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YEAR 3 Manchester Medicine > 18 - AAA > Flashcards

18 - AAA Flashcards

1
Q

What is an aneurysm?

A

Increase of 50% the diameter of a normal lumen with thinning of the vessel wall

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2
Q

What is a true aneurysm?

A

lined by the vessel wall

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3
Q

What is a false (pseudo) aneurysm?

A

aneurysm enclosed by tissue rather than vessel wall

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4
Q

What is the normal size of the abdominal aorta?

A

3-3.5 cm

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5
Q

At what point is a AAA eligible for surgery?

A

5.5cm - risk of rupture is greater than surgery.

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6
Q

What is the screening for AAA

A

65 year old males with an abdominal ultrasound

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7
Q

What are the risk factors for AAA?

A 
Smoking 
male 
age
smoking 
diabetes 
hyperlipidaemia 
positive family history
connective tissue disorder - marfans etc.
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8
Q

When to suspect AAA?

A

60 year old with first presentation renal colic

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9
Q

Why might open AAA repair be used over EVAR?

A

AAA to large, anatomy not suitable for EVAR.

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10
Q

What are the 6 Ps for acute limb ischaemia?

A 
Pulsless
Pain 
Palor 
Perishingly in cold 
Parathesia
Paralysis
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11
Q

What is the fontian classification of PVD?

A
  • normal
  • intermittent claudication - claudication distance with pain in calf and gluts
  • critical limb ischaemia - pain at rest and night, leaves leg out of bed.
  • gangrene and necrosis
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12
Q

What antiplatlet is used for PVD?

A

aspirin 75mg

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13
Q

What is the criteria for endarterectomy?

A

stenosis of 70-99% or symptomatic. (vascular surgeon will do 50%)

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14
Q

What are the classification of aortic dissection?

A

Type A - before the left subclavian, MEDICAL EMERGNECY and managed with surgery
Type B - After left subclavian, managed conservatively

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15
Q

What are the symptoms and signs of aortic dissection?

A
  • Severe chest pain radiating between the scapulars.
  • Sudden onset
  • difference in BP in arms
  • radio-radio/femoral delay
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16
Q

What is shock?

A

A acute clinical syndrome initiated by the ineffective percussion and cellular hypoxia resulting in severe dysfunction of organs vital to survival.

17
Q

What types of shocks re there?

A

Hypovolaemic
Cardiogenic
Obstructive
Distributive

18
Q

What example are there of obstructive shock?

A

cardiac tamponade

pneumothorax

19
Q

What examples are there of distributive shock?

A

sepsis
inflammation
pancreatitis
anaphylaxis

20
Q

What is the definition of a massive haemorrhage?

A

> 10 until in 24 hours

> 4 units in 1 hour

21
Q

What clotting factors are controlled by warfarin?

A

2, 7, 9 and 10

22
Q

What are the key points of the cell based model of homeostasis?

A

Initiated by cell outside the vessel with tissue factor. Amplification and propagation takes place on the surface of platelets

23
Q

How does the antiplatelet effect of aspire work?

A

Inhibtion of COX stops thromboxane A2 production.

24
Q

How does clopidogrel and ticagrelor work?

A

ADP inhibitors

25
Q

What is tirofiban?

A

glycoprotein 2b/a inhibitor for anti-platelets

26
Q

How doe glycoprotein 2b/a inhibitor work?

A

stop platelets aggregation

27
Q

How does fibrinolysis work?

A

Tissue plasminogen activator (t-PA) produces plasmin form plasminogen and competes with fibrin. Usually released from damaged endothelial cells.

28
Q

What is DIC?

A

Disseminated intravascular coagulation. Unrelgulated clotting arounds the body.

29
Q

What can cause DIC?

A

dilution - crystalloid etc.

Consumption - inflammation, malignancy and bleeding

30
Q

What is the lethal triad?

A
  • Hypothermia
  • Coagulopathy
  • Metabolic acidosis
31
Q

What is Becks triad?

A
  • raised JVP
  • muffled heart sounds
  • hypotension with narrow pulse pressure
    This indicates cardiac tamponade
32
Q

What is permissive hypotension?

A

Low than normal BP. Enough o perfuse major organs however low as possible in order to deceased bleeding.

33
Q

What investigations for a ruptured AAA?

A

abdominal ultrasound.

A CT angio is not in the guidelines however in practise it is used.

YEAR 3 Manchester Medicine (34 decks)

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