7.18.2012

PANCE REVIEW: Urgency vs Emergency

HTN, both primary and secondary, are fair game for the PANCE - but HTN in general is a huge topic. So in the interest of keeping these entries short and sweet, I went with the niche topic of urgency vs. emergency.

Hypertensive Urgency
Hypertensive Emergency
Systolic > 220, Diastolic >125
Diastolic > 130
Lower in HOURS
Lower within 1 HOUR
Complications: optic disc edema, end organ complications
Complications: hypertensive encephalopathy, IC hemorrhage, aortic dissection, pulm edema

Tests/Possible results:
1-EKG: heart failure/LVH
2-CXR: ventricular hypertrophy
3-Labs: decrease in Hbg/Hct, increase in BUN/Cr/Glucose - renal dz? DM? end organ damage?

Treatments:
Parenteral agents
-sodium nitroprusside
-if MI present, nitro or Beta-blocker
-if aortic dissection present, nitroprusside + beta blocker (Labetalol)





Source: AAPA and PAEA Exam Review Book

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