How is mean arterial pressure (MAP) estimated, and what initial target does the 2026 Surviving Sepsis Campaign recommend in adult septic shock?

At a normal resting heart rate, MAP ≈ DBP + (SBP − DBP)/3, where SBP and DBP are systolic and diastolic blood pressure. The guideline recommends an initial MAP of 65 mmHg; for adults aged ≥65 years, it conditionally suggests 60–65 mmHg. Reassess perfusion and individualize subsequent targets; these are not targets for every type of shock.

What is pulse pressure, and what can widened or narrowed pulse pressure suggest?

Pulse pressure = systolic BP − diastolic BP. Widening can reflect arterial stiffness, aortic regurgitation or a hyperdynamic circulation. Narrowing can accompany low stroke volume, as in hypovolemia, severe heart failure or tamponade. Interpret it with age, blood pressure and the clinical setting; a single pulse-pressure cutoff does not diagnose these conditions.

What determines whether an adult with acute ischemic stroke can receive thrombolysis or thrombectomy?

Treat as early as possible after urgent imaging excludes hemorrhage. The 2026 AHA/ASA guideline supports alteplase or tenecteplase for eligible patients with disabling deficits within 4.5 hours. Selected patients with unknown onset or later presentation may qualify through imaging-based pathways; some extended thrombolysis pathways reach 24 hours when thrombectomy cannot be performed. Thrombectomy eligibility depends on the occluded vessel, imaging, disability and time; selected patients qualify up to 24 hours, including some with a large infarct core or basilar occlusion. A time window alone never establishes eligibility.

After a negative non-contrast CT for suspected subarachnoid hemorrhage, when should lumbar puncture be considered?

Under NICE NG228, do not routinely offer lumbar puncture if CT was obtained within 6 hours of symptom onset and a suitably experienced radiologist has reported and documented no hemorrhage; consider other diagnoses and specialist advice. If CT was obtained after 6 hours, consider lumbar puncture because sensitivity is lower. When indicated, wait at least 12 hours from symptom onset for reliable CSF bilirubin assessment. This is a defined diagnostic pathway, not a claim that every negative CT excludes hemorrhage.

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Medicine, Nursing & Clinical Italiano 3 Interactive Flashcard Decks

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3. Anteprima di Flashcard ad alto rendimento (Patologia)

Livello	Fronte (Domanda / Termine)	Retro (Risposta / Spiegazione)
`basic`	How is mean arterial pressure (MAP) estimated, and what initial target does the 2026 Surviving Sepsis Campaign recommend in adult septic shock?	At a normal resting heart rate, MAP ≈ DBP + (SBP − DBP)/3, where SBP and DBP are systolic and diastolic blood pressure. The guideline recommends an initial MAP of 65 mmHg; for adults aged ≥65 years, it conditionally suggests 60–65 mmHg. Reassess perfusion and individualize subsequent targets; these are not targets for every type of shock.
`basic`	What is pulse pressure, and what can widened or narrowed pulse pressure suggest?	Pulse pressure = systolic BP − diastolic BP. Widening can reflect arterial stiffness, aortic regurgitation or a hyperdynamic circulation. Narrowing can accompany low stroke volume, as in hypovolemia, severe heart failure or tamponade. Interpret it with age, blood pressure and the clinical setting; a single pulse-pressure cutoff does not diagnose these conditions.
`intermediate`	Which ECG pattern supports urgent STEMI treatment, and what are the 2025 ACC/AHA reperfusion time targets?	In an ischemic presentation without LV hypertrophy or left bundle branch block, new J-point ST elevation in at least two contiguous leads is significant at ≥1 mm, except V2–V3: ≥2 mm in men aged ≥40, ≥2.5 mm in younger men, or ≥1.5 mm in women. These thresholds alone do not establish or exclude acute coronary occlusion. Target first-medical-contact-to-device time is ≤90 minutes for direct PCI-center arrivals or ≤120 minutes when transfer is needed. If timely PCI is unavailable, fibrinolysis may be appropriate within 12 hours of symptom onset if there are no contraindications; target door-to-needle time is ≤30 minutes.
`intermediate`	Which four medication classes form foundational therapy for symptomatic heart failure with reduced ejection fraction (HFrEF)?	An angiotensin receptor–neprilysin inhibitor (sacubitril/valsartan), or an ACE inhibitor/ARB when ARNI is not feasible; an evidence-based beta blocker (carvedilol, metoprolol succinate or bisoprolol); a mineralocorticoid receptor antagonist (spironolactone or eplerenone); and an SGLT2 inhibitor (dapagliflozin or empagliflozin). Use these according to eligibility and tolerance, with kidney function, potassium and blood pressure monitoring. ARNI must not overlap with an ACE inhibitor; allow a 36-hour washout.
`advanced`	What determines whether an adult with acute ischemic stroke can receive thrombolysis or thrombectomy?	Treat as early as possible after urgent imaging excludes hemorrhage. The 2026 AHA/ASA guideline supports alteplase or tenecteplase for eligible patients with disabling deficits within 4.5 hours. Selected patients with unknown onset or later presentation may qualify through imaging-based pathways; some extended thrombolysis pathways reach 24 hours when thrombectomy cannot be performed. Thrombectomy eligibility depends on the occluded vessel, imaging, disability and time; selected patients qualify up to 24 hours, including some with a large infarct core or basilar occlusion. A time window alone never establishes eligibility.
`advanced`	After a negative non-contrast CT for suspected subarachnoid hemorrhage, when should lumbar puncture be considered?	Under NICE NG228, do not routinely offer lumbar puncture if CT was obtained within 6 hours of symptom onset and a suitably experienced radiologist has reported and documented no hemorrhage; consider other diagnoses and specialist advice. If CT was obtained after 6 hours, consider lumbar puncture because sensitivity is lower. When indicated, wait at least 12 hours from symptom onset for reliable CSF bilirubin assessment. This is a defined diagnostic pathway, not a claim that every negative CT excludes hemorrhage.

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