Sandbox/22: Difference between revisions
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==Management== | ==Management== | ||
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{{familytree | | | A01 | |A01=<div style="float: left; text-align: left; height: 23em; width: 40em; padding:1em;">'''Characterize the symptoms:''' | |||
{{ | ---- | ||
❑ '''Chest pain''' <br> ❑ '''Cough'''<br> ❑ '''Cyanosis'''<br>❑ '''Diaphoresis'''<br>❑ '''Dyspnea'''<br>❑ '''Fever'''<br>❑ Hypotension<br>❑ '''Tachycardia<br>❑ '''Tachypnea'''</div>}} | |||
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{{ | {{familytree | | | B01 | |B01=<div style="float: left; text-align: left; height: 17em; width: 40em; padding:1em;">'''Patient evaluation:''' | ||
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''' | ❑ '''Obtain a detailed history:'''<br>♦ Age<br>♦ History of heart disease<br>♦ History of chest infection<br> | ||
---- | ---- | ||
❑ '''Examine the patient:'''<br>♦ Head/Neck - Neck veins (flat, no ↑JVP)<br>♦ Chest - No S3/S4, no murmurs<br>♦ Limbs - Hyperdynamic pulses, no edema</div>}} | |||
''' | {{familytree | | | |!| | | |}} | ||
{{familytree | | | C01 | | |C01=<div style="float: left; text-align: left; height: 30em; width: 40em; padding:1em;">'''Urgent Labs:'''<br> ❑ ABG<br> ❑Calculate A-a gradient<br> ❑ [[CBC]]<br>❑ [[Electrolytes]] <br> ❑ [[BUN]] <br> ❑ [[Creatinine]]<br>❑ [[CXR]]<br>♦ normal-sized heart<br>♦ Peripheral distribution of infiltrates<br>♦ Air-bronchogram (80%) | |||
---- | ---- | ||
'''Consider additional tests based on each patient's presentation:'''<ref name="pmid12974970">{{cite journal| author=Varon J, Marik PE| title=Clinical review: the management of hypertensive crises. | journal=Crit Care | year= 2003 | volume= 7 | issue= 5 | pages= 374-84 | pmid=12974970 | doi=10.1186/cc2351 | pmc=PMC270718 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12974970 }} </ref> <br> | |||
<table> | |||
<tr class="v-firstrow"><th>❑ Urine [[electrolytes]], [[creatinine]], protein </th><th>❑ [[CT]]/[[MRI]]</th></tr> | |||
<tr><td>❑ Renal ultrasound + doppler </td><td> ❑ [[TSH]], free T3, free T4 </td></tr> | |||
<tr><td>❑ Serum [[cortisol]] </td><td> ❑ Serum [[aldosterone]] </td></tr> | |||
<tr><td>❑ Serum [[renin]] </td><td> ❑ 24-hr urinary [[catecholamine]] & [[metanephrine]] </td></tr> | |||
<tr><td>❑ Serum [[parathyroid hormone]] </td><td> ❑ Urine and serum [[toxicology]] screen </td></tr> | |||
<tr><td>❑ Urine [[pregnancy]] test </td><td>❑ [[ANA]]/[[ESR]]/[[CRP]]/anti-dsDNA/anti-smith/rheumatoid factor/p-ANCA/c-ANCA</td></tr> | |||
</table> | |||
</div>}}}} | |||
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Revision as of 18:26, 20 January 2014
Management
}}Characterize the symptoms:
❑ Chest pain ❑ Cough ❑ Cyanosis ❑ Diaphoresis ❑ Dyspnea ❑ Fever ❑ Hypotension ❑ Tachycardia ❑ Tachypnea | |||||||||||||||||||||||||
Patient evaluation:
❑ Obtain a detailed history: ❑ Examine the patient: ♦ Head/Neck - Neck veins (flat, no ↑JVP) ♦ Chest - No S3/S4, no murmurs ♦ Limbs - Hyperdynamic pulses, no edema | |||||||||||||||||||||||||
Urgent Labs: ❑ ABG ❑Calculate A-a gradient ❑ CBC ❑ Electrolytes ❑ BUN ❑ Creatinine ❑ CXR ♦ normal-sized heart ♦ Peripheral distribution of infiltrates ♦ Air-bronchogram (80%) Consider additional tests based on each patient's presentation:[1]
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References
- ↑ Varon J, Marik PE (2003). "Clinical review: the management of hypertensive crises". Crit Care. 7 (5): 374–84. doi:10.1186/cc2351. PMC 270718. PMID 12974970.