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Medical Council of Canada Qualifying Examination Part 1 Exam MCCQE Question # 12 Topic 2 Discussion

Medical Council of Canada Qualifying Examination Part 1 Exam MCCQE Question # 12 Topic 2 Discussion

MCCQE Exam Topic 2 Question 12 Discussion:
Question #: 12
Topic #: 2

A 79-year-old woman presents to the Emergency Department with sudden-onset severe chest and back pain that started 1 hour ago. She has a history of hypertension and looks unwell. Her vital signs are as follows: blood pressure 168/108 mm Hg, heart rate 110/min, respiratory rate 22/min, temperature 36.7°C. Findings of a physical examination of the chest and abdomen are normal. An urgent computed tomography (CT) scan of the chest and abdomen shows an aortic dissection extending from the descending thoracic aorta to the upper abdominal aorta. The branches of the abdominal aorta are patent. Following initial resuscitation, which one of the following is the best next step?


A.

Perform endovascular repair of the thoracic and abdominal aorta.


B.

Conduct open repair of the thoracic and abdominal aorta.


C.

Initiate intravenous labetalol.


D.

Start intravenous heparin.


E.

Admit the patient to the Intensive Care Unit and repeat CT in 6 hours.


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