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nbme24/Block 1/Question#10 (42.8 difficulty score)
A 75-year-old man is brought unconscious to ...
AtherosclerosisπŸ”,πŸ“Ί
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 +10 
submitted by happysingh(45),
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giar/umwm/r/wltuedd/urywnh/nulrueedciltm.eu/e/hmauE/ueRM2tSypr.muons.:cldc.

hpeo ihst hspel eyvon,eer neve eth oens htat just "kiel" genvyrhtei




 +3 
submitted by andro(189),

Abdominal Vs Thoracic Aneurysm

Abdominal :typically infrarenal

Etiology -smoking ( most important risk factor )
-atherosclerosis

Clinical features pulsatile abdominal mass bruit on auscultation * lower back pain

Recall: All men above 65 who have smoked or are still smokers always screened for AAA

Thoracic aneurysm : typically in ascending aorta

Etiology : - arterial hypertension - connective tissue disorders - syphillis

Clinical features : * thoracic back pain * feeling of pressure in the chest * may lead to compression of local structures like recurrent laryngeal nerve and esophagus




 +0 
submitted by solgabrielamoreno(5),

NOT MARFAN: True abdominal aortic aneurysm (AAA) in patients with Marfan syndrome is relatively rare because most aortic aneurysms in this disease are dissecting aneurysms in the thoracic area.




 +0 
submitted by therealslimshady(27),

Given the diagnosis of AAA, why did he have syncope? I was first thinking it was from rupture, but his blood pressure is not hypotensive, so how could he get syncope from that.

Or maybe the AAA was compressing the inferior vena cava, causing syncope?

obgynnycstep1  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178120/ worth taking a look +  



 +0 
submitted by an_improved_me(16),

What's all that anechoic stuff on the left side of the CT?




 -2 
submitted by keycompany(310),
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Imega swhos cernseCt ginS, a moomcn fngniid ni mdoailnAb tocAri seAunmrys due ot uralm sutromhb c.lcounosi

happysingh  crescent sign is a finding on radiographs that is associated with avascular necrosis, NOT aneurysms !!! what you're seeing is Calcification of wall of the aortic aneurysm +12  
sabistonsurgery  @happysingh - Thank you. You are correct indeed. +  
suckitnbme  Adding on, this patient is a >65 yo Male with a 120 pack year smoking history. Both are significant risk factors for AAA. +