q??cardio. - sadaf1987

[ArchivalUser]

A 72-year-old white man with history of type 2 diabetes mellitus and hypertension is evaluated in your office during a follow up visit. He was discharged 3 days ago from the hospital after undergoing diagnostic cardiac catheterization for an abnormal exercise stress test. Femoral sheath was removed three days ago. He denies any chest pain or shortness of breath. On physical examination, he is afebrile, HR 120/min and blood pressure is 120/70 mm hg. There is a new palpable mass in the right groin and systolic bruit is heard at the catheter insertion site. Dorsalis pedis and posterior tibial pulses are intact. Which of the following is the most likely diagnosis?

A) Arterio-venos fistula

B) Local Hematoma

C) Femoral artery true aneurysm

D) Hematoma in continuity with arterial lumen

E) Femoral artery thrombosis

[ArchivalUser]

i think A

bruit is typical of av fistula

[ArchivalUser]

No try again
In AV fistula,expect to see hyperdynamic circulatuin

[ArchivalUser]

C?

[ArchivalUser]

ops, it's actually a pseudo aneurysm, just saw femoral artery anuerysm and picked that. So, maybe D?

[ArchivalUser]

After catherization

palpable mass + no overlying bruit= hematoma

palpable mass + overlying bruit without hyperdynamic circulation= pseudoaneurysm

palpable mass + overlying bruit with hyperdynamic circulation = AV fistula

palpable mass +/- bruit with no distal pulse= femoral artery thrombosis

So definitely yes doc 0610
D is correct answer

[ArchivalUser]

nice explanation!Thank you!