aneurysms

Question 1

what is an aneurysm

Answer 1

an aneurysm is an increase in diameter in an artery greater than 1.5 times of normal and involves all layers

Question 2

pathophysiology of an aneurysm

Question 3

aneurysmal diameter of the intrarenal aorta

Answer 3

greater than 3 cm

Question 4

what is the diameter of an aneurysmal common iliac

Answer 4

greater than 1.5 cm

Question 5

what is the diameter of an aneurysmal popliteal artery

Answer 5

greater than 1.1 cm

Question 6

what is a true aneurysm

Answer 6

there is enlargement on both or one side of the artery ,the enlargement is uniform on all the layers of the artery.

Question 7

false aneurysm

Answer 7

an aneurysm that there is no uniform enlargement

Question 9

what are the risk factors for aneurysms

Answer 9

males
increased age
positive family history
connective tissue disorder
smoking and hypertension

Question 10

why does RAA have a higher mortality ?

Answer 10

patients can rapidly lose their entire circulating volume in the peritoneal cavity

Question 11

size of the aneurysm and the risk of rupture

Answer 11

AAA size​ Annual rupture risk​

<4cm​ <0.5%​

4 – 4.9cm​ 0.5% - 5% ​

5 – 5.9cm​ 3% - 15%​

6 – 6.9cm​ 10 – 20%​

7 – 7.9cm 20 – 40%​

> 8cm​ 30 – 50%​

Question 12

how can aneurysms be prevented

Answer 12

all men above 65 are eligible for screening

Question 13

what are the outcomes for aneurysm screening

Answer 13

less than 3 discharged
between 3 and 5,5 surveillance
above 5.5 vascular surgery

Question 14

how is the diameter of the of the aneurysm measured

Answer 14

from anterior to posterior

Question 15

results of clinical examination

Answer 15

palpation of a mass just above the umbilicus
presence of a popliteal aneurysm on palpation have a chance of AAA.

Question 16

past medical history that may be suggestive of IHD myoc

Question 17

treatment options for aneurysms

Answer 17

​

Laparotomy​

​Cross-clamp abdominal aorta​

​Open aneurysm sac​

​Sew graft proximally and distally​

​Close abdomen ​

Question 18

EVAR

Answer 18

acces through the femoral artery with wires and catheters and they are ballooned to give a good seal with special closure devices

Question 19

what are the advantages of open surgery

Answer 19

higher upfront
with good long term outcomes
no long term surveillance

Question 21

what are the considerations before surgery for an aneurysm

Answer 21

whether the patient is fit for an open surgery if there would be any recovery

Question 22

assessment of pre operative fitness

Answer 22

blood tests
ECG
cardiopulmonary exercise
anaesthetic review

Question 23

car or motorcycle license in the case of an AAA

Answer 23

you must tell DVLA if there is an aneurysms
you must not drive if the aneurysm is greater than 5.5

Question 24

symptoms of an aneurysm

Answer 24

pain in the abdomen
hypotension

Question 25

management of ruptured AAA

Answer 25

CT angiogram haemorrhage protocol analgesia full blood count lactate in ABG no IV fluids permissive hypotension

Question 26

what are complications that come with aneurysms

Answer 26

rupture of the aneurysms thrombosis embolus dislodging compression on the sites and the size

Question 27

thrombosis and aneurysms

Answer 27

there would be clotting of the blood that is pooled / stagnated on the blood

Question 28

management of trash from popliteal artery aneurysm

Answer 28

ct angiogram anticoagulation analgesia of course so much pain