Sandboxkarol: Difference between revisions
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{{familytree | | | | | | | | | | |!| | | | | | }} | {{familytree | | | | | | | | | | |!| | | | | | }} | ||
{{familytree | | | | |,|-|-|-|-|-|^|-|-|-|.| }} | {{familytree | | | | |,|-|-|-|-|-|^|-|-|-|.| }} | ||
{{familytree | | | | | {{familytree | | | | B01 | | | | | | | | B02 | B01='''If yes:''' <br> <div style=height: 1em; width: 10em; padding:1em;">❑ Proceed with non-invasive imaging<br> </div>| B02= '''If no:'''<br> <div style=height: 1em; width: 10em; padding:1em;">❑ Proceed with invasive renal arteriography </div>}} | ||
{{familytree | | | | |!| | | | | | | | | |!| | | | | | | }} | {{familytree | | | | |!| | | | | | | | | |!| | | | | | | }} | ||
{{familytree | | | | |!| | | | | | | | | |!| }} | {{familytree | | | | |!| | | | | | | | | |!| }} | ||
{{familytree | | | | | {{familytree | | | | C01 | | | | | | | | |!| | C01=<div style="height: 1em; width: 15em; padding:1em;">'''Is patient allergic to contrast'''</div>}} | ||
{{familytree | | |,|-|^|-|.| | | | | | | |!| | }} | {{familytree | | |,|-|^|-|.| | | | | | | |!| | }} | ||
{{familytree | | | {{familytree | | D01 | | D02 | | | | | | D03 | D01= '''If yes:'''<br> <div style=height: 1em; width: 10em; padding:1em;">❑ Proceed with US<br></div>| D02= '''If no check for:''' <br><div style=float: left; text-align: LEFT; height: 16em; width: 10em; padding:1em;"> | ||
❑ Implanted devices:<br> | ❑ Implanted devices:<br><div style=float: left; text-align: LEFT; height: 16em; width: 10em; padding:1em;"> | ||
- Pacemakers<br> | - Pacemakers<br> | ||
- Defibrillators<br> | - Defibrillators<br> | ||
- Cochlear implants<br> | - Cochlear implants<br> | ||
- Spinal cord stimulators <br> | - Spinal cord stimulators <br> | ||
❑ Claustrophobic patient </div>| | ❑ Claustrophobic patient </div>| D03= <div style="height: 3em; width: 25em;">❑ [[Abdominal aortography]] to assess the renal arteries during coronary and peripheral[[angiography]]</div>}} | ||
{{familytree | | |!| |,|-|^|-|.| | | | | |!| |}} | {{familytree | | |!| |,|-|^|-|.| | | | | |!| |}} | ||
{{familytree | | |!| | {{familytree | | |!| E01 | | E02 | | | | |!| | | | E01=<div style="height: 3em; width: 10em; padding:1em;">If none of the above proceed with [[MRA]] | ||
</div>| | </div>| E02= <div style="height: 3em; width: 13em; padding:1em;">If yes to any of the above, proceed with [[CT]]</div>}} | ||
{{familytree | | |`|-|-|+|-|-|'| | | | | |!| |}} | {{familytree | | |`|-|-|+|-|-|'| | | | | |!| |}} | ||
{{familytree | | | |,|-|^|-|.| | | | | | |!| |}} | {{familytree | | | |,|-|^|-|.| | | | | | |!| |}} | ||
{{familytree | | | | {{familytree | | | F01 | | F02 | | | | | F03 | F01= <div style="height: 5em; width: 10em;">Negative noninvasive test but with high clinical suspicion </div>| F02= <div style="height: 3em; width: 10em;">Evidence of RAS </div>| F03= <div style="height: 3em; width: 10em;">Evidence of RAS </div>}} | ||
{{familytree | | | |!| | | |!| | | | | | |!| | }} | {{familytree | | | |!| | | |!| | | | | | |!| | }} | ||
{{familytree | | | | {{familytree | | | G01 | | |!| | | | | | |!| G01= <div style="height: 2em; width: 10em; padding:1em;">'''Go to invasive imaging'''</div>}} | ||
{{familytree | | | | | | | |!| | | | | | |!| | }} | {{familytree | | | | | | | |!| | | | | | |!| | }} | ||
{{familytree | | | | | | | |`|-|-| | {{familytree | | | | | | | |`|-|-| H01 |-|'| H01= <div style="height: 7.5em; width: 10em; padding:1em;">'''Confirmed RAS:''' | ||
❑Proceed to medical therapy | ❑Proceed to medical therapy | ||
❑Consider revascularization | ❑Consider revascularization</div>}} | ||
{{familytree/end}} | {{familytree/end}} |
Revision as of 19:07, 8 January 2014
Clinical Clues to the Diagnosis of RAS
Determine if one or more of the following is present: ❑ Onset of hypertension before the age of 30 years or severe hypertension after the age of 55 ❑ Accelerated, resistant, or malignant hypertension ❑ Development of new azotemia or worsening renal function after administration of an ACE inhibitor or ARB agent ❑ Unexplained atrophic kidney or size discrepancy between kidneys >1.5 cm ❑ Sudden, unexplained pulmonary edema ❑ Unexplained renal dysfunction, including individuals starting renal replacement therapy ❑ Multi-vessel CAD ❑ Unexplained CHF ❑ Refractory angina | |||||||||||||||||||||||||||||||||||||||||||
If yes: ❑ Proceed with non-invasive imaging | If no: ❑ Proceed with invasive renal arteriography | ||||||||||||||||||||||||||||||||||||||||||
Is patient allergic to contrast | |||||||||||||||||||||||||||||||||||||||||||
If yes: ❑ Proceed with US | If no check for:
❑ Implanted devices: - Pacemakers | ❑ Abdominal aortography to assess the renal arteries during coronary and peripheralangiography | |||||||||||||||||||||||||||||||||||||||||
If none of the above proceed with MRA
| If yes to any of the above, proceed with CT | ||||||||||||||||||||||||||||||||||||||||||
Negative noninvasive test but with high clinical suspicion | Evidence of RAS | Evidence of RAS | |||||||||||||||||||||||||||||||||||||||||
Go to invasive imaging | |||||||||||||||||||||||||||||||||||||||||||
Confirmed RAS:
❑Proceed to medical therapy ❑Consider revascularization | |||||||||||||||||||||||||||||||||||||||||||