In the context of vascular procedures via femoral access, which sign suggests retroperitoneal bleeding may be developing?

• A. Back pain and hypotension
• B. Headache and dizziness
• C. Nausea and vomiting
• D. Rash at injection site

Answer: (A)

The main idea here is recognizing signs of retroperitoneal bleeding after femoral arterial access. If bleeding begins in the retroperitoneal space, the patient may not have obvious external bleeding right away, but the accumulating blood irritates tissues and reduces circulating volume. A hallmark clue is sudden back or flank pain coupled with a drop in blood pressure, indicating internal hemorrhage and hemodynamic instability. This combination requires urgent evaluation and intervention.

Headache and dizziness are nonspecific and can stem from many causes, not specifically retroperitoneal bleeding. Nausea and vomiting likewise can occur with various conditions. Rash at the injection site suggests a local skin reaction, not internal vascular injury.