Abdominal Aortic Aneurysm

Question 1

What is the definition

Answer 1

Diameter >3cm

Question 2

What are risk factors

Answer 2

Male
Increased age
Smoking
HTN
FHx
Existing CVD

Question 3

What screening program is there for AAA?

Answer 3

Men at 65 years are offered a screening USS

Question 4

How does it present

Answer 4

Mostly asymptomatic
Non-specific abdo pain
Pulsatile and expansile mass
Incidental finding

Question 5

What investigations might you do

Answer 5

USS
CT angiogram

Question 6

How often should patients have surveillance scans for aneurysms 3-4.4cm

Answer 6

Yearly

Question 7

How often should patients have surveillance scans for aneurysms 4.5-5.4 cm

Answer 7

3 monthly

Question 8

What are indications for elective repair ?

Answer 8

Symptomatic
Diameter growing more than 1cm per year
Diameter >5.5 cm

Question 9

What are the rules regarding driving?

Answer 9

Inform DVLA if aneurysm above 6cm
Stop driving if above 6.5cm

Question 10

How does ruptured AAA present

Answer 10

severe abdo pain radiating to the back or groin
Haemodynamic instability
Pulsatile and expansile mass
collapse
loss of consciousness

Question 11

What is permissive hypotension

Answer 11

Strategy of aiming for a lower than normal blood pressure so that blood loss isn’t increased