Abdominal Aortic Aneurysm Flashcards
What are the risk factors for an AAA. (3)
It is more common in patients above 60.
It is more common in men.
There may be a family history.
What are the typical causes of an AAA. (4)
Atherosclerotic.
Inflammatory (due to infection, eg E coli, salmonella).
Trauma.
Congenital (eg Marfan’s, Ehlers-Danlos).
Where do AAAs usually occur.
95% are infrarenal.
What is the biggest risk associated with AAAs.
Rupture.
What increases the risk of an AAA rupturing.
The risk of rupture increases exponentially with increasing diameter.
What are the symptoms of an AAA. (2)
May be asymptomatic.
Back or loin pain (most commonly intermittent or continuous).
What are the physical signs of an AAA. (3)
Pulsatile abdominal mass (if ruptured or rapidly expanding).
Patient may present with ‘Trash feet’ - dusky discoloration of the digits secondary to emboli from the aortic thrombus.
What percentage of the population over 60 have an AAA.
5%.
What symptoms does a rapidly expanding AAA cause. (2)
Severe epigastric pain, that radiates to the back.
What signs are associated with a ruptured AAA. (6)
Pulsatile Abdominal Mass. Hypotension. Tachycardia. Profound Anaemia. Sudden Death. Hypovolemic shock (if ruptured)
What is the differential diagnosis for AAA pain. (4)
Renal colic.
Diverticulitis.
Severe lower abdominal pain.
Testicular pain.
What signs are present in overweight patients with a potential AAA.
Usually none, as the aorta is retroperitoneal.
What are some complications associated with inflammatory aneurysms.(3)
They may obstruct adjacent structures. (eg vena cave, ureter, duodenum)
If a patient with haematemesis in the context of an AAA, what is the cause.
The haematemesis is secondary to an artoduodenal fistula.
What are some incidental presentations of an AAA. (3)
On physical exam.
Plain x-ray.
Abdominal ultrasound.
Where can AAA pain present. (5)
Pain location is dependent on the location of the AAA. Central abdomen. Back. Loin. Illiac Fossa. Groin.
What are some thromboembolic complications of an AAA. (2)
A thrombus within the aneurysm sac may be a source of emboli to the lower limbs.
Less commonly, the aorta may undergo thrombotic occlusion.
What signs are present if an AAA is compressing the duodenum. (2)
Obstruction.
Vomiting.
What signs are present if an AAA is compressing the inferior vena cava. (2)
Oedema.
DVT.
Where do AAA rupture. (3)
Retroperitoneum.
Peritoneal Cavity.
Any other surrounding structures.
What surrounding structure is a common location for AAA rupture.
Inferior vena cava.
What is a complication of AAA rupture near the inferior vena cava.
Aortocaval fistula.
What is an aneurysm.
An artery with a dilation of more than 50% of its original diameter.
What diameter is required to diagnosis an AAA on ultrasound.
More than 3cm.
What is the prevalence of AAA between men and women.
3:1 men:women.
In what group are AAA less common.
Diabetics.
What is the pathophysiology of AAA development.
Degeneration of elastic lamellae and smooth muscle loss.
