AAA

Question 1

typical presentation of rupture

Answer 1

sudden onset of epigastric/central abdominal pain radiating to back

Question 2

rupture may mimic

Answer 2

renal colic

Question 3

people with Marfans are more likely to get what aneurysm

Answer 3

dissecting

Question 4

dissecting aneurysm main location

Answer 4

thoracic aorta

Question 5

dissecting aneurysm features

Answer 5

acute chest pain with hypertension or shock

Question 6

berry aneurysm main location

Answer 6

branching points of circle of willis and cerebral arteries

Question 7

berry aneurysm rupture causes

Answer 7

subarachnoid haemorrhage

Question 8

pathogenesis of AAA - affects which layer of the wall

Answer 8

middle

Question 9

pathogenesis of AAA - what happens to enzymes and protein

Answer 9

imbalance in things that break down and build up - elastin and collagen

Question 10

pathogenesis of AAA - imbalance in proteins etc leads to

Answer 10

weakening of the wall - aneurysmal dilatation

Question 11

prevalence

Answer 11

age males > female

Question 12

presentation

Answer 12

75% asymptomatic 25% symptomatic

Question 13

what pain may AAA mimic

Answer 13

renal colic

Question 14

examination

Answer 14

pulsatile expansible mass

examine peripheral pulses

Question 15

screening

Answer 15

all men are screened at 65 years, decreasing mortality from rupture (75% are asymptomatic until rupture)

Question 16

imaging

Answer 16

duplex ultrasound and CT scan

Question 17

duplex ultrasound will show

Answer 17

AP diameter and whether there or not

Question 18

how to see if AAA has ruptured (imaging )

Answer 18

CT scan

Question 19

what phase is the CT scan in

Answer 19

arterial phase

Question 20

management options

Answer 20

open repair and EVAR

Question 21

open repair - mortality risk and effectiveness

Answer 21

possible in all patients greater mortality risk but effective for life

Question 22

EVAR - mortality risk and effectiveness

Answer 22

possible in 25% patients

less mortality risk, but may require follow up operations

Question 23

how is EVAR done

Answer 23

X ray guided

Question 24

when to intervene - symptomatic

Answer 24

pain, trashing or rupture

Question 25

when to intervene - asymptomatic

Answer 25

size: >5.5 AP diameter expanded >0.5cm/6 months or >1cm/year