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Year One - Cardiovascular System > Abdominal Aortic Aneurysm > Flashcards

Abdominal Aortic Aneurysm Flashcards

1
Q

What is an abdominal aortic aneurysm (AAA)?

A

It is a condition in which there weakening of the aortic wall, creating a bulge in the aorta

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2
Q

What is the pathological consequence of an abdominal aortic aneurysm?

A

The aneurysms can rupture, causing life threatening bleeding

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3
Q

What are the two classifications of abdominal aortic aneurysms?

A

True Abdominal Aortic Aneurysm

False Abdominal Aortic Aneurysm

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4
Q

What is a true abdominal aortic aneurysm?

A

It involve weakness and dilatation of all three layers of the aortic wall

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5
Q

What is a false abdominal aortic aneurysm?

A

It involve weakness and dilatation of a single layer of the aortic wall

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6
Q

Which aortic wall layer is involved in false abdominal aortic aneurysms?

A

Adventitia layer

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7
Q

What are the eight risk factors associated with abdominal aortic aneurysms?

A

Male Gender

Older Age > 65 Years Old

White Race

Family History

Hypertension

Syphilis

Connective Tissue Diseases

Smoking

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8
Q

Which two connective tissue diseases are associated with abdominal aortic aneurysms?

A

Ehlers Danos Type One

Marfan’s Syndrome

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9
Q

How do unruptured abdominal aortic aneurysms tend to present?

A

Asymptomatically

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10
Q

What are the three clinical features of unruptured abdominal aortic aneurysms?

A

Abdominal Pulsatile Mass

Central Abdominal Pain

Back Pain

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11
Q

What are the five clinical features of ruptured abdominal aortic aneurysms?

A

Sudden Collapse

Abdominal Pulsatile Mass

Severe Central Abdominal Pain

Severe Back Pain

Shock

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12
Q

What are the two features of shock?

A

Hypotension

Tachycardia

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13
Q

What two investigations are used to diagnose abdominal aortic aneurysms?

A

Ultrasound Scan

CT Angiogram

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14
Q

What is the first line investigation used to diagnose abdominal aortic aneurysms?

A

Ultrasound scan

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15
Q

What is the feature of abdominal aortic aneurysms on ultrasound scan?

A

Dilated aorta diameter > 3cm

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16
Q

What is the normal diameter of the aorta in females?

A

1.5cm

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17
Q

What is the normal diameter of the aorta in males?

A

1.7cm

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18
Q

What is the gold standard investigation used to diagnose abdominal aortic aneurysms?

A

CT angiogram

19
Q

What is the feature of abdominal aortic aneurysms on CT angiogram scan?

A

Dilated aorta diameter > 3cm

20
Q

Why are CT angiogram scans considered the gold standard investigation used to diagnose abdominal aortic aneurysms?

A

This imaging scan provides a more accurate measurement in comparison to an ultrasound scan

21
Q

What is the most appropriate investigation to conduct in individuals with a suspected ruptured aortic aneurysm, who are haemodynamically unstable?

A

None

Instead these patients should be taken to theatre immediately

22
Q

What is the most appropriate investigation to conduct in individuals with a suspected ruptured aortic aneurysm, who are haemodynamically stable?

A

CT scans

They can be conducted in where there is diagnostic doubt. It also enables assessment of endovascular repair suitability

23
Q

What is the aim of the abdominal aortic aneurysm screening programme?

A

It aims to detect aneurysms in the asymptomatic phase, prior to rupture

24
Q

Which patient group is offered abdominal aortic aneurysm screening?

A

Males > 65 years old

25
Q

What does the abdominal aortic aneurysm screening programme involve?

A

One time ultrasound scan

26
Q

What does an aorta diameter < 3cm indicate?

A

It indicates that there is no aneurysm present

27
Q

How do we manage individuals with an aorta diameter < 3cm?

A

The patient requires no further treatment or monitoring, and will not be invited for screening again

28
Q

What does an aorta diameter 3cm - 4.4cm indicate?

A

It indicates that there is a small aneurysm present

29
Q

How do we manage individuals with an aorta diameter 3cm - 4.4cm?

A

The patient requires no treatment due to a low risk of rupture occurrence

Instead, these individuals are invited annually for another screening scan

They are also advised on conservative measures that can prevent enlargement of the aorta – such as smoking cessation, healthy eating and regular exercise

30
Q

What does an aorta diameter 4.5cm - 5.4cm indicate?

A

It indicates that there is a medium sized aneurysm present

31
Q

How do we manage individuals with an aorta diameter 4.5cm - 5.4cm?

A

The patient requires no treatment due to a low risk of rupture occurrence

Instead, these individuals are invited every three months for another screening scan

They are also advised on conservative measures that can prevent enlargement of the aorta – such as smoking cessation, healthy eating and regular exercise

32
Q

What does an aorta diameter > 5.5cm indicate?

A

It indicates that there is a large aneurysm present

33
Q

How do we manage individuals with an aorta diameter > 5.5cm?

A

A 2 week referral to vascular surgery for surgical intervention

34
Q

What are the two other circumstances in which individuals should receive a 2 week referral to vascular surgery for surgical intervention?

A

Symptomatic

Rapidly enlarging aorta diameter > 1cm/year

35
Q

What are the two surgical management options for abdominal aortic aneurysms?

A

Endovascular Surgery

Open Repair Surgery

36
Q

What is the first line surgical management option for abdominal aortic aneurysms?

A

Endovascular surgery

37
Q

What is abdominal aortic aneurysm endovascular surgery?

A

It involves the insertion of a catheter through the femoral artery, which is then guided into aorta

A graft on the end of the catheter is placed at the site of the aneurysm, which strengthens the weakened section of the aorta in order to prevent rupture

38
Q

What is a common complication of endovascular surgery?

A

Endovascular leak

39
Q

What is an endovascular leak?

A

It occurs when the stent fails to exclude blood from the aneurysm

40
Q

What is the second line surgical management option for abdominal aortic aneurysms?

A

Open repair surgery

41
Q

How do endovascular leak complications present?

A

Asymptomatically on routine follow up

42
Q

What is abdominal aortic aneurysm open repair surgery?

A

It involves open abdominal surgery to remove the damaged aorta section and replace it with a graft

This strengthens the weakened section of the aorta in order to prevent rupture

43
Q

How do we manage ruptured abdominal aortic aneurysms?

A

An immediate vascular review is required to enable emergency surgical repair

44
Q

In terms of blood products, what is recommended to manage ruptured abdominal aortic aneurysms?

A

A crossmatch of 6 units of blood

Year One - Cardiovascular System (20 decks)

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