acintya wrote:
A: Atherosclerosis?
If I remember ....Atherosclerosis is the most common cause of aneurysms in the descending aorta (abdominal) and cystic medial necrosis is the most common cause of aneurysms in the thoracic aorta.....
What do you say nnl?
CMD is the pathogensis for Aortic dissection not for Aortic aneurysms and yes you are right about the locations. Mostly abdominal aneurysms would have an atherosclerosis as a major risk factor. While the thoracic ones will have CMD as their pathological process.
Edited by new_n_lost on 12/10/07 - 02:29 PM
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The correct answer is A.
This is a typical presentation of an abdominal aortic aneurysm, which is almost always due to severe atherosclerosis. The foci of calcification described occur within the atherosclerotic plaques, and indicate severe atherosclerotic disease.
Congenital weakness of vessels (choice B) can produce berry aneurysms, especially in cerebral vessels in the circle of Willis.
Cystic medial necrosis (choice C) can produce dissecting aneurysms, especially in Marfan's syndrome.
Syphilitic aneurysms (choice D) typically involve the aortic root as it leaves the heart.
Vasculitis (choice E) can produce aneurysms in small arteries.
So rule of thumb as explained by Goljan in RR pgs 156-160 is that
The ascending thoracic aorta is generally most affected by cystic medial necrosis, whereas a descending (thoracic & abdominal) aneurysm is primarily a consequence of atherosclerosis.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| acintya
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Thanks NNL, for clarifying about CMD for Aortic dissection and Atherosclerosis for Aneurysms!
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