docofthebigapple wrote:A 43 year old agitated male university professor comes rushing to your ER complaining of severe chest pain for the past three hours. The pain is excrutiatingly severe. It is radiating to his left jaw and left arm upto his medial epicondyle. The patients is very vocal about his pain and tells you he has never had this kind of pain previously. He is sweating profusely. The patient has a past history of angina and is taking medications for that S.O.S. He also reports allergy to aspirin and carries an Epi-pen with him at all times. He has no history of Diabetes. He has family history of obesity. His father died of a Car accident at the age of 55. His mother is alive and has chronic Bronchial asthama. He is 5 feet 9 inches and weighs 235 pounds on presentation. He lives with his wife for the past 16 years and has 3 children. He is very aware of his health and begs you to save his life. The next step in the management of this patient should be - Give chewable Aspirin
- Schedule an EKG
- EKG right away
- Emergency CT scan chest
- X-ray chest.
- Pulmonology consult
- Refer to a cardiologist
- IV. heparin
- clopidogrel
- Sublingial Nitrate
- Give IV thrombolytic
Please share your thoughts. Thanks
Management of MI is not to choose one single best answer.
So EKG right the way, chewable aspirin and also NTG are all correct.
Not need to argue. Not such question in management of MI !
EKG is very important to rule out anxiety, MI etc.
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
veens wrote:
i feel the best option wld be ekg....
aspirin is known to reduced mortality,if given immediately following mi
The patient has a past history of angina and is taking medications for that S.O.S. He also reports allergy to aspirin and carries an Epi-pen with him at all times
Chewable aspirin would have been the right answer if the pt does not have anaphylactic reaction to ASA.
Dr. Veens, you KILL the patient always.
Always, read the stem of the question very carefully !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
veens wrote:
i feel the best option wld be ekg....
aspirin is known to reduced mortality,if given immediately following mi
Aspirin, patient is allergic to aspirin and will DIE,
Doc Veens, You really want to kill your patient ?
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| veens
Forum Junior
Topics: 4
Posts: 64
|
hmmm such vehement response.....
i dint mean aspirin for this pt ,i have written it with regard to the previous post by docofthe apple regarding aspirin protocol in mi....
maybe u havent seen the first line where i said ekg is the next best option to proceed with the management
|
| vinidoc
Forum Newbie
Topics: 0
Posts: 10
|
why not iv thrombolytics?
|
| nihal
Forum Junior
Topics: 0
Posts: 10
|
sublingual nitrate and ekg rigth away
|
|
| |
| | | | | | | 
