Abdominal Aortic Aneurysm (AAA) Flashcards

1
Q

What is an Abdominal Aortic Aneurysm?

A

Dilatation of the abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the diameter of an abdominal aortic aneurysm?

A

More than 3cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does an AAA normally present?

A

Asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What ways can an AAA present?

A

Non-specific abdominal pain

Pulsatile and expansile mass in the abdomen when palpated with both hands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the initial investigation for an AAA?

A

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can be done to give a more detailed picture of the aneurysm?

A

CT angiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the classification of an AAA based on?

A

Size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the normal diameter of an abdominal aorta?

A

Less than 3cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the diameter of a small aneurysm?

A

3 – 4.4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the diameter of a medium AAA?

A

4.5 – 5.4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the diameter of a large AAA?

A

More than 5.5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is an AAA usually discovered?

A

An incidental finding on an abdominal x-ray, ultrasound or CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who is invited for screening for an AAA?

A

All men in England are offered a screening ultrasound scan at age 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can the risk of progression of an AAA be reduced?

A

Stop smoking
Healthy diet and exercise
Optimising the management of hypertension, diabetes and hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How often are people with an aneurysm 3-4.4cm screened?

A

Yearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How often are people with an aneurysm 4.5-5.4cm screened?

A

Every 3 months

17
Q

When is it suggested that elective repair is carried out in someone with an AAA?

A

Symptomatic aneurysm
Diameter growing more than 1cm per year
Diameter above 5.5cm

18
Q

What is elective surgical repair?

A

Inserting an artificial “graft” into the section of the aorta affected by the aneurysm

19
Q

What are the 2 methods of elective surgical repair?

A

–Open repair via a laparotomy

–Endovascular aneurysm repair (EVAR) using a stent inserted via the femoral arteries

20
Q

What does the risk of rupture increase with?

A

The diameter of the aneurysm

21
Q

How does a ruptured AAA present?

A

Severe abdominal pain that may radiate to the back or groin
Haemodynamic instability (hypotension and tachycardia)
Pulsatile and expansile mass in the abdomen
Collapse
Loss of consciousness

22
Q

How is a patient with a rupture AAA haemodynamically unstable?

A

Hypotension

Tachycardia

23
Q

What can be used to diagnose a ruptured AAA?

A

CT angiogram

24
Q

What type of emergency is a ruptured AAA?

A

Surgical emergency

25
What is the most common management of an AAA?
Endovascular aneurysm repair (EVAR) using a stent inserted via the femoral arteries
26
What are the main presenting features of a ruptured AAA?
Hypotensive and tachycardic severe, central abdominal pain radiating to the back pulsatile, expansile mass in the abdomen
27
What are the main RF for AAA?
- smoking - hypertension - hypercholesterolaemia - old age - male gender - diabetes mellitus - Marfan’s syndrome
28
What is the main complication of EVAR?
Endo-leak, where the stent fails to exclude blood from the aneurysm
29
What can rupture of the anneursym lead to?
Suddent death
30
What are the other possible complcations of an AAA?
Infection or thromboembolic phenomena--> acute ischaemia of the lower limbs
31
What are the other possible symptoms of AAA?
- compression of the femoral nerves, causing paraesthesia of the anterior thigh and quadriceps weakness - embolic phenomena leading to acute lower limb ischaemia