new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
|
A 53-year-old man develops acute, excruciating chest pain that radiates to his back. En route to the emergency room, he becomes unresponsive, and is pulseless on arrival. Resuscitation attempts are unsuccessful. Autopsy reveals massive hemoperitoneum due to a ruptured aortic dissection. There is a jagged intimal tear in the ascending aorta, with a dissecting hematoma in the media, extending from the aortic valve to the renal arteries.
Which feature of this scenario most strongly suggests hypertension as the cause of the aortic dissection?
A. Adventitial tear above renal arteries
B. Dissection through media
C. Involvement of major aortic branches
D. Origin at ascending aorta
E. Rapid exsanguination
___________________
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."
|
| paheli
It'sAllAboutGoodKarma
Topics: 170
Posts: 2,215
|
D?
good qn
___________________
Prepare as if you're the worst, Perform as if you're the best! As you dream, so you manifest. So, DREAM BIG!! When you face hardship, remember, God never gives you more than you can handle. Keep your face to the sunshine and you cannot see the shadows.
|
| SURVIVOR
Forum Junior
Topics: 9
Posts: 75
|
B?
|
| SURVIVOR
Forum Junior
Topics: 9
Posts: 75
|
Sorry I'd go 4 D 2!  B is a feauture shared by all dissecting aneurysms! D is specific for HTN!
Such aneurysms that arise from the ascending aorta are called type A dissecting aneurysms! These are more dangerous as opposed to the type B since bleeding in2 the pericardium is a common feature.
Pericardial bleed happens to be the most common cause of death in a dissecting aneurysms!
good qn!
|
| new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
|
paheli wrote:
D?
good qn
___________________
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."
|
| new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
|
The correct answer is D.
The two most common causes of aortic dissection are hypertension and atherosclerosis. An important distinction between the two is that hypertensive dissections generally originate in the ascending aorta, at an intimal surface free of atherosclerosis.
Dissection secondary to atherosclerosis is typically the consequence of a ruptured aortic aneurysm, which originates in the abdominal aorta at the iliac bifurcation. Dissections due to both hypertension and atherosclerosis generally course through the wall within the media (choice B). They both can involve the entire length of the aorta, and may rupture anywhere along its course (choices A and C). Well recognized sequelae of dissections include rupture through the adventitia, compromise of major arterial branches or the aortic valve, cardiac tamponade, and rapid exsanguination (choice E).
___________________
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."
|
|
| |
| | | | | | |
