Pulmonary embolism - harry206

[ArchivalUser]

ct with contrast

[ArchivalUser]

I would say treat PE bcoz of high suspicion but if we do any investig ...it will be angiography

[ArchivalUser]

treat PE

[ArchivalUser]

chest CT angiogram

[ArchivalUser]

whats the answer? charismatician????????

[ArchivalUser]

oh sorry whats answer harry206?????????

[ArchivalUser]

where D dimer testing fall in this

[ArchivalUser]

start heparin

[ArchivalUser]

pt with high suspicion for PE (history and PE)
i wouldn't go for far,
if ekg and chest x-ray ---> normal
and ABG suggestive of PE--
i would go for Heparin.
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i gathered this from kaplan ck, MTB and UW (didn't go far, so do not know) --
Diagnosis of PE
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CXR abnormal --- spiral CT (= CT angiogram)
CXR normal ----- V/Q scan

Regarding V/Q,

Truly normal ---> exclude PE

high probability --------> straight rx “ heparin

intermediate probability --------->lower extremities venous USG or CT angiogram.

low probability -------------> if want to exclude PE, single test ans: d-dimer test.  normal (i.e. no PE), if increased ------> CT angiogram

But remember,
Sudden SOB+ clear lungs + risk factor i.e. clinically suggestive of PE

FIRST thing to do after CXR, EKG, ABG ------ Heparin.

Hopefully and surprisingly you will not find any confusing options in ques. As example heparin and V/Q scan together. I observed it in UW ques.

[ArchivalUser]

Ans- Angiography