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Flashcards in 14 - vascular emergencies Deck (22)
1

stanford classification of aortic dissections

class A - ascending
class B - more distal

2

3 normal aging risk factors

1. age
2. male
3. HT

3

4 predispositons to weak wall

1. preg
2. fam Hx
3. previous repair
4. CT disorders

4

2 increased stresses to wall

1. cocaine
2. congenticla bicuspid valve

5

3 chest pain red flags

1. with neuro features
2. migrating to abdomen
3. with ischemic Sx

6

4 signs on physical

1. HT
2. pulse differential at different sites
3. BP diff >10 in 2 arms
4. murmuer of aortic insuff

7

main investgations

CXR - widened mediastinum
CT with contrast
Transeso US - best if patient unstable

8

2 principles behind mgmt

1. pain control
2. prevet more tearing

9

how to manage

rate and BP control
-BB - labetalol
- nitroprusside
then surgery

10

risk factors for AAA (8)

common (5-10% of men over 65)
1. HT
2. over 50
3. male
4. PVD
5. fam Hx
6. smoking
7. diabetes
8. CT disease

11

Sx of ruptures AAA

sudden onset back or flank pain
- speed of onset important
- syncope
-

12

4 diagnoses that should think about AAA

1. renal colic
2. unexplained HypoT or syncope
3. MSK back pain
4. previosu repair of AAA

13

imaging for AAA

1. US is best - outside diameter of 3 cm
2. CT is 100% accurate

14

mgmt of AAA

folllow for serial ultrasound or repair

15

mgmt of AAA rupture

prep for surgery
- 2 IVs
- crossmatch

16

importance of arterial occlusion

serious - can require amputation

17

risk factors for arterial emoblism 3

1. MI
2. a fib
3. valve stenosis/replacement

18

2 risks for thrombosis

1. occlusion of previosu stent or graft
2. PVD

19

5 other sources of emboli

1. AAA
2. cancer mets
3. recent surgery
4. bact, endocardidits
5. IV drug use

20

6 Ps on Hx

1. pain
2. pallor
3. parathesia
4. pulseless
5. polar - cool to touch
6. paralysis

21

investigations for occlusions

mostly clinical
- can use US and CT angio

22

mgmt of occlusion

- IV heparin
- vascular consult