Abdominal Aortic Aneurysm Flashcards
1
Q
What is a AAA and what are the key parts of the definition?
A
PERMANENT pathological dilation of the abdominal aorta that is >1.5CM the expected diameter
2
Q
Where do most AAAs occur and why?
A
95% occur below the renal arteries because there is less elastin here.
3
Q
How might a AAA present?
A
most are asymptomatic
May present with:
- Palpable, pulsatile abdominal mass
- Abdo/back/groin pain
4
Q
What investigations would you do for a AAA?
A
- USS abdo - can visualise and measure the dilation - can also do CT/MRI
- FBC - leukocytosis, anaemia, raised CRP, ESR
- Aortography - pre-op
5
Q
How would you manage a ruptured AAA?
A
- RESUS
- Emergency EVAR surgery
- Peri-operative ABx
6
Q
How would you manage a symptomatic (non-ruptured) AAA?
A
- Pre-operative B-blockers
- EVAR
- Perioperative ABx
7
Q
How would you manage an asymptomatic AAA?
A
- Monitor with USS abdo every 6/12
- CVS risk control
- can do elective EVAR
8
Q
What are some possible complications of a AAA?
A
- Rupture, shock, death
- Thrombi and blue toe syndrome
- Ureteric/duodenal obstruction
- compression of vena cava
9
Q
What is the prognosis of a ruptured AAA?
A
90% mortality
10
Q
What are some key risk factors for AAA?
A
- Male
- ↑ age (due to calcification of wall)
- Smoking
- FHx
- Connective tissue disorders
- HTN
- Atherosclerosis
- Hyperlipidaemia
- COPD
11
Q
What are the 4 key pathophysiological mechanisms behind AAA formation?
A
- Degradation of the connective tissue
- Inflammatory response
- Biomechanical stress
- Genetics
