abdominal aortic aneurysm

Question 1

what is aneurysm

Answer 1

permanent dilatation of the artery to twice the normal diameter

Question 2

what is a true aneurysm

Answer 2

arterial wall forms the wall of the aneurysm

Question 3

what arteries are usually involved

Answer 3

• abdominal aorta
• iliac
• popliteal
• femoral arteries
• thoracic aorta

Question 4

what are false aneurysm called

Answer 4

psuedoaneurysms

Question 5

what is false aneurysms

Answer 5

surround tissues form the wall of the aneurysm

Question 6

what can false aneurysms occur due to

Answer 6

femoral artery puncture

Question 7

why do haematoma form

Answer 7

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

Question 8

where do AAA commonly occur

Answer 8

below the renal arteries

Question 9

who gets AAA more men or women

Answer 9

men

Question 10

what do aneurysms occur secondary to

Answer 10

• atherosclerosis
• infection
• trauma
• genetic

Question 11

risk factors of AAA

Answer 11

• age
• male
• family history.
• smoking
• hypertension
• hypercholesterolaemia

Question 12

does a normal <3cm require ultrasound

Answer 12

no

Question 13

does small 3-4.4cm require ultrasound

Answer 13

annual ultrasound and surveillance from GP

Question 14

does a medium 4.5-5.4cm require

Answer 14

quarterly ultrasound and cardiovascular prevention therapy

Question 15

does a large >5.5cm require ultrasound

Answer 15

referred for assessment and elective repair

Question 16

symptoms

Answer 16

• asymptomatic

- severe pain

Question 17

what is the pain like

Answer 17

epigastric pain radiating to the back

Question 18

what does a ruptured AAA cause

Answer 18

• hypotension
• tachycardia
• profound anaemia
• sudden death

Question 19

what can the symptoms mimic

Answer 19

• renal colic
• diverticulitis
• lower abdominal pain
• testicular pain

Question 20

signs

Answer 20

pulsatile, expansile abdominal mass is felt

- trash feet

Question 21

what should be done to diagnose

Answer 21

ultrasound rather than CT

Question 22

what should be done for treatment

Answer 22

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

Question 23

when is an operation done

Answer 23

when aneurysm is:

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

Question 24

what do patients need careful control of

Answer 24

• hypertension
• smoking cessation
• lipid lowering medication

Question 25

what is standard therapy

Answer 25

open surgical repair

Question 26

how is an endovascular stent inserted via

Answer 26

femoral or iliac arteries = non surgical approach

Question 27

what is an alternative to open surgical repair

Answer 27

laparoscopic surgery

Question 28

what is prognosis

Answer 28

after repair can return to normal repair within few months

Question 29

who most likely gets thoraco-abdominal aneurysms

Answer 29

patients with Marfan’s or hypertension

Question 30

what do descending or arch thoraco-abdominal aneurysms occur secondary to o

Answer 30

atherosclerosis and are rarely due to syphilis

Question 31

how are most aneurysms found

Answer 31

on routine CXR or cardio investigations

Question 32

what can rapid expansion of aorta cause symptoms

Answer 32

• severe chest pain (radiating to upper back)
• stridor
• haemoptysis
• hoarseness

Question 33

what is rupture associated with

Answer 33

• hypotension
• tachycardia
• death

Question 34

what investigation are done for thoraco-abdominal aneurysms

Answer 34

• CT or MRI
• aortography
• transoesophageal echo

Question 35

what is used for assessment of thoraco-abdominal aneurysms

Answer 35

CT or MRI

Question 36

when is operative repair done

Answer 36

aneurysm >6cm