1 - Purple Flashcards
What cancers are most likely to have brain metastases?
Lung, breast, kidney and melanoma
What are the signs and symptoms of uncal herniation?
GCS <15
Contralateral hemiparesis
Ipsilateral blown pupil
How should you approach a CSF leak?
Most will resolve on their own
DO NOT put them on ppx abx for meningitis
Admit for observation
What factors contribute to intracranial volume?
Brain Volume + CSF volume + blood volume + space occupying lesion volume
What is the treatment for ICP?
Mannitol (1-2 g/kg) Unless ++ hypotensive
No role for steroids
Abx may be useful for brain abscesses
What physiologic changes are hemodynamically significant AV fistulas associated with?
Increased blood volume but no increase in central venous pressure
Increased CO (inc HR + inc SV)
Decreased dBP w/ big pulse pressure
What are the causes of ischemic bowel?
Thrombotic: underlying atherosclerotic disease
Embolic: arrhythmia, valvular lesion, PFO, MI, mural thrombi
Non-Occlusive mesenteric ischemia: systemic hypoperfusion -> shock
Mesenteric vein thrombosis: hepatobiliary sx, hypercoagulable states
What are the absolute indications for IVC filter?
Failure of heparin anticoagulation
Active hemorrhage
Post-pulmonary embolectomy
Failed other aggressive interventions
What are the relative indications for an IVC filter?
Little cardiopulmonary reserve
Free floating thrombus in iliofemoral vessels
Post-major trauma
How should lower limb DVTs be treated?
Treat any clots above the knee
Controversial about treating clots below the knee
How do you manage superficial thrombophlebitis?
NSAIDS + follow
Saphenofemoral junction -> legate saphenous vein
What are the hard signs for exploring the leg after a knee dislocation?
Ischemic
Pulseless
Expanding hematoma
Pulsatile hematoma
What are the soft signs for exploring the leg after a knee dislocation?
Proximal injury
What is the most common true peripheral aneurism?
Popliteal aneurisms
** Femoral artery aneurism is most common but it is a pseudoaneurism
What is the most common complication of a popliteal artery aneurism?
Thrombosis
Distal embolism can also occur, but less commonly
