Which of the following are risk factors for abdominal aortic aneurysm (AAA)? (Select all that apply.)

Diabetes mellitus

Total cholesterol 170 mg/dL (less than 200 mg /Dl

HDL cholesterol 65 mg/dL (male greater than 45 mg/dL; female greater than 55 mg/dL)

Smoking cigarettes

Family history of aneurysm

Answer and Explanation

Correct Answer : D,E

A. Diabetes mellitus: An inverse association between diabetes mellitus (DM) and abdominal aortic aneurysm (AAA) risk has been reported. Apart from a lower AAA prevalence among patients with vs those without DM, there is data showing that DM may exert a protective role on aneurysmal growth in patients with small AAAs, thus decreasing the risk of rupture. As atherosclerosis has almost the same risk factors as aneurysms, the decreased AAA prevalence in patients with DM may indicate that atherosclerosis is an associated feature and not a cause of the aneurysms.

B. Total cholesterol 170 mg/dL (less than 200 mg/dL): While elevated total cholesterol is a risk factor for cardiovascular disease, it is not specifically listed as a risk factor for abdominal aortic aneurysm (AAA). However, dyslipidemia, including elevated total cholesterol levels, can contribute to the development of atherosclerosis, which is a risk factor for AAA.

C. HDL cholesterol 65 mg/dL (male greater than 45 mg/dL; female greater than 55 mg/dL): High-density lipoprotein (HDL) cholesterol levels greater than 65 mg/dL are not listed as a risk factor for abdominal aortic aneurysm (AAA). However, low levels of HDL cholesterol are associated with an increased risk of cardiovascular disease, which may indirectly contribute to the development of AAA through the promotion of atherosclerosis.

D. Smoking cigarettes: Smoking cigarettes is a significant modifiable risk factor for abdominal aortic aneurysm (AAA). Smoking damages the walls of blood vessels, promotes inflammation, and accelerates the development of atherosclerosis, increasing the risk of AAA formation and rupture.

E. Family history of aneurysm: A family history of aneurysm, particularly abdominal aortic aneurysm (AAA), is a risk factor for developing AAA. Genetic factors can predispose individuals to the development of aneurysms, and a positive family history increases the likelihood of AAA occurrence.

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Correct Answer is ["B","C","E"]

Explanation

A. Varicose veins: Varicose veins are dilated, twisted veins that commonly occur in the legs and are typically associated with venous insufficiency or venous valve dysfunction rather than valvular dysfunction of the heart.

B. Heart murmur: This is the correct answer. Valvular dysfunction can result in abnormal blood flow patterns across the heart valves, leading to turbulent blood flow and the production of audible heart murmurs upon auscultation.

C. Palpitations: Palpitations, or the sensation of rapid, pounding, or irregular heartbeats, can occur with valvular dysfunction, particularly if the dysfunction leads to alterations in heart rhythm or cardiac output.

D. Abdominal pain: Abdominal pain is not typically associated with valvular dysfunction. It may be a symptom of various gastrointestinal or abdominal conditions, but it is not a direct manifestation of valvular heart disease.

E. Chest pain: This is the correct answer. Chest pain can occur with valvular dysfunction, especially if the dysfunction leads to inadequate blood flow to the heart muscle (ischemia), which can cause angina or chest discomfort.

A. "Blood flow is altered and causes blood to pool in the legs." B. "Blood flow is altered due to atherosclerosis affecting the tissues' ability to receive oxygen-rich blood." C. "Blood flow is altered due to incompetent valves causing increased venous pressure." D. "Blood flow is altered due to excessive stretching of the ventricles impairing the heart to contract."

Correct Answer is B

Explanation

A. "Blood flow is altered and causes blood to pool in the legs." This statement inaccurately describes venous insufficiency rather than peripheral arterial disease (PAD). In PAD, blood flow is reduced or obstructed due to atherosclerosis, leading to inadequate oxygen supply to tissues rather than pooling of blood in the legs.

B. "Blood flow is altered due to atherosclerosis affecting the tissues' ability to receive oxygen-rich blood." This statement correctly explains the underlying pathology of peripheral arterial disease (PAD). Atherosclerosis, characterized by the buildup of plaque in the arteries, narrows or blocks blood flow, impairing the delivery of oxygen-rich blood to the tissues. This can result in symptoms such as pain, cramping, and tissue damage, especially during activity when oxygen demand increases.

C. "Blood flow is altered due to incompetent valves causing increased venous pressure." This statement describes venous insufficiency rather than PAD. In venous insufficiency, faulty valves in the veins result in increased venous pressure, leading to symptoms such as swelling, heaviness, and varicose veins, but it does not involve arterial obstruction as seen in PAD.

D. "Blood flow is altered due to excessive stretching of the ventricles impairing the heart to contract." This statement describes a condition related to the heart's function rather than peripheral arterial disease. Excessive stretching of the ventricles may occur in conditions such as heart failure, but it does not directly affect blood flow in the peripheral arteries as seen in PAD.

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Which of the following are risk factors for abdominal aortic aneurysm (AAA)? (Select all that apply.)

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