msyamp
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C in massive embolism
Edited by msyamp on 08/15/06 - 09:38 PM
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| study_ing
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E..a v/q scan is the initial DIAGNOSTIC test.
pulmonary angigram is the gold standard.
echo wud only reveal large clots occasionally i guess
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| achilles
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i'll go for E too.
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| wyvern
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me too E.
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| HighHopes
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E
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| shumaila
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most appropriate initial diagnostic study I think ABGS bc we could rule out PE is there is no evidence of hypoxemia
then v/qscan
angiography i am wrongis gold standard
correct me if
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| shumaila
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gold standard angio
correct me if iam wrong
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| usmlecracker
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in kaplan it says..
v/q is the first initial
angio gold standard..
but the question asks appropriate test...i go for ABG
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| AAAAA
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[quote=nida]The most appropriate initial diagnostic study to confirm the diagnosis of pulmonary embolism is:
a) sputum culture
b) arterial blood gas
c) echocardiogram
d) lower extremity ultrasound
e) ventilation/perfusion (V/Q) scan[/quote
E
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| frank100
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yes, the question says "most appropriate initial diagnostic study" and v/q scan is the one here.
if the question says,"first best next step in management", or so... ABG would be a good bet
my answer is (e)
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| sheeezooo
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E
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| nida
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Yes, E) is the right anwser for this Q (From Blueprint Cardiology)
V/Q scan is the first diagnostic procedure to be performed. this is highly specific but insensitive.
Pulmonary angiography is the definitive diagnostic method for PE, but should be used only after non-invasive procedure have failed.
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| juanma0
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Note : ABG's are wrong because we use them to screen for pulmonary embolus, not to diagnose. They have terribly low specificity and moderate sensitivity. Inpedently of results of abg we still use V/Q scan.
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| ssrpk
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hey study ing, why don't u type it up on another page, as it is nopt even related to this topic!
wel, the only management in head trauma with evidence of intracranial bleed and raised ICP is emergency decompression! [craniotomy/burr hole and evacuation]
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| study_ing
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oops wrong document attacthed..the step 2 is getting to my neurons!!..ill edit it
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| tolito
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try some vit b12  !!!!
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| cbenitesch
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I think we need to think CHEAP first!... Iīll go for ABG and then V/Q scan, I know V/Q is a gold standard but I think we need first to think cheap... thatīs what Goljan says! 
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| study_ing
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well its not about expenses, its about the case. i realized it today when i got loads of Qs wrong again!!
if the pt is being evaluated for dyspnea, u need to have ABG and a CXR first.. ( this wud be gthe next best step)
if the case mentions an acute onset dyspnea, and cxr and ABGs already have been done we have a strong suspicion abt PE, we go for a v/q scan provided the lungs are normal. if there are preexisting lung abnormalities, we choose CT instead. ( or if they ask for the next best test to confirm dx)
gold standard is pulm. angiography which is seldom done. if there is a high clinical supicicon and the results of thge other noninvasive investigations are equivocal, then perhaps it cud beb done.
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| chemamr
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E
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