Abdominal Aortic Aneurysms

benryan95's version from 2015-10-22 18:19

Section 1

Question Answer
What is the definition of an AAA?A permanent pathological dilation of the aorta with a diameter > 1.5 times the expected AP diameter of that segment
what % of AAAs originate below the renal arteries?90%
Are AAAs more common in men or women?Men
What in tissues may diminish the integrity of the arterial wall, contributing to AAAs?metalloproteinases
There are 3 specific types of AAAs, what are they?Congenital, Infectious (Rare), Inflammatory
Name 2 congenital conditions that predispose to AAAs?Bicuspid aortic valve disease, Marfan's syndrome
What are key risk factors for AAA?Cigarette smoking, family history, increased age, male sex, congenital/connective tissue disorders
Are palpable pulsatile abdominal masses common in AAA?No, has only been shown to be sensitive in thin patients and those with AAA > 5cm
What pain can be felt with an AAA?Abdominal, back or groin pain - however patients are usually asymptomatic
What is the 1st diagnostic test to order in screening/suspected AAA?Abdominal ultrasound
What other tests can be done for AAA?ESR/CRP, FBC, blood cultures, CT, magnetic resonance angiography, aortography
Why can blood cultures be done in AAA?Can indicate infectious AAA

Section 2

Question Answer
How is a ruptured AAA managed?Standard resuscitation measures, urgent surgical repair, perioperative antibiotic therapy
What is the target systolic pressure pre-operatively in a ruptured AAA?50-70 mmHg
Infusing more than what volume of fluid preoperatively may increase the relative risk of death?3.5 litres
What may aggressive fluid replacement cause?Dilutional and hypothermic coagulopathy, secondary clot disruption from increased blood flow, increased perfusion pressure and decreased blood viscosity thereby exacerbating bleeding
What is the most efficacious form of urgent surgical repair?Endovascular AAA repair, aortoiliac anatomy permitting - otherwise traditional open repair is performed
What size should an asymptomatic AAA be before it is repaired?5.5cm (in men, 5cm in women)
What is involved in an endovascular AAA repair?the transfemoral endoluminal delivery of a covered stent graft into the aorta
What is the mortality for ruptured AAA?90%
What should patients be instructed of the important of if at risk of, or following an AAA?smoking cessation, blood pressure and cholesterol control

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