2023 NSG 6001 MIDTERM EXAM 2 WITH COMPLETE SOLUTIONS

2023 NSG 6001 MIDTERM EXAM 2 WITH COMPLETE SOLUTIONS Abdominal aortic aneurysm 1. What is a Saccular Abdominal Aneurysm? Saccular aneurysm is an asymmetric weakness or bleb on the side of the aorta; these defects result from trauma or an internal wall defect caused by an ulcer. Fusiform aneurysm is a symmetric weakness of the entire circumference of the aorta that produces a bulge. 2. What are the risks for abdominal aortic aneurysm? AAA is an important clinical diagnosis because it is associated with considerable risk of rupture and death as the aneurysm enlarges to a diameter of more than 5.0cm (1.96 inches) 3. Know the causes of an abdominal aortic aneurysm. P493 proposed causes of AAA include atherosclerosis, inflammation, mycotic infection, inheritable connective tissue disorders (Marfan syndrome, type IV Ehlers-Danlos syndrome), and trauma. atherosclerosis has been considered the most common cause of AAA and the known cause in 25% of all AAA. 4. Understand risk factors for abdominal aortic aneurysm. P494 Development of AAA: Atherosclerotic vascular disease, white race, male gender, advanced age, HTN, smoking, COPD, history of hernias, family history of AAA, and presence of other aneurysms. Hypercholesterolemia AAA expansion: Advanced age, Severe cardiac disease, Previous stroke, Tobacco use, Cardiac or renal transplant. AAA rupture: Female gender, Low FEV1, Larger initial AAA diameter, Higher mean blood pressure, Current tobacco use, Cardiac or renal transplant, Critical wall stress–wall strength relationship AAA is an important clinical diagnosis because it is associated with considerable risk of rupture and death as the aneurysm enlarges to a diameter of more than 5.0cm (1.96 inches). Evidence suggests that the high prevalence of AAA in patients with COPD may be related to medications (oral steroids) and coexisting diseases rather than to a common pathway of pathogenesis involving plasma elastase or α1-antitrypsin deficiency AAA and elevated homocysteine plasma levels. AAA represent 75% of aortic aneurysms 5. Know the symptoms of an abdominal aortic aneurysm. AAA may cause symptoms as a result of the pressure on surrounding structures, about 75% are asymptomatic at initial diagnosis. Symptoms: Symptomatic aneurysms increase in number after the age of 70years. In thin patients, a supine abdominal examination may readily show a pulsatile abdominal mass,