Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Q4 EM Surg > Exam 2 CARDIOTHORACIC/VASCULAR EMERGENCIES > Flashcards

Exam 2 CARDIOTHORACIC/VASCULAR EMERGENCIES Flashcards

1
Q

Aneurysm is?

A

Abn vessel dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dissection is?

A

Tear in intima of vessel wall

Blood into media -> splits creating false channel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Artherosclerotic Aneurysm U located?

Preceding sxs?

U a/w?

A

abdominally

U none before rupture

Comorbidities: CAD, PVD, COPD, DM, Renal fail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

AAA diagnostics? (2)

A

US for dx and follow (always do US for abd complaint)

CT/MRI for plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

AAA intervention determination?

A

< 5.5, not enlarging, asympt =
US Q 6-12 mo

> 5.5, rapid expansion or sympt =
intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AAA presentation? (6)

A 
Abd pain
P Flank/Back pain
Pulsatile abd mass
Tender
HypoTN
Hemodynamic instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ruptured or Sympt AAA management?

A 
ABCs
2 large bore IVs
Type/Cross 10u PRBC
Pain mgmt
BP @ 80-100
US
To OR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TRIAD of Aortic Dissection- CONSTELLATION

A
  1. Abrupt onset of thoracic or abdominal PAIN w/a sharp, tearing quality
  2. mediastinal &/or aortic WIDENING on chest radiograph
  3. HTN +/- discrepant BP or pulse (absence of a proximal extremity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aortic Dissection (AD) U located?

Risk factors? (4)

A

thoracic

age
HTN
CT dz
Preggos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

AD presentation? (7)

A 
EMERGENCY
Chest pain
Back pain b/w shoulder blades
Neuro ∆s
Distal ischemia (limb, gut, kidney)
Acute cardiac failure (aortic regurg, ischemia)
HypoTN
Shock w/ rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

AD preceding signs/sxs? (6)

A 
HTN
Discrepant BP b/w extremities
Widen mediastinum
Pleural capping
Pleural effusion
Hoarseness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AD Type A?

A

In ascending aorta
Most C
Emergent surgery for all
High mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

AD Type A complications?

A

Aortic rupture
Tamponade
Acute aortic regurg
Acute coronary ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AD Type B Uncomplicated?

A

Not involving ascending aorta
No rupture or ischemia
Surgical or endovascular tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

AD Type B Complicated or Failed Mgmt sxs?

A

Persistent pain
Progress to dissection
Marfans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AD imaging? (3)

A

Spiral CT = standard of care
MRI
TEE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

AD initial mgmt? (3)

A

1) ↓ SBP < 100
2) ↓ LV dP/dT (contractility)
3) Pain mgmt

w/ β-block then vasodilator (Nipride)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Thoracic Aortic Aneurysm invasive tx:

Ascending and/or Arch?

Descending?

A

asc = Sternotomy w/ surgical repair, P aortic valve

des = Thoractomy w/ surgical repair or endovasc graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thoracic Aorta injury: Transection caused by?

A

U from rapid deceleration

???? slide 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Thoracic Aortic injury: Transection diagnosis?

A 
Mishaped mediastinum
Blurred aortic knob
Wide mediastinum
2nd rib fracture
Pleural effusion
Apical capping

CXR then Spiral CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Thoracic Aortic injury: Transection mgmt?

A

Open or endocardial repair

High risk of paraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Blunt cardiac injury: Cardiac Rupture?

A

U pulmonary hilum

23
Q

Blunt cardiac injury: Myocardial Contusion?

A

similar sxs to MI (pain, N/V, SOB, arryh)
P Rv or RA infarct or rupture

Serial ECG/telem
Serial enz
ECHO
watch for 48 hrs

24
Q

Traumatic Diaphragmatic Hernia?

A

U Male and L sided

Resp distress
↓ Breath Sounds
BS in chest
Abd pain
Paradox resp

Tx w/ transabdominal repair

25
Q

Penetrating Chest Trauma signs/sxs? (5)

A 
Hemoptysis
Pneumothor
SQ emphysema (air in skin on chest/neck)
Mediastinal emphysema
Beck's Triad
26
Q

Penetrating Chest Trauma work-up?

A

Helical CT
Echo
Angiography

27
Q

Penetrating Chest Trauma: Emergent L Thoracotomy when?

A

Hemodyn unstable

Witnessed arrest despite resuscitation

28
Q

Esoph Rupture/Boerhaave Synd location?

Presentation? (6)

A

L postlateral distal esoph

Retrosternal/Up abd pain
Tachy
Dyspnea
Fever
Odynophagia
Hamman's Sign (crunching, rasping sound synchronous w/ heart beating against air-filled tissues)
29
Q

Boerhaave Synd diagnostics? (3)

Tx? (4)

A

CXR = free air in mediastinum
CT
Esophogram w/ gastrograffin

FATAL if not caught (still high mortality)

ABCs
Fluids
ABX
Surgery

30
Q

PeriMyocardial Infarct Emergencies include? (3)

A

Acute VSD (Ventricular Septal Defect)
Acute Mitral Regurg
Acute Mesenteric Ischemia

31
Q

Acute VSD (C) a/w?

Exam finding? (3)

A

Transmural Anterolat MI
2-5 days post

Harsh, holosystolic murmur
+/- thrill
↓ hemodynamics

32
Q

Acute VSD study?

Tx?

A

Echo w/ color flow

Thrombolytics
URGENT SURG REPAIR

33
Q

Acute Mitral Regurg caused by?

A

Papillary mm rupture in acute MI
U postmedial
~13 hrs post

34
Q

Acute Mitral Regurg exam findings?

Tx?

A

Acute pulmonary edema
Pansystolic murmur, apex to axilla
↓ afterload

U surgery necessary

35
Q

Acute Mesenteric Ischemia caused by Arterial Embolism?

A

C 2° to cardiac thromboembolism (Afib)

U location is SMA, IMA least

36
Q

Acute Mesenteric Ischemia caused by Arterial Thrombus?

A

U from progression of preexist atherosclerosis

C involvement of 2 vessels following dehydration, hypercoag state

37
Q

Acute Mesenteric Ischemia caused by Non-occlusive events: Types of causes?

A

Severe/Prolonged vasoconstrict
Low CO
α-agonists, digoxin, ergots, cocaine

38
Q

Acute Mesenteric Ischemia exam findings?

If SMA involvement?

A

Early dx critical (< 12 hrs)

Severe abd pain w/o many abd findings,
N/V/D and ileus (P) + guaiac

TRIAD of SMA embolism:
GI emptying
Abd pain
Underlying cardiac dz

39
Q

Acute Mesenteric Ischemia labs? (3)

A 
CBC = Leukocytosis
D-Dimer = ↑
LDH = ↑

All are non-specific

40
Q

Acute Mesenteric Ischemia management? (6)

A 
ABC
Cardiac monitor
O2
IV access/fluids
Abx
Pain mgmt
41
Q

Acute Mesenteric Ischemia imaging?

A

Multi-detector CT

Angiography

42
Q

Acute Mesenteric Ischemia tx?

A

Papaverine Infusion
Embolectomy
Intraarterial Thrombolysis
Bypass or Reimplant

43
Q

Aorto-Iliac Occlusive Dz is?

A

EMERGENCY
Saddle embolism at bifurcation OR
In-situ thrombosis of already dz’d segment

44
Q

Aorto-Iliac Occlusive Dz presentation?

A

Neuro deficit including paralysis,

Absent femoral pulses

45
Q

Aorto-Iliac Occlusive Dz tx?

A

Quick imaging

Surgery

46
Q

Acute Arterial Obstruction is?

A

EMERGENCY

Sudden stop of blood to extremity

47
Q

Acute Arterial Obstruction cause by? (4)

A

Embolism U from heart or aorta
Thrombus in situ from trauma or ↓ flow
Hypercoag state
External compression of artery

48
Q

Acute Arterial Obstruction from Embolism U result of? (5)

A 
Afib
LV thrombus
Cardiac myxoma (benign tumor)
Valve dz
Plaque, fat, air
49
Q

Acute Arterial Obstruction from In-situ Thrombus result of? (5)

A 
Catheter
Stent/graft
Popliteal aneur
Hypercoag or low flow states
Arterial dissection
50
Q

6 P’s of Acute Obstruction?

A 
Pain
Pallor
Paresthesia
Paralysis
Pokilothermia
Pulselessness
51
Q

Acute Arterial Obstruction tx?

A 
Emergency surg
Heparin
Thrombolytics
Thrombus removal
Embolectomy or Bypass
52
Q

Compartment Syndrome C after what?

6 Ps of Compartment Synd?

A

Reperfusion of ischemic limb (U) calf

Pain out of proportion
Pain w/ passive stretch
Paresthesia
Paralysis
Pokilothermia
Pulselessness
53
Q

Compartment Syndrome diagnosed how?

Untreated w/i 8hrs P results in?

A

Clinically
P pressure measurement > 25 mmHg

Permanent nn damage
Limb loss
Death

54
Q

Compartment Syndrome tx?

A

Fasciotomy

Q4 EM Surg (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions