PAEA EOC & Summative Practice

PAEA EOC & Summative Practice what exactly causes the occlusive vascular disease of thromboangiitis obliterans? - aka Buerger's disease inflammatory thrombi affecting the medium and small vessels (nonatherosclerosis) polymorphonuclear leukocytes, microabscesses, and multinucleated giant cells may be present Treatment options for thromboangiitis obliterans? - smoking cessation most important! cilostazol (PDE 3 inhibitor) has vasodilator properties (alleviated symptoms) if raynauds also present, CCB (nifedipine) what heart failure treatment provides a benefit of reduction in morbidity and mortality? - ACE inhibitors beta blockers can also reduce M&M diuretics have no reduction in mortality how would you manage a patient with a MI in the setting of cocaine use? - benzodiazepine early no beta blockers If PCI cannot be done for a STEMI patient within 120 minutes, what should be done? - fibrolytic therapy then do PCI & coronary angiography when it can be done ideally PCI is done within 90 minutes fibrolytic therapy can be used up to 12 hours of symptoms If you suspect an acute limb ischemia due to arterial embolism, what imaging should you get? - catheter-based arteriography (digital subtraction arteriography) provides the most useful information. can also help with treatment can help distinguish between thrombosis and embolus where are arterial emboli often found? - lower extremities more common than upper extremities The common femoral, common iliac, and popliteal artery bifurcations are frequent locations majority originate in the heart fun fact: Compared with thromboemboli, atheroemboli are less likely to produce symptoms of acute limb ischemia how would you work up a patient with treatment resistant hypertension that you suspect a secondary cause? - 24-hour ambulatory monitoring (to ensure not white coat) medical hx (assess adherence to meds, other meds) physical exam (look for abominal/renal bruits) labs (electrolytes, glucose, creatinine, UA) If pheo suspected: measure fractionated metanephrines and catecholamines in a 24-hour urine collection other than atherosclerosis leading to renal artery stenosis and secondary HTN, what is another causes of a renal-associated secondary HTN? - fibromuscular dysplasia (usually in a young pt) most important modifable risk factor for