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23 Cards in this Set

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A 55 year old woman presents with chest pain radiating between her shoulder blades. Her BP is 180/90 and her HR is 80. How should you control her blood pressure?
Beta blockade first, then nipride.
List the risk factors for DVT.
1. stasis
2. hypercoagulability
3. vessel wall damage
recent prolonged travel, recent surgery, smoking, birth control pills, lupus, cancer, pregnancy, immobilizaton
What is the difference between a Stanford Type A dissection and a Type B dissection?
Type A involves the ascending aorta, type B involves the descending aorta. Type A dissections are treated surgically.
What is the treatment for septic thrombophlebitis?
Antibiotics and heparin.
What is the correct location for the catheter tip for transvenous pacing?
Apex of the right ventricle.
What is the most common sign of PE?
Tachypnea
then tachycardia
then fever
What is the most common symptom of PE?
Dyspnea
then chest pain
then apprehension
How do you calculate an A-a gradient?
150 - (PO2 + PCO2/0.8)
A patient complains of shortness of breath. Her EKG shows a new RBBB. Her CXR shows a small pleural effusion. What is the likely diagnosis?
PE
What are common CXR findings in PE?
atelectasis, elevated hemidiaphragm, pleural effusion, hampton's hump, westermark's sign.
What are indications for lysis in the setting of PE?
hypotension, severe hypoxia, severe underlying disease such as cardiomyopathy or single lung.
Which is more common, abdominal aortic aneurysm or thoracic artery dissection?
Dissection is about 3 times more common
A 52 year old man presents with syncope at home and then woke up complaining of flank pain. The pain is on the left. What is the worst case diagnosis?
AAA. Most people with flank pain have left sided flank pain.
An intact AAA is usually tender, true or false?
False. most non-ruptured AAA are not tender.
What are risk factors for aortic dissection?
Third trimester pregnancy, Ehlers-Danlos, Marfans, Trauma, Turner's syndrome, bicuspid aortic valve, coarctation, cocaine and methamphetamine use, aortic stenosis, epstein's anomaly, HYPERTENSION (present in 70-90%)
What is the most common type of aortic dissection?
Ascending aorta and part of descending aorta.
What is the most common presenting complaint in patients with dissection?
Chest pain. Migration of pain is highly specific for dissection.
What are the risk factors for AAA?
Advanced age, male sex, family history, smoking history, hypertensive history, h/o CAD or peripheral vascular disease, hypercholesterolemia
An ill-appearing elderly patient with a BP of 90/60 presents with severe abdominal pain and heme positive stools, but his abdominal exam is benign. What are appropriate next steps?
This patient likely has mesenteric ischemia. IVF hydration, antibiotics, pre-operative labs, abdominal x-ray, and surgical consult. a long-drink CT is not something you should do in a hemodynamically unstable patient.
What is the most sensitive finding for DVT?
unilateral extremity swelling
A patient has a history of DVT and PE, and has a Greenfield filter in. He throws a PE anyway. Name two ways that could occur.
The patient could throw a PE from the filter itself, or he could have a clot travel by way of the left gonadal vein to the left renal vein, which bypasses the filter.
What are indications for lysing a patient with a PE?
A known PE with hemodynamic compromise, a saddle PE, and no contraindications to lysis.
a patient is complaining of arm pain. he was recently discharged from the hospital, and the pain is at the site of his previous IV. it is warm with tenderness along a superficial vein, which is firm. how do you treat him?
warm packs and analgesia. there's no indication for heparin.