mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
From what I read if there is "high" suspicion you go right to V/Q scan. I also understand that the spiral CT is not as sensitive for distal segmental arteries PE's. Just my 2 cents. (but heparinize first)
Edited by mjl1717 on 02/07/07 - 04:52 PM
___________________
Smell the coffee! "Is That an Osler move??"
|
| Aashi
Forum Moderator
Topics: 114
Posts: 1,062
|
Dr.jojo...relax..and dont get too anxious..be cool and read the q well..this is a clinical exam..ur treatment will be based on the pts presenting s/s ..u dont have to strictly follow,wht the book tells u ...use ur logic at times...if the clinical hx tells u the pt comes with sudden onset of dyspnea,hypotensive inc RR and sinus tachycardia with a rt ventricular strain and u find the pts past med hx has risk factors that can predispose him/her for a pul embolism like recent long trips, or OCP,obesity pregnancy etc--> then u MAY START TREATING the pt...but if the hx is not that sugesstive and not many s/s, that is highly suggestive of P.E and u want to rule out P.E-->do V/Q-->V/Q also will be ur answer if the pt doesnt have any hx of lung disease coz V/Q can be FALSELY POSITIVE in such conditions, so if the history tells u that pt has hx of EMPHYSEMA, PNEUMONIA, etc--> V/Q is not the right answer--> u may do a CT directly..and if lungs are clear,but hx not that suggestive do V/Q---if V/Q IS of HIGH probabilty-->start heparin...and now if low probablity--->answer can be DOPPLER u/s of legs---> if this negative---> do CT chest( NOWAdays this test is replaced V/Q scans in many centers)...and then finally pul angio..
So it all depends on the hx and clinical presentation of the pt ...relax ,dont panic and u will answer the qs right..
GL
Edited by Aashi on 02/07/07 - 04:57 PM
___________________
"Obstacles are those frightful things you see when you take your EYES off your goal."
|
| neuroblastoma
Forum Guru
Topics: 109
Posts: 1,091
|
DR AASHI .. u didnt mention about ABG?
|
| dr_jojo
|
thanx alot Dr aashi for ur explanation , when i should answer ABG 1st
can u clear this option 4 me plz
GL
|
|
| |
| | | | |
Similar forum topics