Continuous pressure on the vessel walls from hypertension causes the walls to weaken and an aneurysm to occur. The association between hypertension and AAA could potentially be confounded by other risk factors because hypertension is more common among persons with overweight and obesity, less physical activity, who smoke and who have unhealthy diets.

Option A: Diabetes mellitus doesn’t have a direct link to an aneurysm. Diabetes mellitus (DM) is a strong cardiovascular risk factor; however, multiple epidemiological studies have confirmed that a negative relationship exists between DM and abdominal aortic aneurysm (AAA) presence, growth, and rupture. Arteries from patients with DM are often harder and more calcified than those from patients without DM; however, increased vessel wall calcification alone does not appear to explain the reduced rate of aortic expansion seen in diabetic patients.
Option C: Atherosclerotic changes can occur with peripheral vascular diseases and are linked to aneurysms, but the link isn’t as strong as it is with hypertension.
Option D: Only 1% of clients with syphilis experience an aneurysm. Classically, syphilitic aneurysms occur in 90% of cases on the thoracic aorta, and in 10% in the abdominal aorta [3, 7–9]. Infection of the aortic wall develops during the secondary or bacteremic phase of syphilis, having a latent period from infection until the clinical presentation ranging from 5 to 50 years.

A bruit, a vascular sound resembling a heart murmur, suggests partial arterial occlusion. In addition to abdominal palpation, auscultation for abdominal or femoral bruits may be useful for clinical detection of AAA. Auscultation is performed along the course of the aortic and femoral arteries. However, absence of a bruit does not exclude an aneurysm.

Option B: Crackles are indicative of fluid in the lungs. Crackles occur if the small air sacs in the lungs fill with fluid and there’s any air movement in the sacs, such as when breathing. The air sacs fill with fluid when a person has pneumonia or heart failure.
Option C: Dullness is heard over solid organs, such as the liver. A dull or thud-like sound is normally heard over dense areas such as the heart or liver. Dullness replaces resonance when fluid or solid tissue replaces air-containing lung tissues, such as occurs with pneumonia, pleural effusions, or tumors
Option D: Friction rubs indicate inflammation of the peritoneal surface. A pericardial friction rub is pathognomonic for acute pericarditis; the rub has a scratching, grating sound similar to leather rubbing against leather. Serial examinations may be necessary for detection, as a friction rub may be transient from one hour to the next and is present in approximately 50% of cases.

Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity. When a rupture occurs, the pain is constant because it can’t be alleviated until the aneurysm is repaired. Blood pressure decreases due to the loss of blood. After the aneurysm ruptures, the vasculature is interrupted and blood volume is lost, so blood pressure wouldn’t increase. For the same reason, the RBC count has decreased – not increased. The WBC count increases as cells migrate to the site of injury.

Option A: The pain felt during rupture is severe. Due to the loss of blood, the blood pressure decreases.
Option C: The WBC count increases because the cells migrate to the site of injury.
Option D: The pain is not intermittent during an aneurysm; it is constant and severe.

Blood collects in the retroperitoneal space and is exhibited as a hematoma in the perineal area. This rupture is most commonly caused by leakage at the repair site.

Option A: A hernia doesn’t cause vascular disturbances. A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral.
Option B: A pressure ulcer does not cause significant bleeding, and does not cause a hematoma. Bedsores — also called pressure ulcers and decubitus ulcers — are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone.
Option D: Because no bleeding occurs with the rapid expansion of the aneurysm, a hematoma won’t form. The fast growth of abdominal aortic aneurysm (AAA) diameter is claimed to be an indication for aneurysm repair. If fast growth is a valid indication for operative repair then an episode of measured fast growth should be followed by sustained rapid expansion and a high risk of rupture.

Marfan’s syndrome results in the degeneration of the elastic fibers of the aortic media. Therefore, clients with the syndrome are more likely to develop an aortic aneurysm. Marfan syndrome (MFS) is a spectrum of disorders caused by a heritable genetic defect of connective tissue that has an autosomal dominant mode of transmission. The defect itself has been isolated to the FBN1 gene on chromosome 15, which codes for the connective tissue protein fibrillin. Abnormalities in this protein cause a myriad of distinct clinical problems, of which the musculoskeletal, cardiac, and ocular system problems predominate.

Option A: Although cystic fibrosis is hereditary, it hasn’t been linked to aneurysms. Cystic fibrosis (CF) is the most common potentially lethal genetic disease in the white population. Improvements in life expectancy have led to increasing recognition of hepatobiliary complications from CF. Splenic artery aneurysms are a rare complication of portal hypertension with high mortality due to their significant potential for rupture, resulting in life-threatening i.p. hemorrhage.
Option B: Lupus erythematosus isn’t hereditary. Systemic lupus erythematosus (SLE), is the most common type of lupus. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels.
Option D: Myocardial infarction is neither hereditary nor a disease. Myocardial infarction (MI) (ie, heart attack) is the irreversible death (necrosis) of heart muscle secondary to prolonged lack of oxygen supply (ischemia). Approximately 1.5 million cases of MI occur annually in the United States.