vascular (aorta)

Question 1

pathophysiology of AAA

Answer 1

failure of elastic proteins –> dilation of vessel

Question 2

RF AAA

Answer 2

smoking, hypertension, ehlers danlos, marfans, syphilis

Question 3

what screening is in place for AAAs

Answer 3

single abdo USS for males aged 65

Question 4

what is a normal AAA scan at USS + what follow up

Answer 4

<3cm –> nothing

Question 5

what is small anuerysm AAA scan at USS + what follow up

Answer 5

3-4.4cm –> rescan 12 months

Question 6

what is a medium aneurysm AAA scan at USS + what follow up

Answer 6

4.5-5.5cm –> rescan 3 months

Question 7

what is a large aneurysm AAA scan at USS + what follow up

Answer 7

> 5.5cm –> refer 2 week vascular

Question 8

what is a low rupture risk AAA

Answer 8

asymptomatic + <5.5 cm (small + medium)

Question 9

what is a high rupture AAA

Answer 9

symptomatic // >5.5cm // growing fast (1cm/year)

Question 10

how are unruptured AAA’s managed

Answer 10

elective endovascular repair (EVAR) (stent) or open repair

Question 11

presentation ruptured AAA

Answer 11

severe central abdo pain –> back // pulsatile mass // shock +/- collapse

Question 12

mx ruptured AAA

Answer 12

surgical emergency

Question 13

what invx for ruptured AAA if clinical doubt

Answer 13

CT angio

Question 14

what is aortic dissection

Answer 14

tear in tunica intima –> pain

Question 15

what biggest RF for aortic dissection

Answer 15

hypertension

Question 16

other rf for aortic dissection

Answer 16

trauma // bicuspid aortic valve // collagen def // Turner’s // pregnancy // syphilis

Question 17

where do type A aortic dissections occur + where would pain occur

Answer 17

ascending aorta (more dangerous) + chest pain

Question 18

where do type B aortic dissections occur + where would pain occur

Answer 18

descending aorta + upper back pain

Question 19

presentation aortic dissection

Answer 19

chest or back pain // weak pulses or variation between arms // aortic regurg

Question 20

if coronary arteries are involved in aortic dissection what sympoms can occur

Answer 20

angina

Question 21

if spinal arteries are involved in aortic dissection what symptoms can occur

Answer 21

paraplegia

Question 22

if distal aorta are involved in aortic dissection what sympoms can occur

Answer 22

limb ischamia

Question 23

what classifications are used for aortic dissection

Answer 23

standford (type A + B) // DeKabey (type I,II,III)

Question 24

imaging in aortic dissection (3)

Answer 24

CXR = widened mediastinum // CT angio chest, abdo, pelvis: false lumen // TOE

Question 25

when would transoesophageal echo (TOE) be indicated in aortic dissection

Answer 25

patients who are too unstable for CT

Question 26

mx type A aortic dissection

Answer 26

surgical + systolic BP 100-120 (IV labetolol)

Question 27

mx type B aortic dissection

Answer 27

IV labetolol + bed rest

Question 28

complications of a backwards aortic tear

Answer 28

aortic regurg // MI

Question 29

complications of a forwards aortic tear

Answer 29

unequal BP in arms // stroke // renal failure

Question 30

what is takayasu’s arteritis

Answer 30

large vessel vasculitis –> occlusion of aorta

Question 31

who normally develops takayasu’s arteritis

Answer 31

femals 10-40 asian

Question 32

symptoms takayasu’s arteritis

Answer 32

weak peripheral pulse // unequal arm BP // carotid bruit // aortic regurg // limb claudication // headache + malaise

Question 33

assoc with takayasu’s arteritis

Answer 33

renal artery stenosis

Question 34

imaging takayasu’s arteritis

Answer 34

MRA or CT angio