Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Vascular Surgery > 2: Arterial Aneurysms > Flashcards

2: Arterial Aneurysms Flashcards

(81 cards)

Start Studying
1
Q

Define aneurysm

A

Dilation of a blood vessel to more than 50% of it’s original diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define an abdominal aortic aneurysm

A

Dilation of abdominal aorta to more than 3cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What age is the peak incidence for AAA

A

60-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which gender is AAA more common in

A

Males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What ethnicity is AAA more common in

A

Caucascians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What factors are thought to cause AAA

A

Atherosclerosis
Connective tissue diseases (Marfan, Ehlers)
Infection (Syhphillis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most important risk factor for AAA

A

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are 5 risk factors for AAA

A 
HTN
Hyperlipidaemia
FH
Male
Smoking 
Age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a protective factor for AAA

A

Diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do the majority of AAA present

A

Incidentally on screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If AAAs present clinically, what symptoms may they present with

A

Back Pain
Limb ischaemia - due to embolisation
Pulsatile abdominal mass
Abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain the NHS screening program for abdominal aortic aneurysms

A

Men are invited for a one-off abdominal US scan at 65 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If a males screening test returns as below 3cm what is done

A

This is the normal diameter of the abdominal aorta so they are not invited for screening again

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If AAA is >5.5cm on screening, how soon should individuals have a vascular review

A

Within 2W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If AAA is >3-5.4 cm on screening, how soon should individuals have a vascular review

A

Within 12W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What additional imaging option should be done for individuals with AAA >5.5cm

A

CT w/contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How often should an individual with an AAA of 3-4.4 be followed by AUS

A

Annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How often should an individual with AAA of 4.5-5.4 be followed by AUS

A

3 monthly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the risk of AAA 3 - 5.4 cm rupturing

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How should AAA of 3-5.4cm be managed

A

Optimise risk factors including:

  • anti-HTN
  • Smoking cessation
  • Statin
  • Diabetic medication
  • Aspirin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the three indications for operating on an AAA

A
  1. > 5.5cm
  2. Expanding at a rate of >1cm/year
  3. Symptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What rate does an AAA have to be expanding per year to be operated

A

> 1 cm per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the two treatment options for repairing a non-ruptured AAA

A
  1. Endovascular repair

2. Open repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Explain an Endovascular repair

A

Graft is inserted through the femoral artery into AAA and stent put across

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the advantage of Endovascular repair in the short-term
- Shorter hospital stay | - 30d mortality rate
26
What is the problem with Endovascular repair in long-run
Higher rates of re-innervation
27
What is the 2-year mortality rate for endovascular repair compared to open
Same
28
what does open repair involve
Midline laparotomy
29
what are four complications of AAA
1. Rupture 2. Distal embolisation 3. Retroperitoneal leak 4. Aorta-duodenal fistula
30
What is a true aneurysm
dilation of all three layers of the vascular wall
31
What is a false aneurysm
rupture in intima - meaning haematoma collects between vascular layers
32
What is the most common site of AAA
infra-renal
33
Is AAA or thoracic aortic aneurysm more common
AAA
34
What is the most common site of a thoracic aorta
ascending aorta
35
Who should receive a statin
1. Individuals with cardiovascular disease including TIA, Cerebrovascular disease, IHD, PAD 2. QRISK2 score >10% 3. T1DM diagnosed over 10-year ago or aged >40Y with known nephropathy
36
What time of day should statins be taken and why
Night time - as this is when majority of cholesterol synthesis occurs
37
What are the criteria for primary prevention dose of statins
1. QRISK2 >10% 2. CKD eGFR <60 3. T1DM
38
What dose of statins is given as primary prevention
20mg
39
What is the criteria for secondary prevention statins
established cardiovascular disease
40
What dose is given as secondary prevention
80mg
41
How will an individual with a ruptured AAA present
- abdominal pain that radiates to the back | - haemodynamically compromised
42
How will individual with ruptured thoracic aortic aneurysm present
tearing chest pain radiating to the back
43
As the thoracic dissection expands, what arteries are affected if a person presents with following symptoms a. hemiplegia b. paraplegia c. anuria
a. carotid arteries b. anterior spinal arteries c. renal arteries
44
What is a complication of endovascular aneurysm repair
endoleak
45
what is an Endoleak
there is a leak in the prosthetic graft used to stent the aneurysm
46
what is the problem with Endoleaks
leaks are asymptomatic until severe and individual haemodynamically compromised - therefore requires regular post-op US
47
what is the most common type of Endoleaks following thoracic AA repairs
type 1
48
what is a type 1 endoleak
leak at the end of the graft due to an inadequate seal
49
what is the most common type of Endoleaks in AAA repairs
type 2
50
what is a type 2 endoleak
leak at branching vessels
51
what is a type 3 endoleak
leak occurs due to defect in fabric graft
52
what is a type 4 endoleak
leak due to porosity in the graft
53
what is a type 5 endoleaks
continued aneurysm expansion with no demonstrable leak
54
what are four risk factors for rupture of AAA
1. Size of aneurysm 2. Female 3. Smoking 4. HTN
55
what is the classical triad of symptoms for ruptured AAA
1. Back pain 2. Hypotension 3. Pulsatile abdominal mass
56
what other symptoms may a ruptured AAA present with
Syncope | Vomiting
57
explain emergency work-up and management of patient with ruptured AAA
1. ECG 2. Bloods (Cross-Match, Amylase, U+Es) 3. IV access - Rh O-ve blood if compromised maintain systolic BP <100 to contain leak 4. Transfer to vascular unit
58
if patient with ruptured AAA is unstable what is done
Immediate transfer to surgery for open repair
59
if patient with ruptured AAA is stable what is done
CT angiogram and EVAR
60
how can a thoracic aortic aneurysm be divided
Anatomically into: - Ascending aorta (60%) - Aortic arch (10%) - Descending aorta (40%) - Thoracoabdominal aorta (10%)
61
what has a higher mortality TAA or AAA
TAA
62
what are 6 causes of thoracic AA
- Connective tissue disease - Bicuspid aortic valve - Aortic dissection - Tertiary syphillis - Takayasu's arteritis (Inflammation) - Trauma
63
what connective tissue diseases may cause thoracic AA
Ehlers Danlos | Marfans
64
which condition has a higher risk of bicuspid aortic valve and hence thoracic AA
Turner's syndrome
65
Give 5 risk factors for thoracic aortic aneurysms
``` Smoking HTN Atherosclerosis Age FH Obese Male ```
66
How are thoracic aortic aneurysms most commonly identified
incidental finding on imaging
67
In symptomatic individuals, how does TAA present
pain depending on site of aneurysm
68
If pain is in the ascending aorta, where is the TAA
anterior chest pain
69
If pain is in the neck, where is the TAA
aortic arch
70
If the aneurysm is in the descending thoracic aorta where is the thoracic aortic aneurysm
pain between the shoulder blades
71
Why may an individual have the following in thoracic aortic aneurysm a. back pain b. hoarse voice c. distended neck veins d. heart failure e. dyspnoea
a. due to aneurysm compressing spinal cord b. recurrent laryngeal nerve compression c. SVC compression d. aortic valve involvement e. tracheal obstruction
72
What is first-line investigation for thoracic abdominal aneurysm
CXR
73
what will be seen on CXR in thoracic abdominal aneurysm
widened mediastinum with possible tracheal deviation
74
what other imaging must be offered to those with thoracic AA to make a diagnosis
CT with contrast
75
what medical management is offered to those with thoracic aortic aneurysms
``` RF control: Smoking cessation Statin Anti-HTN Diabetic control Aspirin ```
76
when should ascending aortic aneurysms be operated on
>5.5cm
77
if the aortic valve is involved in an ascending aortic aneurysm what procedure is performed
Bentall procedure
78
what does the bentall procedure involve
Graft contains a prosthetic aortic valve
79
what is criteria for operating on aortic arch aneurysm
>5.5cm
80
what is criteria for operating on descending aortic aneurysm
>6cm
81
what type of thoracic aortic aneurysm has the highest mortality
aortic arch aneurysm

Vascular Surgery (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions