Acute Medical Presentations — Flashcards

Flashcard 291: What is the gold-standard investigation for aortic dissection? _____

Answer: CT angiography chest, abdomen, pelvis

Flashcard 292: What is the best initial investigation for aortic dissection? _____

Answer: CXR (Chest X-ray)

Extra: Chest X-ray (CXR) is often the first test performed in the ER for chest pain and may show a widened mediastinum (in ~60-90% of cases), but it is not sensitive or specific enough to diagnose or rule out aortic dissection.

Flashcard 293: NSTEMI patients with a GRACE score < 3% (_____ risk) should have dual antiplatelet management (aspirin + ticagrelor)

Answer: low

Flashcard 294: Aortic dissection can present with _____ between each arm

Answer: BP difference > 20mmHg

Flashcard 295: According to the Killip Class, what prognostic feature is the highest risk of 30 day mortality post-MI? _____

Answer: Cardiogenic shock

Flashcard 296: An ECG should be repeated _____ after fibrinolysis for STEMI

Answer: 60-90 minutes

Flashcard 297: If there is persistent myocardial ischaemia after fibrinolyis, then consider _____ management

Answer: PCI

Flashcard 298: What investigation is done for aortic dissection in unstable patients? _____

Answer: Transoesophageal echocardiography (TOE)

Flashcard 299: Initial management for NSTEMI/unstable angina includes _____ & fondaparinux if ↓ bleed risk and angiography is not being immediately performed

Answer: aspirin 300mg

Flashcard 300: Aortic dissection can cause _____

Answer: aortic regurgitation