Abdominal aortic aneurysm

Question 1

Define AAA

Answer 1

Localised enlargement of the abdominal aorta - diameter >3cm or >50% larger than normal (2cm)

Question 2

Aetiology of AAA

Answer 2

No specific identifiable causes

Question 3

Presenting symptoms of AAA - unruptured

3

Answer 3

• No symptoms
• Usually found incidentally
• May have pain in back/abdomen/loin/groin

Question 4

Signs of AAA on physical examination

3

Answer 4

• Pulsatile & laterally expansile mass on bimanual palpation of AA
• Abdominal bruit
• Retroperitoneal haemorrhage can cause Grey-Turner’s sign

Question 5

Investigations for AAA

4

Answer 5

Bloods
US
CT w/ contrast
MRI angiography

Question 6

Risk factors for AAA

9

Answer 6

Severe atherosclerotic damage to aortic wall
FH
Smoking
Male
Age
Hypertension
Hyperlipidaemia
Connective tissue disorders (e.g. Marfan’s, Ehlers-Danlos)
Inflammatory disorders (Behcet’s disease, Takayasu’s arteritis)

Question 7

Presenting symptoms of AAA - ruptured

4

Answer 7

• Pain in abdomen/back/loin - Pain may be sudden/severe
• Syncope
• Shock (degree depends on rupture site & if it’s contained)

Question 8

Investigations for AAA - bloods

4

Answer 8

FBC
Clotting screen
Renal function
Liver function

Question 9

Investigations for AAA - US

Answer 9

Can detect aneurysm but CANNOT tell whether it’s leaking

Question 10

Investigations for AAA - CT w/ contrast

Answer 10

Can show whether aneurysm has ruptured