Vascular Pathology and Aneurysms Flashcards

What is the 'to-and-fro' waveform pattern seen on spectral Doppler at the neck of a pseudoaneurysm?

Answer: Forward flow in systole and retrograde flow in diastole as blood enters and exits the sac

During systole, blood flows into the pseudoaneurysm sac; during diastole, it flows back out, creating the characteristic to-and-fro pattern at the neck.

In Ehlers-Danlos syndrome type IV (vascular type), which vessel is at greatest risk for spontaneous rupture?

Answer: Medium-sized arteries such as the celiac, mesenteric, and renal arteries

EDS type IV causes deficient type III collagen, predisposing medium-caliber visceral and renal arteries (and gut) to spontaneous rupture.

Which criterion is most commonly used to recommend surgical or endovascular repair of an infrarenal AAA in a male patient?

Answer: Diameter ≥ 5.5 cm or growth > 10 mm/year

Standard US guidelines recommend repair for AAAs ≥ 5.5 cm diameter in men or rapid growth > 10 mm per year due to rupture risk.

A celiac artery aneurysm is detected on abdominal duplex. Which finding would most urgently prompt referral for intervention?

Answer: Rapid interval growth of 5 mm over 3 months with symptoms

Rapid growth and symptoms (pain, tenderness) indicate high rupture risk in visceral aneurysms, warranting urgent intervention.

On B-mode ultrasound, intraluminal thrombus within an aortic aneurysm typically appears as:

Answer: Heterogeneous echogenic material layered along the wall with a patent lumen centrally

Mural thrombus appears as heterogeneous echogenic material attached to the aneurysm wall, with a residual flow channel visible centrally.

Which risk factor most significantly accelerates the growth rate of an abdominal aortic aneurysm?

Answer: Current cigarette smoking

Active cigarette smoking is the single strongest modifiable risk factor for AAA growth rate and rupture risk.

When measuring an aortic aneurysm using ultrasound, the outer-wall-to-outer-wall diameter should be measured in which plane?

Answer: True axial cross-section perpendicular to the long axis of the aorta

Measurements must be taken in true cross-section perpendicular to the aortic axis to avoid overestimation from oblique imaging.