Abdominal aortic aneurysm

Question 1

What is a true or false aneurysm

Answer 1

True - involves all layers of the arterial wall whereas false aneurysm doesn’t.
Aneurysm = >50% dilation of an artery.

Question 2

IX for AAA

Answer 2

Abdominal ultrasound - Screening as most AAA are asymptomatic.
Full history and exam,
Comorbidities
CT Angiogram
CPEX to assess cardiorespiratory fitness
Renal function

Question 3

What are the results of screening for AAA?

Answer 3

< 3cm then no action
3-4.4cm then rescan every 12 months
4.5-5.4cm then rescan every 3 months
>5,5cm then 2 week referral to vascular surgery

Question 4

What are the treatment options for AAA?

Answer 4

Open repair
Endovascular aneurysm repair (EVAR)
Conservative

Question 5

Presentation and management of a ruptured AAA?

Answer 5

Presentation: Sudden onset severe back/lower abdominal pain. Cardiovascular instability or collapse.
Management: Imaging - FAST scan
Resuscitation - but do not delay repair
Repair - Open or EVAR

Question 6

What are the differential diagnosis of a AAA?

Answer 6

Renal colic - AAA can also present with abdo pain which radiates to groin.
Pancreatitis
PUD
Diverticulitis