cm infrarenal abdominal aortic aneurysm (AAA). Which of the following is TRUE of this condition?

• The decision to operate is based on the size of the aneurysm.

• The decision to operate is based on the risk of rupture compared to the risk of complications of the operation.

• The decision to operate is based on the age and comorbidities of the patient.

• All of the above are true.