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Author7 Posts
  #1

I guess this stuff comes up a LOT in questions...

Diagnosis of DVT:
FIRST step: Doppler U/S
GOLD Standard: Venogram

Diagnosis of PE:
FIRST step: V/Q Scan
GOLD Standard: Pulm. Angiogram

-When do we do a Spiral CT or MRA?

-Please add any other important points.


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Our greatest glory is not in never falling, but in rising every time we fall.

  #2

You got it right, DrVirgo!
just a little addendum:
-for DVT, Magnetic resonance venography is as accurate as contrast venogram and is useful for pts w/ contraindications to IV contrast.
-for PE: CT angio or spiral CT is the best of choice if V/Q is equivocal or negative but has high suspicion for PE; it's preferable to pulmonary angiogram since it's not invasive. MRA as limited evidence as a good diagnostic test for PE though it could ID small clots.

___________________
"Our greatest glory is not in never falling but in rising every time we fall." --Confucius

  #3

Put in mind in diagnosis of PE, 1st step is an X-RAY,EKG, & ABGs

in case of very high susption (history), X-ray, heparin(will not hirtsmiling face), then as before..

UW


  #4

CT angio or spiral CT is the best of choice if V/Q is equivocal or negative

  #5

neuroblastoma wrote:
CT angio or spiral CT is the best of choice if V/Q is equivocal or negative

if V/Q scan is equivocal

first check the legs (Pressure US)

if +ve--->its PE

If -ve

then an ARTERIOGRAPHY, not CT.

CT is good for mesenteric occlusions.


  #6

Great classic q Dr. Virgo.. But as I remember spiral CT for PE may not pick up distal thromoemboli..

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  #7

In PE u will go for spiral CT if baseline Xray is abnormal and V/Q scan is equivocal or negative, but the clinical findings suggest PE.


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