Differential Diagnosis Flashcards
hypotension
think about 3 categories
decr preload -
hypovolemia (blood loss, dehydration)
decr ven return (positioning, retraction)
incr intrathoracic P (tension PTX)
sympathectomy (neuraxial)
pericardial tamponade
pulmonary embolism
decr afterload -
iatrogenic (anes gas or drugs)
anaphylaxis
adrenal insufficiency
sepsis
decr contractility -
MI
cardiomyopathy
negative inotropic drugs
dysrhythmias (bradycardia, SVT, VT)
Amniotic fluid embolism p/w
hypotension
cardiopulmonary arrest
fetal distress
pulm edema/ARDS
cyanosis, dyspnea
(seizures)
Obstetric causes:
acute hemorrhage
placental abruption
uterine atony
peripartum cardiomyopathy
anesthetic causes:
high/total spinal
aspiration
LAST
other causes:
pulmonary embolism
venous air embolism
anaphylaxis
sepsis
transfusion reaction
DDx for post partum hemorrhage (5 Ts)
Tone: Uterine atony (by far most common)
Tissue: Retained product, Placenta accreta
Trauma: vaginal/cervical lacerations, vascular injury
Thrombin: Coagulopathy: Aquired (ITP, PIH, DIC, TTP) or Prexisting (vWD, hemophilia)
Turn out: Uterine inversion
TREATMENT:
call for help, activate MTP if necessary
drugs: uterine massage
uterotonics: oxytocin, hemabate, methylergonivine, misoprostol, TXA, rVIIa
surgical interventions: b-lynch sutures, packing, uterine artery ligation/IR embolization, hysterectomy
DDx for antepartum bleeding:
Placenta previa (painless)
Placenta abruption (painful)
Uterine rupture (true emergency)
Vasa previa (lethal to fetus, ok for mom)
Other less serious causes
