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MS3 - Vascular > Aneurysms (inc AAA) > Flashcards

Aneurysms (inc AAA) Flashcards

1
Q

Aneurysm definition

A

Dilatation of a blood vessel > 50% normal diameter

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2
Q

True aneurysm definition

A

Involves all layers of vessel wall

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3
Q

Types of true aneurysm

A

Fusiform - eg. AAA

Saccular - eg. Berry aneurysm

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4
Q

False aneurysm definition

A

Collection of blood around vessel wall which comminicates with vessel lumen

Usually iatrogenic - eg. cannulation, puncture

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5
Q

Dissection definition

A

Vessel dilatation caused by blood splaying apart media

Forms channel within the vessel wall

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6
Q

Complications of aneurysms

A

Rupture
Thrombosis
Pressure - DVT, oesophagus
Fistula (IVC, intestine)

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7
Q

Presentation of popliteal aneurysm

A

Easily palpabel popliteal pulse
50% bilateral
Rarely rupture
Thombosis and distal embolism

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8
Q

Management of popliteal aneurysm

A

Acute: embolectomy or fem-distal bypass

Stable: elective grafting + tie off vessel

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9
Q

Pathology of AAA

A

Abdominal aorta > 3 cm
90% infrarenal
30% involve iliac arteries

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10
Q

Presentation of AAA

A 
Usually asymptomatic
Back pain radiating to groin
Acute limb ischaemia
Blue toe syndrome - distal embolus
Acute rupture
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11
Q

Examination findings for AAA

A

Expansile mass
Bruits
Tenderness + shock suggests rupture

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12
Q

Ix for AAA

A

AXR - calcifications
Abdo US - screening + monitoring
CT/MRI - gold standard
Angiography

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13
Q

Management of AAA

A

Conservative - RFs

Surgical

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14
Q

Indications for surgical management of AAA

A

Symptomatic
Diameter > 5.5 cm
Rapidly expanding > 1 cm/yr
Causing complications

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15
Q

Open repair of AAA

A

Clamp aorta + bypass

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16
Q

EVAR of AAA

A

Endovascular aneurysm repair

“Stent” placed within aorta - reduces strain upon vessel wall

17
Q

AAA screening

A

UK men offered one time US screen at 65 yrs
Aneurysm identified - yearly monitoring
> 4.5 cm - 6 monthly monitoring
> 5.5 cm - consider surgery

18
Q

RFs for AAA rupture

A

HTN
Smoker
F
FH

19
Q

AAA rupture presentation

A 
Sudden onset severe abdo pain
Intermittant or continuous
Radiates to back or flanks
Collapse / shock
Cullen's / Grey-Turner's sign
20
Q

Emergency management of AAA rupture

A 
High flow O2
Fluid but keep SBP < 100 mmHg
xmatch 10 u
Major haemorrhage protocol
Analgesia
Abx prophylaxis - cef + met 
Clamp neck + insert graft

MS3 - Vascular (7 decks)

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