abdominal aortic aneurysm -AAA

Question 1

best chance of survival

Answer 1

early diagnosis
prompt resuscitation
rapid transfer to theatre

Question 2

MC type and site

Answer 2

saccular
infrarenal site

Question 3

rupture cause hemorrhage- which site?

Answer 3

retroperitoneum

Question 4

what will happen if aneurysm extends involve the renal artery

Answer 4

difficulties during surgery
increase post op complications

Question 5

classic history

Answer 5

sudden in onset
severe in nature
central abdominal or back pain esp. in known cases

Question 6

other presentations

Answer 6

PEA
cardiac arrest
painless sudden collapse

Question 7

on examination

Answer 7

distressed
tachycardia
hypotension
sweating
pale
mottled skin of lower body
tender pulsatile abdominal mass

Question 8

differential diagnosis esp. in elderly patients who presents with back/abdominal pain and/or collapse

Answer 8

ureteric colic

Question 9

diagnosis -investigations

Answer 9

Abdominal U/S
CT scan- if renal failure or contrast allergy then pain CT scan

Question 10

management

Answer 10

-high flow oxygen
-2 large bore IV cannulas
-baseline bloods
-glucose
-coagulation screen
-LFTs
-emergency cross match
-O neg blood
-IV analgesia
-IV antiemetics
-CXR
-ECG
-radial line
-urinary catheter
-avoid excessive IV fluid resuscitation (SBP >90)
-inform ICU, emergency theatre staff
-refer to vascular team -open or endovascular repair

Question 11

abdominal/back pain after previous surgery for aortic aneurysm?

Answer 11

-infection of the graft
-anastomotic leak
-endoleak
-fistula