abdominal aortic aneurysm Flashcards

1
Q

what is aneurysm

A

permanent dilatation of the artery to twice the normal diameter

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2
Q

what is a true aneurysm

A

arterial wall forms the wall of the aneurysm

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3
Q

what arteries are usually involved

A
  • abdominal aorta
  • iliac
  • popliteal
  • femoral arteries
  • thoracic aorta
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4
Q

what are false aneurysm called

A

psuedoaneurysms

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5
Q

what is false aneurysms

A

surround tissues form the wall of the aneurysm

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6
Q

what can false aneurysms occur due to

A

femoral artery puncture

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7
Q

why do haematoma form

A

because of inadequate compression of the entry site and continued bleeding into the surrounding compressed soft tissue

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8
Q

where do AAA commonly occur

A

below the renal arteries

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9
Q

who gets AAA more men or women

A

men

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10
Q

what do aneurysms occur secondary to

A
  • atherosclerosis
  • infection
  • trauma
  • genetic
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11
Q

risk factors of AAA

A
  • age
  • male
  • family history.
  • smoking
  • hypertension
  • hypercholesterolaemia
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12
Q

does a normal <3cm require ultrasound

A

no

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13
Q

does small 3-4.4cm require ultrasound

A

annual ultrasound and surveillance from GP

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14
Q

does a medium 4.5-5.4cm require

A

quarterly ultrasound and cardiovascular prevention therapy

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15
Q

does a large >5.5cm require ultrasound

A

referred for assessment and elective repair

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16
Q

symptoms

A
  • asymptomatic

- severe pain

17
Q

what is the pain like

A

epigastric pain radiating to the back

18
Q

what does a ruptured AAA cause

A
  • hypotension
  • tachycardia
  • profound anaemia
  • sudden death
19
Q

what can the symptoms mimic

A
  • renal colic
  • diverticulitis
  • lower abdominal pain
  • testicular pain
20
Q

signs

A

pulsatile, expansile abdominal mass is felt

- trash feet

21
Q

what should be done to diagnose

A

ultrasound rather than CT

22
Q

what should be done for treatment

A

insert two wide-bore cannula and cross match 8 units of packed red cells

23
Q

when is an operation done

A

when aneurysm is:

  • > 5.5cm
  • expanding at a rate >1cm/year
  • symptomatic
24
Q

what do patients need careful control of

A
  • hypertension
  • smoking cessation
  • lipid lowering medication
25
what is standard therapy
open surgical repair
26
how is an endovascular stent inserted via
femoral or iliac arteries = non surgical approach
27
what is an alternative to open surgical repair
laparoscopic surgery
28
what is prognosis
after repair can return to normal repair within few months
29
who most likely gets thoraco-abdominal aneurysms
patients with Marfan's or hypertension
30
what do descending or arch thoraco-abdominal aneurysms occur secondary to o
atherosclerosis and are rarely due to syphilis
31
how are most aneurysms found
on routine CXR or cardio investigations
32
what can rapid expansion of aorta cause symptoms
- severe chest pain (radiating to upper back) - stridor - haemoptysis - hoarseness
33
what is rupture associated with
- hypotension - tachycardia - death
34
what investigation are done for thoraco-abdominal aneurysms
- CT or MRI - aortography - transoesophageal echo
35
what is used for assessment of thoraco-abdominal aneurysms
CT or MRI
36
when is operative repair done
aneurysm >6cm