AAA Flashcards

1
Q

AAA

A

Abdominal Aortic Aneurism

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2
Q

What physiologically causes AAA

A

Loss of elastin and collagen in arteries. degernerative process. affected by amount of pressure applied to walls

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3
Q

Predisposing Factors for AAA

A
  • 5x more common in males
  • Familial Link
  • Genetic - common in Marfans
  • Age >50
  • Smoking
  • CAD
  • HTN
  • COPD
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4
Q

Symptoms of Un-ruptured AAA

A
  • Vague abd - belt-like tightening on abd
  • back pain - from pressing on spinal nerves
  • Related symptoms of AAA pressing on other structures
    • Nausea/vomiting - pressing on GI viscera
  • Ischemia from embolization resulting from aneurism
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5
Q

Symptoms of AAA Rupture

A

-Hypovolemic Shock
-PEA arrest
-if RPB - may have radiating groin pain and swelling
Symptoms Triad:
-Severe Abd pain
-Hypotension
-Pulsatile Mass

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6
Q

When to operate?

A

> 5.5cm, measured on CT/US

-or of course if its ruptured

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7
Q

Declamping shock

A
  • area proximal to area has increased preload to heart, inc HTN, inc afterload, activating PNS to compensate
  • area distal to aorta has been ischmic during procedur,e, leading to significant vasodilation from CO2 buildup
  • When blood flow through aorta is suddenly returned. preload tanks, afterload drops in to boggy vasodilated systemic circulation, CO dec. acidosis from lactate and CO2. takes a bit to normalize. dec effect by slow unclamping
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8
Q

Post op complications

A
  • Dysrhythmias
  • embolism
  • fluid imbalance
  • CNS effects from ischemia during clamp
  • organ ischemia distal to clamp
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