Abdominal Aortic Aneurysm Overview
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Abdominal Aortic Aneurysm Overview

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Questions and Answers

What type of shunting occurs in atrial septal defect (ASD)?

  • Left-right shunting (correct)
  • No shunting
  • Bidirectional shunting
  • Right-left shunting

    • Which characteristic is typically noted in a physical exam of a child with ASD?

  • Murmur audible at birth
  • Decreased breath sounds
  • Single S2 sound
  • Split S1 sound (correct)

    • What is a common outcome if ASD is left untreated in children?

  • Increased exercise tolerance
  • Complete closure of the defect
  • Right ventricular failure (correct)
  • Rapid weight gain

    • Which study is primarily used to identify the defect in ASD?

    <p>Echocardiogram</p> Signup and view all the answers

    At what age do patients with ASD typically become symptomatic if left untreated?

    <p>By age 40</p> Signup and view all the answers

    What is the most significant risk factor for the occurrence of Patent Ductus Arteriosus (PDA)?

    <p>Prematurity</p> Signup and view all the answers

    In the case of a small PDA, what is the most likely characteristic during a cardiac exam?

    <p>Continuous flow murmur</p> Signup and view all the answers

    What may happen to a large PDA over time if it remains uncorrected?

    <p>Development of cyanotic heart disease</p> Signup and view all the answers

    What symptoms might an older child with a moderate PDA experience?

    <p>Shortness of breath and easy fatigue</p> Signup and view all the answers

    What diagnostic tool is NOT commonly used for assessing PDA?

    <p>MRI</p> Signup and view all the answers

    What is the primary physiological consequence of coarctation of the aorta?

    <p>Obstruction of blood flow leading to hypertension</p> Signup and view all the answers

    Which symptom is NOT typically associated with coarctation of the aorta in older children?

    <p>Cyanosis</p> Signup and view all the answers

    Which diagnostic tool is primarily used to assess coarctation of the aorta?

    <p>Echocardiogram (ECHO)</p> Signup and view all the answers

    Which of the following is NOT one of the four defects associated with Tetralogy of Fallot?

    <p>Aortic regurgitation</p> Signup and view all the answers

    Which clinical sign is characteristic of Tetralogy of Fallot?

    <p>Crescendo-decrescendo systolic murmur</p> Signup and view all the answers

    Which imaging technique may show a boot-shaped heart indicative of Tetralogy of Fallot?

    <p>Chest X-ray</p> Signup and view all the answers

    What is a common management step for patients suspected of having congenital heart disease?

    <p>Referral to cardiology or cardiovascular surgery</p> Signup and view all the answers

    Which factor most influences the clinical presentation of Tetralogy of Fallot?

    <p>Degree of right ventricular outflow obstruction</p> Signup and view all the answers

    What defines an abdominal aortic aneurysm (AAA)?

    <p>Dilation of 3 cm or greater</p> Signup and view all the answers

    Which is NOT a risk factor for developing an AAA?

    <p>Low cholesterol levels</p> Signup and view all the answers

    What is the most common physical exam finding in a patient with AAA?

    <p>Pulsatile mass above the umbilicus</p> Signup and view all the answers

    Which screening recommendation is advised for men aged 65-75 regarding AAA?

    <p>One-time screening for non-smokers with a family history of AAA</p> Signup and view all the answers

    What is a significant factor influencing the rupture of an AAA?

    <p>Asymmetric shape of the aneurysm</p> Signup and view all the answers

    What is the recommended action if an AAA is detected during patient care?

    <p>Refer to a vascular surgeon for management</p> Signup and view all the answers

    Which of the following treatments is associated with reducing the growth rate of an AAA?

    <p>Increased exercise</p> Signup and view all the answers

    What is considered the size threshold for elective surgical repair of an AAA in an average patient?

    <p>5.5 cm</p> Signup and view all the answers

    What is the most common congenital heart lesion?

    <p>Congenital bicuspid valve</p> Signup and view all the answers

    What distinguishes large VSDs from small VSDs in physical examination findings?

    <p>Presence of a diastolic rumble at apex</p> Signup and view all the answers

    What effect does pulmonary hypertension have in the context of a large VSD?

    <p>Causes reversal of shunt</p> Signup and view all the answers

    How do small defects in VSD typically progress over time?

    <p>78% undergo spontaneous closure within two years</p> Signup and view all the answers

    Which symptom is not commonly associated with moderate to large VSDs?

    <p>Severe chest pain</p> Signup and view all the answers

    What does the EKG typically show for small, isolated VSDs?

    <p>Normal readings</p> Signup and view all the answers

    Which of the following is a potential consequence of uncorrected large VSDs?

    <p>Right ventricular hypertrophy</p> Signup and view all the answers

    What is a common diagnostic finding for large VSDs on a chest X-ray?

    <p>Prominent left ventricular contour</p> Signup and view all the answers

    What is the primary function of the internal carotid artery?

    <p>To supply blood to the brain</p> Signup and view all the answers

    Which of the following is a non-modifiable risk factor for carotid artery disease?

    <p>Age</p> Signup and view all the answers

    What diagnostic tool is considered the gold standard for assessing carotid artery stenosis?

    <p>Catheter based angiography</p> Signup and view all the answers

    Which of the following can be a sign of congenital heart disease during a physical examination?

    <p>Presence and character of murmurs</p> Signup and view all the answers

    What is a common risk factor associated with carotid artery disease?

    <p>Smoking</p> Signup and view all the answers

    Which congenital heart defect is characterized by an abnormal opening in the septum between the heart's chambers?

    <p>Ventricular septal defect (VSD)</p> Signup and view all the answers

    What non-instrumental method is used to assess carotid artery disease?

    <p>Palpation of peripheral pulses</p> Signup and view all the answers

    What is an effective management strategy for carotid artery disease?

    <p>Aggressive management of modifiable risk factors</p> Signup and view all the answers

    Which type of diagnostic imaging is primarily used for its cost-effectiveness in diagnosing carotid artery disease?

    <p>Ultrasound</p> Signup and view all the answers

    What is a known environmental factor that can contribute to congenital heart disease?

    <p>Exposure to air pollution</p> Signup and view all the answers

    Study Notes

    Abdominal Aortic Aneurysm (AAA)

    • AAA is abdominal aortic dilation of 3 cm or greater.
    • Normal aortic dilation with age is about 2 cm.
    • Two types: true (involves all three vessel layers) and false (pseudoaneurysm).
    • True aneurysm is the most common.
    • False aneurysm occurs from trauma/infection.
    • Risk factors include: atherosclerosis, cerebrovascular disease, family history of AAA, history of other vascular aneurysms, hypertension, high LDL, and obesity.
    • Old age and tobacco use are also risk factors.
    • Clinical presentation includes a triad of ruptured AAA: hypotension, pulsatile abdominal pain, and abdominal/back pain.
    • This is a medical emergency.
    • Physical examination may find a pulsatile mass above the umbilicus and a bruit.
    • Diagnosis is usually incidental from imaging studies (e.g., ultrasound).
    • Ultrasound is highly sensitive and specific.
    • Screening is cost-effective and has no associated harms.
    • Screening recommendations: men aged 65-75 who smoke, and men aged 65-75 who are non-smokers but have a first-degree relative who required AAA repair or died from AAA.
    • AAA is usually a silent disease, so screening can be beneficial.
    • If an aneurysm is found, surveillance is required every 6 months to 3 years, depending on the size.

    Carotid Artery Disease (CAD)

    • Definition: atherosclerosis narrowing of the internal carotid arteries (60-99%).
    • Most frequently occurs at bifurcations.
    • Two carotid arteries: internal and external.
    • Internal supplies blood to the brain.
    • External supplies blood to structures outside the skull.
    • CAD is associated with symptoms that depend on stenosis location (ipsilateral stenosis or bilateral stenosis).
    • Risk factors: hypertension and smoking.

    Carotid Artery Disease - Diagnostics

    • Catheter angiography (gold standard) to diagnose the degree and characteristics of plaque formation in carotid artery stenosis.
    • Ultrasound for diagnosis due to cost and high specificity/sensitivity.
    • MRI and CT angiography.

    Carotid Artery Disease - Management

    • Medical therapy involves aggressive management of modifiable risk factors, statins, and antiplatelet therapy.
    • Carotid revascularization (endarterectomy).

    Congenital Heart Disease (Pediatrics)

    • Alteration in fetal development of embryonic heart.
    • Commonly affects the 2nd-8th week of gestation.
    • Causes can be: teratogens, maternal conditions, or environmental influences.
    • Potential causes include drugs (lithium, retinoic acid, antiepileptics), certain metabolic conditions, pesticides, air pollution, and others.
    • Diagnostic evaluation involves EKG and physical exam, checking for murmurs, defects, and other characteristics.

    Congenital Heart Disease - Initial Evaluation for Defects

    • Congenital heart defects are divided into two major groups based upon the presence or absence of cyanosis and whether pulmonary vascular markings are present.
    • Increased pulmonary vascular markings indicate increased risk of blood pressure.
    • Decreasing pulmonary vascular markings indicate less risk.

    Congenital Heart Disease Classification

    • Acyanotic: Left-to-right shunting; increased pulmonary blood flow. Includes atrial septal defect (ASD). Ventricular septal defect (VSD). Patent ductus arteriosus (PDA).
    • Cyanotic: Right-to-left shunting; decreased pulmonary blood flow. Includes Tetralogy of Fallot (TOF).

    Specific Defects (detailed info)

    • ASD: Hole in the atrial septum causing left-to-right shunting; increased pulmonary blood flow.
    • VSD: Hole in the ventricular septum; commonly left-to-right shunting.
    • PDA: Connection between the aorta and pulmonary artery persists; left-to-right shunting.
    • TOF: Combination of 4 congenital defects resulting in right ventricular outflow tract obstruction. Marked by pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy and an overriding aorta.

    Management of Congenital Heart Disease

    • Referral to cardiology and/or cardiovascular surgery for diagnosis and management is necessary.
    • Treatment plans are variable and depend on the type and severity of any lesions.
    • Surgical intervention may be required.

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    Description

    This quiz covers the essential aspects of Abdominal Aortic Aneurysm (AAA), including its definition, types, risk factors, clinical presentation, and diagnostic methods. Learn about the importance of screening and the medical implications of AAA. Test your knowledge on this critical vascular condition.

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