14 - vascular emergencies Flashcards
1
Q
stanford classification of aortic dissections
A
class A - ascending class B - more distal
2
Q
3 normal aging risk factors
A
- age
- male
- HT
3
Q
4 predispositons to weak wall
A
- preg
- fam Hx
- previous repair
- CT disorders
4
Q
2 increased stresses to wall
A
- cocaine
2. congenticla bicuspid valve
5
Q
3 chest pain red flags
A
- with neuro features
- migrating to abdomen
- with ischemic Sx
6
Q
4 signs on physical
A
- HT
- pulse differential at different sites
- BP diff >10 in 2 arms
- murmuer of aortic insuff
7
Q
main investgations
A
CXR - widened mediastinum
CT with contrast
Transeso US - best if patient unstable
8
Q
2 principles behind mgmt
A
- pain control
2. prevet more tearing
9
Q
how to manage
A
rate and BP control
-BB - labetalol
- nitroprusside
then surgery
10
Q
risk factors for AAA (8)
A
common (5-10% of men over 65)
- HT
- over 50
- male
- PVD
- fam Hx
- smoking
- diabetes
- CT disease
11
Q
Sx of ruptures AAA
A
sudden onset back or flank pain
- speed of onset important
- syncope
-
12
Q
4 diagnoses that should think about AAA
A
- renal colic
- unexplained HypoT or syncope
- MSK back pain
- previosu repair of AAA
13
Q
imaging for AAA
A
- US is best - outside diameter of 3 cm
2. CT is 100% accurate
14
Q
mgmt of AAA
A
folllow for serial ultrasound or repair
15
Q
mgmt of AAA rupture
A
prep for surgery
- 2 IVs
- crossmatch
