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Kaplan Qbank USMLE



Author9 Posts
  #1

Pt dies within 24 hrs after carotid endartrectomy. What is most likely cause:

a) air embolism
b) Pulm embolism
c) embolic stroke
d) MI

  #2

C :?:

  #3

A?

  #4

Well, any of these can happen in pts with carotid disease except air embolism, as it is associated with venous punctures (low pressure vessels). For sudden death either massive pulm. embolism or MI is more appropriate. Not sure..

___________________
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lout kar phir waheen aa jata hoon
baaraha tor chuka hoon jinko
phir unhin dewaroon se takrata hoon...

  #5

I go with c) embolic stroke

  #6

Me too...embolic stroke seems reasonable...since removal of occulsion may dislodge some particles and send them on the way. But 24 hours???? Seems like the results would be more immediate. So based on the time line I would go with PE.

___________________
"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson

  #7

Answer given was MI (NMS). I went for PE too.
Only reason I can think of is that stroke and PE has to be massive to cause sudden death, while MI can result from smaller emboli and are potentially fatal (arrhythmias).

  #8

Endarterectomy is a surgical procedure, and probably carries the same surg risk as any other surg procedure. So the massive PE is possible. So i don't think the MI or PE were caused DIRECTLY by the procedure...rather it was an INDIRECT cause.

___________________
"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson

  #9

thanks friends,my ignorance :oops:







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