cirus
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& This ??
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Edited by cirus on 08/14/07 - 04:26 PM
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| dr in trouble
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Echocardiography
Renal ca
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| Ivonne
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I have a question for the first case if the V/Q scan shows low probability but with high clinical probability the next step should be? Angiography.
Dr in trouble would you please explain your answer in this case
Renal CA
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| dma89
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For next best step in management type of questions, you have to go from least invasive to most invasive step. For the first case, the choice that will give you a diagnosis and is least invasive is an echo. You'd certainly do a pulmonary angiography but only as a last resort since it's a very invasive procedure.
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| radonc
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1st question: Pulmonary angio. Strong suspicion of PE.
2nd question - Polycystic kidney disease, leading to chronic renal failure. The disease presentation over 20 years makes this unlikely to be cancer.
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| cirus
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radonc wrote:
1st question: Pulmonary angio. Strong suspicion of PE.
2nd question - Polycystic kidney disease, leading to chronic renal failure. The disease presentation over 20 years makes this unlikely to be cancer.
Agree with radonc
for the first qs, u have to exclude PE prior to other investigs.
For the 2nd qs, its very unlikely to have Renal C for 20 years, with such mild sympts,& if Renal cancer, why does she have HTN then as renal cancer is unilateral & the other Kidney is supposed to be functioning, I answered it Polycystic Kid, but the only problem I had is that by palation, a unilateral mass was there & PKD is bylateral...
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| Ivonne
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Thanks guys for info
interesting questions
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| Justice
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E
D
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| hanwin
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I agree with radonc.
1. Pul angio
2. PKD
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| dr_arc
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the first one is def a PE so next step would be further inv, hence angiography
second question, PKD. in addition to the HT , long standing urinary complaints. palpable flank mass, what also goes against the diagnosis of renal cell ca is the absence of wt loss or other systemic features as also the prescence of pale mucus memb.
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| MAGY17
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-ANGIOGRAPHY
-PKD=FLANK PAIN, NOSTURIA AND MASS
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