Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardiovascular > AAA > Flashcards

AAA Flashcards

1
Q

What is the definition of an aneurysm?

A

An artery with a dilation of >50% its original diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different classifications of aneurysms?

A

True and false (pseudoaneurysm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a true aneurysm?

A

An aneurysm that involves all layers of the arterial wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a pseudoaneurysm?

A

An aneurysm that involves a collection of blood in the outer layer (adventita) that still communicates with that lumen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can aneurysms be in the shape of?

A

Fusiform (symmetrical) (most AAAs)

Sac-like (unsymmetrical, berry-aneurysms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the causes of aneurysms?

A 
atheroma
trauma
infection
connective tissue disorders (ehler's danlos)
inflammatory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which common aneurym causing infections are there?

A

Endocarditis - mycotic aneurysm

Tertiary syphilis - thoracic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give an example of a connective tissue disease

A

Marfan’s Syndrome

Ehlers-Danlos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give an inflammatory cause of aneurysms

A

Takayasu’s aortitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the most common sites of aneurysms?

A 
Aorta (infrarenal)
Thoracic aorta
Suprarenal
Iliac
Femoral
Popliteal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the complications of an aneurysm?

A 
Rupture
Thrombosis (DVT)
Pressure on other structures (ureter)
Embolism (PE/stroke)
AV Fistulae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Is there screening for AAA?

A

Yes. All men aged over 65 are invited for screening in the UK. This decreases mortality from rupture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs/symptoms of an AAA?

A

Intermittent or continuous abdominal pains radiating to back/iliac/fossa/groin
Collapse
Abdominal mass
Shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the sizes of an AAAs?

A

Ectasia<3.5cm
Small aneurysm <4.5cm
Large >5.5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How big is a normal aorta for men and women?

A

Women 2cm

Men 2.5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does prevalence of AAA change with sex?

A

Men 3x more than women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What, pathologically, causes AAAs?

A

Generation of elastic lamaellae - atherosclerosis

There is a genetic component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the size at which we begin to worry? and why?

A

> 5.5cm (5.2cm female)
If <5.5cm there is a less than 1% risk of rupture/yr.
At 6cm roughly 7%
At 8cm roughly 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What increases the chances of rupture?

A

> BP
Smoking
Familial history
Male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the surgical options?

A

Elective surgery to replace with plastic graft, tube or bifucation.
BIG OPERATION
EVAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When do we do elective surgery?

A

When aneurysm is >5.5cm, growing by >1cm per year, or symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is EVAR?

A

Endovascular arterial repair

Go up through the femoral artery and stent the aorta using a metal coil an synthetic graft, guided by X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the risks of EVAR and elective surgery?

A

EVAR - smaller risk of death but higher graft complication risk e.g. stent leak (endoleak)

ES - 5% complications including spinal/visceral ichaemia and emboli

24
Q

What is the plan of action for an AAA in an emergency situation?

A

Activate major haemorrhage protocol
Give blood to maintain SBP of about 90mmHg
Summon vascular surgeon and anaesthetist
Do ECG, bloods for amylase, Hb, coag, U+Es, crossmatch, ABG
Catheterise the bladder
2x large bore IV access
Take to theatre straight away, but if uncertain, a CT scan might help.

25
What are the risk factors for an AAA?
HTN CAD Smoking
26
What does emergency surgery involve?
Clamping the aorta above the leak and inserting a Dacron graft (tube graft). If an iliac aneurysm, can do trouser graft to the iliac artery.
27
How many people die ruptured AAA?
41% with surgery | 100% without
28
What are the common causes of sudden, severe abdominal pain with high pulse and low BP?
``` Perforation Acute pancreatitis Biliary colic/acute cholangitis Mesenteric Occlusion Ruptured AAA ```
29
Does a clinical examination always pick up AAA?
No, high chance you can miss it
30
What are differences in leg symptoms with AAA and dissection/PVD?
Ruptured AAA would cause bilateral limb ischaemia whereas PVD/dissection are more likely to cause unilateral leg ischaemia
31
What does an expansile mass make your fingers do?
Pulse outwards
32
What are the branches of the coeliac trunk?
Left gastric Common hepatic Splenic
33
At which level does the coeliac trunk lie?
L1
34
What are the branches of the abdominal aorta?
``` Inferior Phrenic Coeliac Suprarenal Renal SMA Gonads IMA Lumbar ```
35
Which types of clamping can occur in open AAA repair?
Supra-coeliac clamping Supra-renal clamping Infra-renal clamping
36
What are the pros and cons of the different types of clamping?
Supra-coeliac - highest stress on the heart and ischaemia to all organ of the gut and below (w/reperfusion injury) risk of renal failure Supra-renal - high stress on the heart with ischaemia and repe injury to organs of mid, hind gut and below, risk of renal failure Infra-renal - relatively less stress on the heart but ischaemia to all the organs below the kidneys (mid and hind gut)
37
What do we call dilations that aren't quite aneurysms yet?
Ectasia if up to 50% | Arteriomegaly if generalised dilation
38
What is the most common AAA?
Infrarenal
39
How does smoking increase the chance of an AAA?
1 in 25 random | 1 in 6 smoking
40
What is the typical AAA patient?
``` Male over 60 HTN Smoker FH ```
41
Where do you palpate for an aortic aneurysm?
Above umbilicus
42
What is the major risk of open surgery with AAA?
Where you put the clamp, due to stress on heart and renal failure
43
What is the mortality of open surgery?
5%
44
What is the mortality of endovascular surgery?
2%
45
How many people are suitable for EVAR?
around 70%
46
What is the follow up of EVAR?
Lifelong with duplex/CT | 6-8% need more surgery due to leak or increased pressure
47
Which is the most dangerous aneurysm to repair?
Thoracic
48
Which aneurysm are often bilateral?
Popliteal
49
What are the complications of popliteal aneurysm?
Acute limb ischaemia
50
What is the triad of collapse?
Hypotension Collapse Lower back/flank pain
51
What is the significance of triad of collapse?
ANYONE WHO PRESENTS WITH THIS HAS A RUPTURED ANEURYSM UNTIL PROVEN OTHERWISE
52
What is AAA a local manifestation of?
Arterial disease
53
What is indapamide?
Thiazide like diuretic
54
What are side effects of sitagliptin and amlodipine?
Ankle oedema!
55
What is tazocin?
It is a penicillin antibiotic

Cardiovascular (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions