robin082006
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A 50-year-old man has had pain in his right arm for 3 hours. It is swollen, ruddy, and warmer than left arm. He was treated with heparin for superficial thrombophlebitis of right cephalic and the right saphenous vein 2 wks ago. His past medical history is remarkable only for back pain for a few months treated with NSAIDs. Vital signs are: PR: 70/min; BP: 140/80; RR: 10/min; Temperature: 37.0C(98.6F). Apart from the right arm, his thorough physical exam is normal. Cervical and chest x-rays show no abnormalities.
Laboratory results are:
Hct 50%
WBC 9,600/cmm
Neutrophils 60%
Eosinophils 2%
Basophils 0%
Lymphocytes 31%
Monocytes 7%
Platelets 120,000/cmm
PT 25 sec
PTT 39 sec
Fibrinogen 300 mg/dL
Fibrin split products positive
The next step is:
A. Protein C, S and antithrombin III level
B. Perfusion scintigraphy of lungs
C. Venography of right brachial, axillar and subclavian veins
D. CT of chest, abdomen and pelvis
E. CT of thoracic outlet
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| farewel
Forum Newbie
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A
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| Guptashutosh
Forum Elite
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C venography , look 4 dvt
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| anjushree
Forum Guru
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migrating thrombophlebitis-----answer is D
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| robin082006
Forum Hero
Topics: 471
Posts: 5,123
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answer is D, chronic DIC
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