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professional football player complains of sudden onset of palpitations and shortness of breath 5 days after having knee replacement surgey.His pulse is 100/mt and regular.oxygen saturation is 90%.an ECG shows tachycardia.chest x ray is nl.which is most appropriate next step?
a.order an arterial blood gas
b.duplex doppler for lower extremity
c.V/Q scan
d.I/V heparin
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This question was discussed earlier...
This is a Surgery question from Kaplan Q-book...Surgery test #1 and Question #12
The management has changed...I have two Q-books with me...the old Q-book the answer is A...he gives a rational explanation to doing ABG's...but the new Qbook says the answer is D. IV heparin...he explains that looking at the oxygen sat. and h/o, PE is diagnosed and there is not need for any further investigation...and treatment with IV heparin is started along with oxygen...In real life both are started at the same time for exam purpose D is the correct answer...I think you missed one option (Oxygen)
anyways...D IV HEPARIN IS the CORRECT ANSWER...
over the last some years....management of PE has changed quite a bit...Step up for Medicine has PE in it...and it is very well explained.
Thanks for bringing up this question...I had planned on posting it...
Take care,
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ck007 u r rt but the book i have is 2008 fourth edition,is there any fifth edition u r talking about??
and the ans given in 2008 edition is AA
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what I have inferred is if first step is needed give heparin but if once invg have started like ABG or VQ scan go on to invg with doppler, CT , Angio. till the result is there & than only give heparin.
similar is the case with pul nodule in hgh risk pt & breast lump in female more than 40 yrs age to go on to invg till result is there.
what do u say friends
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Question on Page 505 of kaplan Q-book 2008-2009
12: A 40 year old retired professional football player complains of the sudden onlset ............what is the next step in management?
A. Order an arterial blood gas
B. Schedule a duples Doppler examination of the lower extremities
C. Schedule a ventilation-perfusion scan
D. Administer supplemental oxygen
E. Administer IV heparin
Explaination: Correct answer is E.
Pg 518 and 519
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by the way when you have a suspicion of PE, what do you do first ?
HRCT or V/Q scanning ?
my doubt.
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vq scan by book
ct practically
