Investigations Flashcards
1
Q
What are misdiagnosis of AAA?
A
- Renal colic
- Diverticulitis
- GI bleed
- MI
- Muscular or mechanical back pain
2
Q
When would you suspect AAA?
A
- Shock and bilateral leg ischaemia
- Men >60 yrs with first presentation of renal colic
3
Q
How can you tell it’s expansive pulsatile?
A
Fingers will move outwards
4
Q
How can you tell it’s a transmitted pulsatile?
A
- Fingers will move outwards
- Can make the pulsation disappear if you move swelling away from aorta
5
Q
What is the investigations for cerebrovascular disease?
A
- Duplex
- Angiography
- CT/MRI
6
Q
How do you diagnose aortic dissection?
A
- Transoesophageal echocardiogram
- CT with iodine contrast
- MR angiogram (MRA)
7
Q
What are the investigations for hypovolaemic shock?
A
- Blood tests - cross matched, FBC, clotting, U+E, LFTs, glucose, lactate, ABG
- ECG
- US of abdomen - free fluid
- Temperature - prevent fall
8
Q
What is fluid management protocol?
A
- Consider type of fluid lost
- Initial therapy with crystalloids or colloids
- Major blood loss will need blood urgently
- Fluid administration initially guided by frequent assessment of clinical response (HR, BP, skin, mental state, urine output)
9
Q
What is used to check the extrinsic pathway?
A
- PT - 12 secs
- Monitored with warfarin
- Elevated in liver disease
10
Q
What is used to check the intrinsic pathway?
A
- APPT- 42 secs
- Monitored with heparin
11
Q
What types of drugs are used for platelets?
A
- Thrombin: thrombin inhibitors
- Adenosine phosphate: clopidogrel, ticlopidine
- Thromboxane A2: aspirin
- Glycoproteins IIb/IIIa: inhibitors
12
Q
What type of drugs are used for fibrinolysis?
A
- Thrombolytics: alteplase, streptokinase
- Anti-fibrinolytics: antagonise fibrinolysis e.g. tranexamic acid
