A 60-year-old man with hypertension and known aortic dilation presents with acute severe "tearing" chest pain radiating to the back. BP difference between arms is 25 mmHg. What is the next immediate step in management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Start IV beta-blocker and arrange urgent CT aortography
Tearing pain radiating to the back plus a difference in BP between the arms in a hypertensive patient means suspected aortic dissection. Start medical therapy right away: an IV beta blocker (esmolol, labetalol) brings down HR and BP and reduces shear stress. Then confirm the diagnosis with CT angiography, which is the preferred test in most EDs. Aspirin and heparin (or thrombolytics) are dangerous if the patient has a dissection. TTE is not the preferred diagnostic test.
ليش كل خيار صح أو غلط
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A
ليش غلط
Aspirin and heparin (antiplatelet and anticoagulant therapy) belong to ACS management; for aortic dissection the listed management is BP control with IV beta-blockers (esmolol, labetalol).
✓ Cardiac emergencies.pdf · p. 1 -
B
ليش غلط
The preferred tests for acute aortic dissection are CTA and TEE (transesophageal), and CTA is much more readily available in emergency rooms; TTE is not listed.
✓ Step Up To Medicine 6th(Aortic dissection ).pdf · p. 3 -
C
ليش صح
Medical therapy starts immediately with an IV beta-blocker (labetalol, esmolol) to reduce shear stress, and CT angiogram is highly accurate for diagnosis.
✓ Step Up To Medicine 6th(Aortic dissection ).pdf · p. 3 -
D
ليش غلط
The notes say to initiate medical therapy immediately (IV beta-blockers, goal systolic BP below 120 and HR below 60), not to observe.
✓ Step Up To Medicine 6th(Aortic dissection ).pdf · p. 3
- المصدر
- Step Up To Medicine 6th(Aortic dissection ).pdf · p. 3
Aortic Dissection.pdf · p. 3 - المحاضرة
- Hypertensive Crisis & Aortic Dissection · Cardiology · Module B
- ظهر في
- MED43 ♂ Quiz B