The angiogram in Figure 19.7 is most likely to be associated with which of the following?

1. 70-year-old African American woman
   
2. 38-year-old Asian Indian woman
   
3. 35-year-old Polish male
   
4. 60-year-old Peruvian male

An 80-year-old woman presents with 20 lb weight loss over the last 6 months. She also reports nausea and diarrhea and states she has to eat small meals as she has abdominal pain if she eats normal portions. She has a history of coronary artery bypass grafting, done 10 years ago. She had traveled to India 6 months ago. What is the test that will have the highest yield?

1. Esophagogastroduodenoscopy
   
2. Colonoscopy
   
3. Infectious disease consultation
   
4. CT with contrast of the chest and abdomen
   
5. None of the above

The patient in Figure 19.9 has history hypertension and shortness of breath. Which of the following does the patient have?

1. Hyperparathyroidism
   
2. Lymphoma
   
3. Prostate cancer
   
4. None of the above

A patient presents with “trash foot” after a cardiac catheterization with the TEE image shown in Figure 19.10. There is a palpable pulse and the foot is warm. Which of the following would you order?

1. IV prostaglandin
   
2. IV steroids
   
3. IV heparin
   
4. IV nitroglycerine
   
5. None of the above

What is your test of choice to make the diagnosis of the patient in Question 19.10?

1. Arterial duplex of the lower extremities
   
2. Venous duplex study of the lower extrenities
   
3. CT of the abdomen
   
4. Abdominal ultrasound

A 53-year-old male presents with symptoms of progressive hoarseness. Figure 19.12 shows the TEE (long-axis view) done. What is the best next step?

1. IV vancomycin and gentamicin
   
2. Repeat echocardiography in 2 weeks
   
3. Esmolol drip
   
4. CT of the chest with contrast

A 58-year-old male is known to have Marfan syndrome. His echocardiogram shows ascending an aortic aneurysm 4.1 cm in size. What is the next step?

1. CT every 6 months
   
2. Echocardiogram every 6 months
   
3. Annual CT or magnetic resonance imaging (MRI)
   
4. Echocardiogram every 3 months

A 43-year-old male had recent surgery for a dissecting aortic aneurysm. Which of the following is/are recommended?

1. CT or echocardiogram at 6 and 12 months after surgery
   
2. Lifelong beta blockade
   
3. Use of homografts to replace infected prostheses is contraindicated
   
4. Control BP to less than 135/80 mmHg
   
5. B and D
   
6. A and D

A 60-year-old male was diagnosed with infrarenal abdominal aortic aneurysm (AAA) of 5.5 cm. What should this patient have?

1. CT every 6–12 months
   
2. Should undergo repair
   
3. Monitored by ultrasound every 3–6 months
   
4. Only A and C

Endovascular repair of the aneurysm of the descending thoracic aorta is associated with which of the following complications compared with open surgical repair?

1. Higher risk of paraplegia with endovascular repair
   
2. Lower risk of paraplegia with surgical repair
   
3. Higher risk of respiratory failure with open repair
   
4. Higher risk of respiratory failure with endovascular repair

A 50-year-old woman presents to your office with 6-month history of hypertension that has been difficult to control, headaches, fatigue of the lower extremities on minimal effort, and claudication if she pushes herself. She has had malaise, low-grade fevers, and night sweats. Her BP is 200/105 mmHg in both upper extremities and 100/60 mmHg in both of her ankles. What is the diagnosis?

1. Takatsubo’s syndrome
   
2. Coarctation of the aorta.
   
3. Mid aortic syndrome
   
4. Bilateral iliac artery stenosis

With which of the following is 45,X chromosomal anomaly associated?

1. Development of complete heart block
   
2. Ventricular septal defect
   
3. Aortic aneurysm and dissections
   
4. Tall stature and a violent personality

“Bamboo” spine is associated with which of the following?

1. Ascending aortic aneurysm
   
2. Uveitis
   
3. Arthritis
   
4. Ulcerative colitis
   
5. A, B, and C
   
6. A, C, and D
   
7. All of the above

Leriche syndrome is associated with which of the following?

1. Impotence
   
2. Buttock claudication
   
3. Atrophy of the lower extremities
   
4. All of the above
   
5. A and B only

Which of the following describes collateral arterial pathways around total occlusions of the infrarenal aorta?

1. Inferior epigastric artery to the internal mammary artery
   
2. Lumbar artery to the hypogastric artery
   
3. Inferior mesenteric artery to the hypogastric artery
   
4. The sacral artery to the hypogastric artery
   
5. A and B only
   
6. All of the above
   
7. A, B, and C only

A 68-year-old woman presents with severe anterior unrelenting chest pain that radiates to her back. BP is 200/110 mmHg. She has a CT scan of the chest, shown in Figure 19.22a. Which of the following is the next best step?

1. Coronary angiography and aortogram
   
2. TEE
   
3. Cardiothoracic surgery consultation and proceed to the operating room
   
4. MRI of the chest

Which of the following is the treatment of choice in the 80-year-old patient in Figure 19.23a with advanced chronic obstructive pulmonary disease and hypertension? She is status post mastectomy 3 years ago with no residual disease.

1. Endovascular repair
   
2. Open surgical repair
   
3. Risk factor modification with conservative therapy

You successfully repaired a 6.5 cm infrarenal aortic aneurysm a year ago. The aneurysm has continued to grow by 1 cm on a follow-up CT scan. There is no contrast seen within the sac of the aneurysm. What is this an example of?

1. Type I endoleak
   
2. Type II endoleak
   
3. Type III endoleak
   
4. Type IV endoleak
   
5. Type V endoleak

True or false, “sartans” slow the growth of aneurysms in Marfan syndrome?

1. True
   
2. False

Which of the following may 45,X0 be associated with?

1. Brachiofemoral delay
   
2. Bicuspid aortic valve
   
3. Dilatation of the aorta
   
4. Impaired glucose tolerance
   
5. All of the above

A bifid uvula is seen in which of the following?

1. Ehlers–Danlos syndrome (EDS)
   
2. Loeys–Dietz syndrome (LDS)
   
3. Aneurysms–osteoarthritis syndrome (AOS)
   
4. Arterial tortuosity syndrome (ATS)
   
5. Marfan syndrome

The non-syndromic forms of thoracic aortic aneurysm and dissection (nsTAAD) may be associated with bicuspid aortic valve and/or persistent ductus arteriosus and display typical cystic medial necrosis on pathological examination. Mutations in genes (FBN1, TGFBR1, and TGFBR2) are frequently seen.

1. True
   
2. False

The most characteristic and frequently reported clinical presentation of an intimal angiosarcoma of the aorta is the embolic occlusion of the mesenteric or peripheral artery. Leiosarcomas and fibrosarcomas originate from the media or adventitia of the aortic wall. Which rare tumor of the aorta is most common?

1. Angiosarcoma
   
2. Leiosarcoma
   
3. Fibrosarcoma