Abdominal Aortic Aneurysm

Question 1

epidemiology of AAA

Answer 1

abdominal accounts for 3/4, 3% of population, male 3x more likely. elderly.
risk factors
smokers/males/white
70-90 years

Question 2

aetiology of AAA?

Answer 2

atherosclerosis, hypertension, diabetes, inflammatory conditions such as RA.
/infection/trauma or endocarditis
Smoking, family history, marfans

Question 3

pathogensis of AAA

Answer 3

distension, weakening wall usually at bifurcation of aorta.
mutlifactors in cause
chronic inflammation
decreased tensile strength of smooth muscle

Question 4

natural history of AAA

Answer 4

slow developing ‘wait and see’
sudden enlargement = emergency
20 percent rupture

Question 5

symptoms of AAA

Answer 5

steady boring lumbosacral and abdominal pain. Sometimes nausea and vomiting.

if thoracic - difficulty breathing, swallowing, hoarseness.

may be asymptomatic

Question 6

signs of AAA

Answer 6

pulsitile palpable mass >3cm wide. - if palpable 40% chance of aneurysm

Question 7

complications of AAA

Answer 7

kidney affected, lower limb claudication, embolism, rupture -> internal bleeding, shock

Question 8

prognosis

Answer 8

rupture 20% chance
50% treated still die
untreated fatal