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The SAH's medical treatment!

Topic: Anatomy

Created on Friday, May 29 2009 by rednucleus

Last modified on Saturday, June 6 2009.

You admit a 54-year-old man into the neurology ward after securing the diagnosis of acute subarachnoid hemorrhage. You start medical therapy for him. Regarding medical treatment of acute subarachnoid hemorrhage (SAH), which one is the wrong statement?

 
        A) Hyponatremia should be treated by water restriction
 
        B) Hypotension should be prevented
 
        C) Anti-platelets should be avoided
 
        D) Bed rest and mild sedation may be helpful in reducing the raised blood pressure
 
        E) Is mainly directed at stabilizing the patient and reducing the systemic blood pressure and intracranial pressure
 

 


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This question was created on May 29, 2009 by rednucleus.
This question was last modified on June 06, 2009.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Hyponatremia should be treated by water restriction

This answer is correct.


The medical arm of treating acute subarachnoid hemorrhage is mainly directed at stabilizing the patient and reducing the systemic blood pressure and intracranial pressure and this includes bed rest, mild sedation, elevation of head of bed (15-20 degrees) and analgesics. Anti-platelets should be avoided as well as heparin. Hypotension should be prevented to ensure adequate cerebral perfusion, and intravenous fluids should be used with caution to avoid over-hydration. Hyponatremia should NOT be treated by water restriction; hyponatremia should be treated by oral NaCl or iv 3% saline infusion rather than fluid restriction. It may be due to cerebral salt wasting rather than SIADH. Bed rest and mild sedation are usually effective in reducing the raised blood pressure, and pharmacological intervention should be used if these fail. The objective is to decrease the blood pressure to around 160/100 mmHg. High blood pressure portends both an increased mortality and increased risk of re-bleeding and seizures.   (See References)

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B) Hypotension should be prevented

This answer is incorrect.


The medical arm of treating acute subarachnoid hemorrhage is mainly directed at stabilizing the patient and reducing the systemic blood pressure and intracranial pressure and this includes bed rest, mild sedation, elevation of head of bed (15-20 degrees) and analgesics. Anti-platelets should be avoided as well as heparin. Hypotension should be prevented to ensure adequate cerebral perfusion, and intravenous fluids should be used with caution to avoid over-hydration. Hyponatremia should NOT be treated by water restriction; hyponatremia should be treated by oral NaCl or iv 3% saline infusion rather than fluid restriction. It may be due to cerebral salt wasting rather than SIADH. Bed rest and mild sedation are usually effective in reducing the raised blood pressure, and pharmacological intervention should be used if these fail. The objective is to decrease the blood pressure to around 160/100 mmHg. High blood pressure portends both an increased mortality and increased risk of re-bleeding and seizures.   (See References)

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C) Anti-platelets should be avoided

This answer is incorrect.


The medical arm of treating acute subarachnoid hemorrhage is mainly directed at stabilizing the patient and reducing the systemic blood pressure and intracranial pressure and this includes bed rest, mild sedation, elevation of head of bed (15-20 degrees) and analgesics. Anti-platelets should be avoided as well as heparin. Hypotension should be prevented to ensure adequate cerebral perfusion, and intravenous fluids should be used with caution to avoid over-hydration. Hyponatremia should NOT be treated by water restriction; hyponatremia should be treated by oral NaCl or iv 3% saline infusion rather than fluid restriction. It may be due to cerebral salt wasting rather than SIADH. Bed rest and mild sedation are usually effective in reducing the raised blood pressure, and pharmacological intervention should be used if these fail. The objective is to decrease the blood pressure to around 160/100 mmHg. High blood pressure portends both an increased mortality and increased risk of re-bleeding and seizures.   (See References)

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D) Bed rest and mild sedation may be helpful in reducing the raised blood pressure

This answer is incorrect.


The medical arm of treating acute subarachnoid hemorrhage is mainly directed at stabilizing the patient and reducing the systemic blood pressure and intracranial pressure and this includes bed rest, mild sedation, elevation of head of bed (15-20 degrees) and analgesics. Anti-platelets should be avoided as well as heparin. Hypotension should be prevented to ensure adequate cerebral perfusion, and intravenous fluids should be used with caution to avoid over-hydration. Hyponatremia should NOT be treated by water restriction; hyponatremia should be treated by oral NaCl or iv 3% saline infusion rather than fluid restriction. It may be due to cerebral salt wasting rather than SIADH. Bed rest and mild sedation may be helpful in reducing the raised blood pressure, and pharmacological intervention should be used if these fail. The objective is to decrease the blood pressure to around 160/100 mmHg. High blood pressure portends both an increased mortality and increased risk of re-bleeding and seizures.   (See References)

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E) Is mainly directed at stabilizing the patient and reducing the systemic blood pressure and intracranial pressure

This answer is incorrect.


The medical arm of treating acute subarachnoid hemorrhage is mainly directed at stabilizing the patient and reducing the systemic blood pressure and intracranial pressure and this includes bed rest, mild sedation, elevation of head of bed (15-20 degrees) and analgesics. Anti-platelets should be avoided as well as heparin. Hypotension should be prevented to ensure adequate cerebral perfusion, and intravenous fluids should be used with caution to avoid over-hydration. Hyponatremia should NOT be treated by water restriction; hyponatremia should be treated by oral NaCl or iv 3% saline infusion rather than fluid restriction. It may be due to cerebral salt wasting rather than SIADH. Bed rest and mild sedation are usually effective in reducing the raised blood pressure, and pharmacological intervention should be used if these fail. The objective is to decrease the blood pressure to around 160/100 mmHg. High blood pressure portends both an increased mortality and increased risk of re-bleeding and seizures.   (See References)

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References:

1. Victor, M., and Ropper, A.H. (2005). Adams and Victor's Principles of Neurology, 8th Edition. McGraw-Hill, New York. (ISBN:007141620X) Advertising:
2. Aminoff, M.A., Greenberg, D.A., Simon, R.P. (2005). Clinical Neurology, 6th Edition. McGraw-Hill, New York. (ISBN:0071423605)Advertising:
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anatomy
The SAH's medical treatment!
Question ID: 052909093
Question written by rednucleus. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 05/29/2009
Modified: 06/06/2009
Estimated Permutations: 120

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