Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YR6 VASCULAR > Aortic aneurysm > Flashcards

Aortic aneurysm Flashcards

1
Q

What is an abdominal aortic aneurysm?

A

DIlation of the abdominal aorta to >50% of normal diameter/ >,3cm, involving all 3 layers of the endothelium

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

What is the normal diameter of the infrarenal aorta in over 50s?

A

F: 1.5cm
M: 1.7cm

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

Describe epidemiology of AAA

A

Peak 60-70y
M > F

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

List 6 risk factors for AAA

A

SMOKING
HTN
FH
COPD
Coronary, cerebrovascular or PAD
Hyperlipidaemia

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

List 3 genetic condition associated with development of AAA

A

Ehlers Danlos
Marfans
Turners

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

Where do most AAA’s occur?

A

90% occur below renal arteries
(10% above)

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

What are the 2 shapes of AAA?

A

Fusiform (equally round)
Saccular (outpouching)

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

Describe the nature of AAA’s

A

Usually asymptomatic or have nonspecific Sx
Often discovered incidentally on US or CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What may be found on examination in AAA?

A

Bruit on auscultation
Pulsatile, expansile mass in abdomen

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

What is the process for AAA screening?

A

In males >65y: single abdominal USS
<3cm = normal, no further action
If AAA:
3-4.4cm: small- rescan every 12m
4.5-5.5cm: medium- rescan every 3m
>5.5cm: 2ww to vascular for probable intervention

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

Give 2 features suggestive of low rupture risk in AAA. What should ongoing management be?

A

Asymptomatic
Diameter <5.5 cm (small + med)
USS surveillance + optimise cardiovascular RFs

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

Give 2 features suggestive of high rupture risk in AAA. What should ongoing management be?

A

Symptomatic
Diameter >5.5cm or rapidly enlarging >1cm/ year
2ww referral to vascular surgery
Treat with EVAR or open surgery

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

Give 3 risk factors for AAA rupture

A

Rapidly expanding
Large diameter
Smoking

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

What operations are used for AAA repair?

A

EVAR
Stent placed in abdominal aorta via femoral artery to prevent blood collecting in the aneurysm

Open replacement
If young (longer recovery time but lower chance of further procedures)

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

Give 1 complication of EVAR

A

Endo-leak: stent fails to exclude blood from the aneurysm
Usually presents w/o Sx on routine f/u

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

What can ruptured AAA present similarly to?

A

Renal colic
Loin to groin pain

17
Q

What are 3 complications of AAA?

A

Rupture
Embolism (thrombotic material from aneurysm)
Aortic dissection

18
Q

How can ruptured AAA present?

A

Catastrophic: sudden collapse
Sub-acute: persistent severe central abdo pain with developing shock

19
Q

What is the mortality rate for ruptured AAA?

A

~80%

20
Q

What is the classic triad of ruptured AAA?

A

Hypotension due to hypovolaemic shock
Sudden onset severe, tearing back or abdo pain with radiation to the flank, buttocks, legs, or groin
Painful pulsatile mass

21
Q

Give 4 non-specific S/S of AAA rupture

A

Grey Turner +/or Cullen sign
N+V
Syncope (due to blood loss)
Haematuria

22
Q

Describe diagnostics in unstable patients with suspected AAA

A

Clinical Dx
Do NOT delay dx + Mx while waiting for imaging

23
Q

What is first line imaging in suspected AAA if not previously known to have AAA, is stable and this doesn’t delay intervention?

A

Aortic USS

24
Q

What imaging is performed in haemodynamically stable patients with ruptured AAA?

A

CT angiogram
Confirms rupture + evaluates whether endovascular repair is feasible

25
Q

Describe management of ruptured AAA

A

Urgent vascular review
Crossmatch 6 units blood

HD UNstable: clinical dx, send to theatre. If frail consider palliation

HD stable: CT angiogram if dx is in doubt + assess ability of endovascular repair

HD = Haemodynamically

26
Q

Describe initial management of ruptured AAA

A

Large bore IV access
Start continuous monitoring
Immediate haemodynamic support (fluid resus, blood transfusion)
Aim for definitive Tx within 90 mins

27
Q

Other than abdominal, what other aortic aneurysm can occur?

A

Thoracic aortic aneurysm

28
Q

Where is the most common site for thoracic aortic aneurysms?

A

Ascending aorta

29
Q

How may TAA’s present?

A

Most asymptomatic
If symptomatic: chest pressure, thoracic back pain, features of mediastinal compression e.g. difficulty swallowing

30
Q

What is the best confirmatory test for TAA’s?

A

CT angiography

31
Q

Describe management of TAA

A

All: reduction of cardiovascular RFs
Asymptomatic: surveillance + elective repair
Symptomatic + Ruptured: repair

32
Q

What are the approaches to surgical repair of TAA’s?

A

Open surgical repair (OSR): ascending aorta + aortic arch
Thoracic endovascular aneurysm repair (TEVAR) or OSR: descending/ thoracoabdominal aneurysms

33
Q

Describe management of cardiovascular risk factors in TAA’s

A

BP Mx: reduce aortic wall stress- BB, ACEi, ARBs
Smoking cessation
Lipid profile optimisation: statins

YR6 VASCULAR (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions