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Intern Survival Series: Dyspnea and Hypertension in hospitalized patients

Intern Survival Series: Dyspnea and Hypertension in hospitalized patients. Aug 17, 2011 Dan Waldman. Dyspnea : Main Goals . Organized thought Process “ Dyspnea ” vs “Hypoxia” “Anchor Bias” in dyspnea Thoughts on PE. Case Presentation.

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Intern Survival Series: Dyspnea and Hypertension in hospitalized patients

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  1. Intern Survival Series: Dyspnea and Hypertension in hospitalized patients Aug 17, 2011 Dan Waldman

  2. Dyspnea: Main Goals Organized thought Process “Dyspnea” vs “Hypoxia” “Anchor Bias” in dyspnea Thoughts on PE

  3. Case Presentation “Mr. Smith’s oxygen requirement is going up. Now he’s on a facemask.” On your signout list: “72 yo M with CHF exacerbation and COPD exacerbation…”

  4. Hypertension Urgency/Emergency/”Malignant” Causes of hypertension in hospitalized pts Who needs meds? What meds?

  5. Most common presnetations of hypertensive Emergency • Stroke: 25% • Pulmonary Edema: 23% • Hypertensive Encephalopathy: 16.3% • CHF: 12% • Some others: • Intracranial hemorrhage • Aortic dissection • Ecclampsia • MI

  6. Contributing factors Pain Alcohol/benzo withdrawal Cocaine/amphetamines Anxiety BP Med withdrawal White Coat Htn NSAIDs Steroids OSA Cuff Size Urinary Retention (think about in post-op)

  7. This may even be overly aggressive

  8. Some non IV meds (if you must) Nitropaste (can be removed) Captopril Nifedipine Clonidine PO (rebound htn) But really…do they need these?

  9. Questions?

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