aortic aneurysm

Question 1

define abdominal aortic aneurysm

Answer 1

focal dilatation of the abdominal aorta to more than 1.5 times its normal diameter

Question 2

AAA is more common in

Answer 2

men
smokers
age 60-70
hypertension
ASCVD
hypercholesterolaemia
family history

Question 3

pathophysiology

Answer 3

inflammation and proteolytic degeneraton of the connective tissue proteins (eg. collagen and elastin nd/or smooth muscle cells)
loss of structural integrity of the aortic wall
widening of the vessel
mechanical stress eg. high blood pressure
diltation and rupture

Question 4

is AAA usually symptomatic?

Answer 4

often asymptomatic and discovered incidentally in US or CT

Question 5

clinical features if symptomatic of AAA

Answer 5

if symptomatic:
lower back pain
pulsatile abdominal mass at or above the level of the umbilicus
bruit on aauscultation
peripheral thrombosis
decreased ankle-brachial index

Question 6

diagnosis of AAA

Answer 6

no lab findings specific for AAA
imaging needed
CTA AP for symptomatic patients

Question 7

when is it reasonable to do AAA screening

Answer 7

abdominal US for men 65-75 who have ever smoked

Question 8

deciding if an AAA needs surgery

Answer 8

bigger than 5cm
expanding rapidly
symptomatic
complications eg. rupture
saccular shape

Question 9

is thoracic or abdominal anurysm more common

Answer 9

abdominl

Question 10

risk factors for thoracic aortic aneurysm

Answer 10

arterial hypertension
bicuspid aortic valve
tertiary syphilis
connective tissue disease eg. Marfan syndrome, ehlers-donlos syndrome
trauma
smoking

Question 11

clinical features of TAA

Answer 11

feeling of pressure in the chest
thoracic back pain
signs of mediastinal obstruction eg. difficulty swallowing

Question 12

how are AAAs classified

Answer 12

either aaffecting the suprarenal or infrarenal aorta

Question 13

how are TAAs classified

Answer 13

either affecting the ascending aorta, descending aorta, or aortic arch