Clinicology

Aortic dissections occur secondary to intimal tears, extending and allowing blood to accumulate between the tunica intima and adventitia in a false lumen. A dissection flap can be seen on chest CT, indicating the boundary between the true and false lumens.

DiGeorge syndrome is a genetic condition caused by a deletion mutation on chromosome 22 (22q11). Classic findings in DiGeorge syndrom are thymic aplasia, hypoparathyroidism, hypocalcemia, and conotruncal heart defects including tetralogy of Fallot (ToF) and truncus arteriosus. Tetralogy of Fallot seems to be the most relevant associated cardiac defect for this disorder on board exams.

Ascending cholangitis
Ascending cholangitis is a bacterial infection (typically E. coli) of the biliary tree. The most common predisposing factor is gallstones.
Charcot's triad of right upper quadrant (RUQ) pain, fever and jaundice occurs in about 20-50% of patients
fever is the most common feature, seen in 90% of patients
RUQ pain 70%
jaundice 60%
hypotension and confusion are also common (the additional 2 factors in addition to the 3 above make Reynolds' pentad)
Other features
raised inflammatory markers
Management
intravenous antibiotics
endoscopic retrograde cholangiopancreatography (ERCP) after 24-48 hours to relieve any obstruction