CC May 2017 Abdominal Aortic Aneurysm (AAA) Monitoring

echoecho's version from 2017-05-14 18:08


Question Answer
Strictest definition of AAA is a focal increase of >50% of the normal aortic diameter based on height, gender and age, for adults, a clinically useful definition is an area of the abdominal aorta that has a diameter of > ____ cm?3.0
Where do most AAAs occur due to the unique hemodynamic forces and embryo logic a origin of the smooth muscle cells here?below the take-off of the renal arteries
Is AAA formation different from atheromatous plaque formation in other arteries, how?AAA involves a complex inflammatory process
***Are the majority of AAAs asymptomatic and never rupture?yes
***How are AAA typically discovered?through screening of high-risk populations (men 65-75 who have ever smoked). These are detected incidentally on physical exam or by abdominal imaging done for other indications
Compare US and CT imaging as to equivalency in accuracy, cost, and radiation?US is equivalent in accuracy to CT imaging and is less expensive without exposure to radiation
For surveillance, is US or CT preferred if the AAA is < 5.0 cm?US is preferred, however, CT is acceptable
At 5.0 he cm or above, is US or CT preferred? Why?1) CT 2)because it provides details of the anatomy necessary for evaluation of open surgical vs. endovascular repair
Repair of an asymptomatic AAA is generally NOT indicated before the diameter reaches ____ cm?5.5
Comparing aneurysm-related rates of mortality and morbidity regarding open vs. endovascular repair techniques?they have similar rates of mortality and morbidity
Annual rates of AAA rupture increase with _______ aneurysm size?increasing
*** The American College of Cardiology/American Heart Association (ACC/AHA) guideline, updated in 2011 recommends patients with AAAs > ____ cm should undergo repair to prevent rupture?5.5
*** Patients with AAAs 4.0 to 5.4 cm should undergo US or CT scan every ___to ___months to detect expansion?6; 12
*** Patients with AAAs 5.0 to 5.4 cm may benefit from _____?repair
*** Patients with AAAs < 4.0 cm may be monitored with US every ____ to ___ years?2; 3
*** Repair is NOT recommended for AAAs < ___ cm in men or < ____cm in women?5.0; 4.5
Risk factors for rupture of an AAA include?1) female gender 2) continued smoking and rapid aneurysm expansion (> 0.5 cm in 6 months or > 1 cm per year)
Continued smoking and rapid aneurysm expansion necessitates?more frequent surveillance imaging and earlier surgical consultation/intervention
Interestingly, DM is associated with a ______ (lower vs. higher) risk for development of and rupture of AAA?lower
*** SUMMARY = The United States Preventive Services Task Force (USPSTF) recommends one-time screening for men aged ____ to ____ who have ever smoked?65; 75
*** SUMMARY = Is abdominal US equivalent in accuracy for CT for monitoring purposes?yes
*** SUMMARY = Patients with AAA < 4.0 cm can be monitored every ___ to ___ years?2; 3
*** SUMMARY = Patients with AAA 4.0 to 4.5 cm should be monitored ___ to ___ months?6; 12
*** SUMMARY = Patients with AAA > ____ cm should be considered for repair?5.5
*** SUMMARY = List risk factors of AAA rupture?1) continued smoking 2) rapid aneurysm expansion 3) female gender
*** SUMMARY = Define rapid aneurysm expansion?> 0.5 cm in 6 months OR > 1 cm per year