Chapter Summary continued

Aortic dissecting aneurysm occur when blood from the vessel lumen enters an intimal tear and dissects through the layers of the media, which have often previously been damaged by cystic medial necrosis.

Berry aneurysms are congenital aneurysms of the vessels near the Circle of Willis. Rupture of these aneurysms may cause subarachnoid hemorrhage.

Deep vein thrombosis usually involves the deep leg veins and may be asymptomatic. The major complication is pulmonary embolus.

Varicose veins are dilated, tortuous veins caused by increased intraluminal pressure. Common sites include the superficial veins of the lower extremities, esophageal varices, and hemorrhoids.

Hemangiomas are extremely common, benign vascular tumors that may involve the skin, mucous membranes, or internal organs.

Hemangioblastomas are vascular tumors associated with von Hippel-Lindau disease that tend to involve the central nervous system and retina.

Glomus tumors are small, painful vascular tumors most often found under the fingernails.

Kaposi sarcoma is a low-grade malignant tumor of endothelial cells that appears to have a viral etiology (HHV8) and in the United States is found most often in AIDS patients,

Angiosarcoma is a malignant vascular tumor with a high mortality that occurs most commonly in skin, breast liver, and soft tissues.

1. A 78-year-old woman comes to the physician because of a severe right-sided headache, weight loss, and "achy muscles" over the past few weeks. She holds her hand over her temple as she describes the intermittent, throbbing pain that is sometimes associated with blurry vision. Her temperature is 37.3°C (99.2°F). Physical examination shows a tender, firm right temporal artery. Laboratory studies show:

Which of the following is the most appropriate next step in establishing the diagnosis?

A. Arteriogram of the head

B. CT scan of the head

C. Laboratory studies for c-ANCA

D. Laboratory studies for p-ANCA

E. Temporal artery

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