Abdominal aortic aneurysms
AAA diameter (cm) 5-year risk of rupture (%/year) <4.0 cm 0% 4.0–4.9 cm 0.5–5% 5.0–5.9 cm 3–15% 6.0–6.9 cm 10–20% 7.0–7.9 cm 20–40% 8.0 cm 30–50% Table 36.2. Risk factors…
Reversal of anticoagulation
Warfarin Inhibits the synthesis of vitamin K-dependent coagulation factors (II, VII, IX, X) and proteins C and S Heparin Activates antithrombin III, leading to inactivation of thrombin and other coagulation…
Disseminated intravascular coagulation and thrombotic thrombocytopenic purpura/hemolytic uremic syndrome
Disseminated intravascular coagulation Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome Meningococcemia, pneumococcemia, staphylococcemia, gonococcemia Rocky Mountain spotted fever Immune thrombocytopenic purpura Henoch–Schönlein purpura Hemorrhagic drug reaction Stevens–Johnson syndrome/toxic epidermal necrolysis Viral hemorrhagic…
Rhabdomyolysis
Traumatic Nontraumatic Multitrauma/crush injury Environmental heat illness/dehydration Burns Seizures Vascular or orthopedic surgery Hereditary myopathies Coma Malignant hyperthermia Immobilization Neuroleptic malignant syndrome Envenomation (snake, black widow) Drugs Extreme exertion Infections…
Gastrointestinal bleeding
Adult patients Peptic ulcer disease Erosive gastritis, esophagitis, or duodenitis Varices (esophageal and gastric) Portal hypertensive gastropathy Mallory Weiss tears Malignancy Aortoenteric fistula Pediatric patients Esophagitis Gastritis Peptic ulcer disease…
Hypertensive emergencies
Hypertensive encephalopathy Acute ischemic stroke Acute intracerebral hemorrhage Aortic dissection Unstable angina/acute myocardial infarction Acute pulmonary edema Preeclampsia/HELLP syndrome/eclampsia Acute renal failure Diagnosis and evaluation History Ask for symptoms related…
Post–cardiac arrest care
Cardiovascular disease Arrhythmia Electrolyte abnormality Pulmonary embolus Hypoxic arrest Tension pneumothorax Trauma Cardiac tamponade Hemorrhage/hypovolemia Medication or drug overdose Acidosis Hypothermia Diagnosis and evaluation An immediate assessment of a patient…
Soft tissue injury: crush injury, arterial injury, and open fractures
Fracture type Description 0 Minimal soft tissue damage; indirect violence; simple fracture patterns (e.g., torsion fracture of the tibia in skiers) I Superficial abrasion or contusion caused by pressure from…
Abdominal compartment syndrome
20 mmHg associated with new organ dysfunction or failure. ACS can be primary (resulting from an intra-abdominal process), or secondary (due to bowel edema from aggressive fluid resuscitation or sepsis)…
The surgical abdomen
Figure 40.1. Location and differential diagnosis of acute abdominal pain. Diagnosis and evaluation History and physical characteristics A thorough history will generally narrow the differential diagnosis. Past medical and surgical…
