aneurysms

Question 1

Aneurysm definition

Answer 1

An aneurysm is a localised abnormal dilation of a blood vessel (most often an artery), involving all layers of the vessel wall.

Question 2

what is true aneurysm

Answer 2

Involves all three layers: intima, media, adventitia

Question 3

what is a false/pseudo aneurysm

Answer 3

Breach in vessel wall, with blood contained by surrounding tissue
Often due to trauma or iatrogenic injury

Question 4

what is a saccular aneurysm

Answer 4

Saccular: localized, balloon-like outpouching

Question 5

what is a fusiform aneurysm

Answer 5

Fusiform: diffuse, circumferential dilation

Question 6

pathogenesis of aneurysm

Answer 6

Chronic inflammation → degradation of elastin and collagen in media
Wall weakening due to:
Proteolytic enzymes (MMPs)
Loss of smooth muscle cells
Increased wall stress
Progressive dilation → risk of rupture

Question 7

complications of aneurysm

Answer 7

Rupture → life-threatening hemorrhage
Thrombosis/embolism (from mural thrombus)
Compression of adjacent structures
Infection (rare, mycotic aneurysms)

Question 8

risk factors of berry aneurysm

Answer 8

Associated with: hypertension, polycystic kidney disease (PKD), coarctation

Question 9

DeBakeys classification of aneurysms

Answer 9

DeBakey classification - Dissections are BAD:

I = (B) - Both ascending/descending aorta

II = (A) - Ascending aorta

III = (D) - Descending aorta

Question 10

Stanford classification of aneurysm

Answer 10

Stanford classification:

Type (A) (A)ffects (A)scending (A)orta, whereas

Type B (B)egins (B)eyond (B)rachiocephalic vessels

Question 11

A male presents with a pulsatile mass in his abdomen. Which of the following conditions MOST predisposes to this?

A Vasculitis
B Infections
C Hypertension
D Atheroscleorisis

Answer 11

Atherosclerosis

atherosclerosis is a greater factor in AAAs
hypertension is the most common aetiology associated with ascending aortic aneurysms.

Question 12

Risk of AAA rupture size 4-5cm

Answer 12

1% per year for AAAs between 4 and 5 cm

Question 13

Risk of 5-6cm AAA rupture

Answer 13

11% per year for AAAs between 5 and 6 cm

Question 14

Risk of >6cm AAA rupture

Answer 14

25% per year for aneurysms >6 cm.