AAA Symptoms and Treatment

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Questions and Answers

What symptom is most characteristic of a ruptured AAA?

Dull, vague abdominal pain

Severe flank pain

Syncope due to hypotension (correct)

Pulsatile mass sensation

Which of the following is an indication of 'Blue Toe' syndrome?

Micro emboli from aortic thrombus (correct)

Severe weight loss due to duodenal obstruction

Diminished femoral pulses

Acute pain in the abdomen

What is the recommended monitoring frequency for an AAA smaller than 4.0 cm?

Every month

Every 6 months

Every year

Every 3 years (correct)

Which complication is associated with vertebral body erosion in AAA?

Severe back pain Signup and view all the answers

Which treatment is beneficial for managing small aneurysms between 4.0 and 5.4 cm?

Regular monitoring with imaging Signup and view all the answers

What is the normal range for cardiac output (CO)?

4-8 liters Signup and view all the answers

Which statement is true regarding stroke volume (SV)?

Normal stroke volume ranges from 50-100 ml/beat. Signup and view all the answers

What does the systemic vascular resistance (SVR) primarily measure?

The resistance faced by the left ventricle. Signup and view all the answers

What is the normal cerebral perfusion pressure (CPP)?

60-100 mm Hg Signup and view all the answers

Which condition can increase intracranial pressure (ICP)?

Arterial pressure fluctuations Signup and view all the answers

Which of the following accurately describes the relationship between PVR and SVR?

PVR is one-sixth of the SVR. Signup and view all the answers

What is a potential complication associated with a Swan Ganz catheter?

Air emboli Signup and view all the answers

When monitoring ICP, at what anatomical landmark should the external transducer be leveled?

At the foramen of Monro Signup and view all the answers

What is the recommended position for a patient to effectively drain cerebrospinal fluid?

Head elevated at 30 degrees Signup and view all the answers

What is a potential consequence of removing cerebrospinal fluid too quickly?

Dumping syndrome Signup and view all the answers

Which of the following signs is indicative of increased intracranial pressure (ICP)?

Decerebrate posturing Signup and view all the answers

Which drug is considered a first-line treatment for reducing brain swelling associated with sodium issues?

Hypertonic saline solution Signup and view all the answers

What is a potential side effect of administering mannitol?

Pulmonary edema Signup and view all the answers

How should the administration of corticosteroids be approached in patients with traumatic brain injuries?

Only given to patients with brain tumors Signup and view all the answers

What is the significance of monitoring glucose levels in patients receiving corticosteroids?

To avoid hyperglycemia and potential infections Signup and view all the answers

Which of the following treatments should be avoided in patients with traumatic brain injuries?

Corticosteroids Signup and view all the answers

Which statement is true regarding the use of CPAP in patients with heart problems?

It increases the workload of breathing. Signup and view all the answers

Which characteristic is essential for a patient to receive Bi-PAP therapy?

They must be able to breathe spontaneously. Signup and view all the answers

What is the appropriate action to take if a patient is to receive propofol?

Monitor sedation using the RAAS scale. Signup and view all the answers

What must be ensured before administering RSI drugs?

The provider is present at the bedside. Signup and view all the answers

Which of the following agents is considered a common sedative for intubation?

Etomidate Signup and view all the answers

What does a RAAS scale of 0 to -2 indicate about a patient's sedation level?

They may require less sedation. Signup and view all the answers

Which of the following is NOT a common neuromuscular blocking (NMB) agent?

Propofol Signup and view all the answers

What effect does high-dose propofol administration have?

Results in anesthesia. Signup and view all the answers

What is the primary function of the AV node in the cardiac conduction system?

Relays impulse from the atria to the ventricles Signup and view all the answers

Which condition occurs above T6 after spinal shock subsides?

Autonomic dysreflexia Signup and view all the answers

What is the estimated blood loss for a femur fracture according to the content?

1,276 mL Signup and view all the answers

Which is the recommended treatment for tension pneumothorax?

Needle decompression followed by chest tube insertion Signup and view all the answers

What is a primary trigger for autonomic dysreflexia?

Fecal impaction Signup and view all the answers

In the context of the cardiac conduction system, what is the role of the Purkinje system?

Carries impulses to the ventricles and can act as a pacemaker if higher sites fail Signup and view all the answers

Which symptom is NOT associated with autonomic dysreflexia?

Increased respiratory rate Signup and view all the answers

What is the primary treatment option for human bites that are 6 to 12 hours old?

Antibiotics Signup and view all the answers

What intervention should be performed during the acute management of a spinal cord injury?

Immobilization and stabilization of the cervical spine Signup and view all the answers

What condition results from prolonged immobility and compromised circulation following a femur fracture?

Rhabdomyolysis Signup and view all the answers

What is the primary goal of administering TAPAZOLE, IODINE, and PROPRANOLOL in the context of an aortic rupture?

To stabilize blood pressure and cardiac rhythm Signup and view all the answers

What is the purpose of a focused abdominal sonography for trauma (FAST) exam in suspected intra-abdominal hemorrhage?

To determine the presence of blood in the peritoneal space Signup and view all the answers

What is an important consideration when suctioning a patient in an emergency setting?

Patients should always be pre-oxygenated before suctioning Signup and view all the answers

Which treatment is NOT typically indicated for elevated potassium levels?

Hypertonic saline Signup and view all the answers

In the context of myocardial infarction, the administration of nitrates should be monitored due to their potential effect on which of the following?

Blood pressure Signup and view all the answers

What distinguishes a STEMI from an NSTEMI in terms of ECG findings?

ST segment elevations Signup and view all the answers

What type of angina is characterized by increasing frequency and severity of episodes?

Unstable Angina Signup and view all the answers

In the management of sinus bradycardia, which intervention is appropriate for a symptomatic patient?

Atropine administration Signup and view all the answers

What is the treatment of choice for stable SVT?

Vagal maneuvers Signup and view all the answers

Which type of arrhythmia shows a rapid heart rate of 350-600 bpm and requires urgent management?

Atrial Fibrillation Signup and view all the answers

Continuous renal replacement therapy (CRRT) is best described as:

A continuous method for treating acute kidney injury Signup and view all the answers

How can oxygen saturation and cardiac rhythm be monitored during suctioning?

With a pulse oximeter and ECG Signup and view all the answers

Which of the following medications is used for immediate relief of angina symptoms?

Nitrates Signup and view all the answers

In the case of acute kidney failure, what is a defining characteristic?

Sudden loss of kidney function due to various factors Signup and view all the answers

Study Notes

AAA Symptoms

Dull, vague pain in abdomen, back, or flank
Can be acute and severe in ruptured AAA
Sensation of a pulsatile mass in the abdomen
Hypotension (often manifesting as syncope)
Usually occurring in ruptured AAA cases
Diminished femoral pulses

Associated Complications

Blue Toe Syndrome
Duodenal obstruction (vomiting, weight loss)
Due to micro-emboli from aortic thrombus
Vertebral body erosion, causing severe back pain

Where AAA Ruptures

Best place for rupture is in the back or posterior because it can tamponade and hold pressure, if it ruptures anteriorly it is a life-threatening situation

Treatment

Medical Management:
- Control hypertension
- Quit smoking
- Control other risk factors
- ACE inhibitors and/or statins may be beneficial
Monitoring small aneurysms (4.0 to 5.4): Ultrasound or CT scans every 6-12 months
Monitoring smaller aneurysms (less than 4.0cm): CT scans every 3 years
Open repair is more complex and requires careful monitoring of kidneys, urine output, and pedal pulses to ensure extremities remain functional.
Monitor neurologic, peripheral perfusion, and renal perfusion status

Hemodynamic Monitoring (Page 2)

Markings on catheter: thin lines=10 cm, thick lines= 50 cm
Various types of waveforms and values are shown (RV, PA, RA, PAWP).

Cardiac Output (CO), Cardiac Index (CI), Stroke Volume (SV), Systemic Vascular Resistance (SVR), and Pulmonary Vascular Resistance (PVR)

Normal CO is 4-8 liters
Normal CI is 2.5-4.5 liters
Normal SV is 50-100 ml/beat
Normal SVR is 800-1200
Normal PVR is 50-250

Cerebral Perfusion Pressure (CPP)

Pressure needed to ensure blood flow to the brain
Calculated by CPP=MAP-ICP

Intracranial Pressure (ICP)

Factors influencing ICP: arterial pressure, venous pressure
Posture: keep head elevated
Neuro assessments are crucial
Keep patient at 30 degrees to drain cerebrospinal fluid slowly.

Hypertonic Saline Solution

3% Saline used as a first-line treatment for brain swelling
Monitor sodium and potassium levels during use

Cerebral Vasospasm/Subarachnoid Hemorrhage (SAH)

Silent killer, symptoms may be delayed until it happens
Worse headache of their life
Calcium channel blockers for brain protection
Clipping of aneurysm is a common surgical procedure to prevent rebleeding
Coiling (another surgical procedure)

Other Medical Conditions

Various medical conditions including brain death, ischemic stroke, hemorrhagic stroke, traumatic brain injury, pneumothorax, femur fracture, autonomic dysreflexia, spinal cord injury are discussed.
Treatment options, diagnoses, and monitoring of these are also included.

Rhythms, Monitor, and Drugs

Various cardiac rhythms and their corresponding treatments are detailed. (e.g., sinus bradycardia, sinus tachycardia, atrial tachycardia, atrial fibrillation, ventricular tachycardia, ventricular fibrillation, asystole)
Associated drugs (e.g., atropine, calcium channel blockers, lidocaine, amiodarone, digoxin) for various conditions are also noted.
Detailed information on treatment procedures for various conditions like cardiac rhythm abnormalities and related interventions (e.g., defibrillation, pacing).

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Description

This quiz explores the symptoms, complications, and treatment options for Abdominal Aortic Aneurysms (AAA). Learn about the critical signs indicating a rupture and the management strategies employed to handle AAA effectively. Perfect for medical students and healthcare professionals.