Diseases Of The Aorta

5 Questions | Total Attempts: 118

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Disease Quizzes & Trivia

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Questions and Answers
  • 1. 
    A 66-year-old man presents to your clinic to establish care. He has a history of hypertension and hyperlipidemia for which he takes a diuretic, an angiotensin-converting enzyme (ACE) inhibitor, and a statin. He has no complaints today and reports normal exercise tolerance without chest pain or dyspnea. Three years ago, he underwent a screening colonoscopy that was found to be normal. His family history is significant for coronary artery disease in both of his brothers and an abdominal aortic aneurysm in his father. He smokes approximately one pack of cigarettes per day and has done so for the last 30 years. On examination, his blood pressure is 130/80 mm Hg and he has mild scattered expiratory wheezes.   Which of the following screening tests is indicated in this patient?  
    • A. 

      Chest x-ray

    • B. 

      Abdominal ultrasonography

    • C. 

      Graded exercise test

    • D. 

      Serum carcinoembryonic antigen

  • 2. 
    A 41-year-old man presents to your clinic for a work physical examination. He takes no medications and has no complaints other than occasional foot pain, which he attributes to his "flat feet." His father died at age 50 because of a "heart problem." On examination, his blood pressure is 130/60 mm Hg and his heart rate is 80 beats per minute. He is 6 feet 4 inches tall and weighs 165 pounds. He has a high arched palate and mild pectus carinatum. On cardiac examination, there is a soft, early diastolic murmur heard best at the left upper sternal border. A transthoracic echocardiogram is ordered and reveals mild to moderate aortic insufficiency, and an aneurysm of the aortic root measured 5.4 cm in diameter.   Which of the following is the next best step in management for this patient?
    • A. 

      Computed tomographic (CT) angiography of the chest

    • B. 

      Beta blocker therapy and repeat transthoracic echocardiogram in 6 months

    • C. 

      Refer for surgical repair

    • D. 

      Dipyridamole-thallium myocardial perfusion scintigraphy

  • 3. 
    A 73-year-old man presents to the emergency department in a tertiary care center after the abrupt onset of  "stabbing" chest pain that began 30 minutes ago. The pain radiates to his jaw and is not associated with nausea, vomiting, or shortness of breath. His past medical history is significant for coronary artery disease, hypertension, chronic kidney disease, and tobacco abuse. His medications include a beta blocker, an ACE inhibitor, a statin, and an aspirin. On examination, he appears in moderate distress. His blood pressure is 156/90 mm Hg in his right arm and 110/70 mm Hg in his left arm. He has a faint diastolic murmur at the left upper sternal border, and his lungs are clear. An electrocardiogram shows sinus tachycardia at 105 beats per minute and T wave inversions in V1 through V4. A chest radiograph shows mediastinal widening. His laboratory tests show blood urea nitrogen of 35 mg/dL and creatinine of 2.1 mg/dL. Cardiac enzymes are pending.   Which of the following is the most appropriate next step in the diagnostic management of this patient?
    • A. 

      Transthoracic echocardiography

    • B. 

      Magnetic resonance imaging (MRI)

    • C. 

      Transesophageal echocardiography (TEE)

    • D. 

      Aortography

  • 4. 
    A 58-year-old man presents to the emergency department with abdominal and chest pain that has been present for 2 days. The pain is sharp and radiates to his midback. He has a history of hypertension but is not currently on medication. He also admits to daily crack cocaine use. On examination, he is in no distress. His blood pressure in both extremities is 210/105 mm Hg and his heart rate is 85/min. His cardiac examination is normal without murmurs, his lungs are clear, and his abdominal examination is benign. CT angiography of his chest and abdomen reveals an acute aortic dissection of the descending aorta. It does not involve the ascending aorta or the aortic arch.   Which of the following is the most common predisposing risk factor for aortic dissection?
    • A. 

      Cocaine use

    • B. 

      Atherosclerosis

    • C. 

      Previous cardiac surgery

    • D. 

      Hypertension

  • 5. 
    A 65-year-old woman is undergoing evaluation for an open surgical repair of an abdominal aortic aneurysm. She has hypertension, diabetes, and coronary artery disease; a coronary stent was placed 2 years ago, and she underwent coronary bypass surgery 6 months ago. She has been doing well since her bypass surgery and has no complaints. She does not have chest pain or shortness of breath. Her medications include insulin, aspirin, clopidogrel, metoprolol, simvastatin, and lisinopril. On examination, her blood pressure is 124/78 mm Hg and her heart rate is 66 beats/min. Her cardiac and lung examinations are normal.   Which of the following is the most appropriate next step in the management of this patient?
    • A. 

      Her beta blocker should be continued during the perioperative period

    • B. 

      She should undergo noninvasive stress testing prior to surgery

    • C. 

      She should undergo coronary imaging testing prior to surgery

    • D. 

      Both A and C

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