Abdominal Aortic Aneurysm

Question 1

What is an abdominal aortic aneurysm?

Answer 1

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

Question 2

What causes AAA?

Answer 2

No specific identifiable causes

Question 3

List 10 risk factors for AAA

Answer 3

Severe atherosclerotic damage to aortic wall  
FH
Smoking  
Male  
Age  
HTN
COPD
Hyperlipidaemia  
CTD: Marfan's, Ehlers-Danlos syndrome  
Inflammatory disorders: Behcet's disease

Question 4

Describe symptoms of an unruptured AAA

Answer 4

NO SYMPTOMS
Usually an incidental finding
May have pain in the back, abdomen, loin or groin

Question 5

List 3 symptoms of a ruptured AAA

Answer 5

Pain in abdomen, back or loin (sudden or severe)
Syncope
Shock: degree depends on site of rupture + whether it is contained

Question 6

List 3 signs of AAA

Answer 6

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

Question 7

What bloods should be ordered in AAA?

Answer 7

FBC: Leukocytosis if infectious AAA
Clotting screen (Clot could block supply to legs)
Renal function
Liver function  
X-match if surgery planned

Question 8

What imaging investigations should be performed in AAA?

Answer 8

Abdominal US: detects aneurysm but CANT tell whether it is leaking or not
CT with contrast: shows whether aneurysm has ruptured
MRI angiography: pre-op assessment

Question 9

What is the definitive test for AAA?

Answer 9

Abdominal Ultrasound

Question 10

What triad characterises a ruptured AAA?

Answer 10

Abdominal +/- back pain
Pulsatile abdominal mass
Hypotension