Acute Medical Presentations — Flashcards

Flashcard 301: What investigation is done for aortic dissection in unstable patients? _____

Answer: Transoesophageal echocardiography (TOE)

Flashcard 302: 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 303: A patient presents complaining of severe chest pain that radiates to the back in between his scapulae. Physical exam reveals BP of 169/108 in the left arm and 120/70 in the right arm. What is the most accurate test? _____

Answer: CT Angiography if stable TOE transoesophageal echocardiography if unstable

Flashcard 304: What is the gold-standard investigation for aortic dissection? _____

Answer: CT angiography chest, abdomen, pelvis

Flashcard 305: A patient with NSTEMI/unstable angina should have immediate coronary angiography→PCI if they are _____

Answer: hypotensive / unstable

Flashcard 306: Chest X-ray of a patient with aortic dissection shows _____ widening

Answer: mediastinal

Flashcard 307: An NSTEMI/unstable angina patient with a GRACE score > 3% (_____) should have coronary angiography→PCI within 72 hours

Answer: high

Flashcard 308: Initial management for NSTEMI/unstable angina includes _____ & fondaparinux if ↓ bleed risk and angiography is not being immediately performed

Answer: aspirin 300mg

Flashcard 309: Killip class is used to stratify _____

Answer: 30 day mortality post-MI

Flashcard 310: Aortic dissection can be complicated by _____ murmur

Answer: aortic regurgitation