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Old 06-10-2011
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Lungs Management of pulmonary embolism!

By now we all know management of pe i,e abg,cxr,ecg,v/q,dvt inv,spiral ct
so which :
1.initial most
2.next step in case-stable,unstable,sympto,asympto
3.gold std for diagnosing
4.inital treatment
5.unresponsive case
we know that as soon as unstable patient reach hospit abg,cxr,ecg are done....but what should be choosen if q asks single
most diagnostic,theraptc,next approach...by next step means theraptic or diagntic approach?if v/q is normal...it means that we have to exclude pe?

Last edited by Ace3; 06-10-2011 at 09:15 AM.
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Old 06-10-2011
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Default VQ in PE!

VQ reports as probability-low, moderate and high!

Not exclude PE completely. Need to proceed with CTPA in moderate risk group if other clinical features are suggestive!
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Old 06-10-2011
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yes..if its low risk with completly normal v/q (as kap says if v/q normal chance of pe to 0%)..so next step is still ctpa?
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Old 06-10-2011
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initial (ABG -cxray -ecg)
if normal cxray the next step to dx is V/Q
if abnormal cxray the next step dx is spiral ct angiography
if spiral ct negtive then do LE doppler or V/Q if they r negtive stop rx
because when u suspect pe u start rx (anticoagulant (warfarin &heparin ) ) dont wait to confirm dx like in DVT (u have to confirm DX 1st then rx given)
if LE doppler is postive no need further IX start anticoagulant (heparin and 6 months warfarin)
if there is C.I to anticoagulant or recurrent emboli or RV dysfunction (RV hypertrophy ) then IVC filter
if unstable or acute RV dysfunction give thrombolytics if they r C.I then emblectomy

Most accurate test is angiography (gold stander )

these all what u need to know to solve q
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Old 06-10-2011
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Quote:
Originally Posted by miss patho View Post
initial (ABG -cxray -ecg)
if normal cxray the next step to dx is V/Q
if abnormal cxray the next step dx is spiral ct angiography
if spiral ct negtive then do LE doppler or V/Q if they r negtive stop rx
because when u suspect pe u start rx (anticoagulant (warfarin &heparin ) ) dont wait to confirm dx like in DVT (u have to confirm DX 1st then rx given)
if LE doppler is postive no need further IX start anticoagulant (heparin and 6 months warfarin)
if there is C.I to anticoagulant or recurrent emboli or RV dysfunction (RV hypertrophy ) then IVC filter
if unstable or acute RV dysfunction give thrombolytics if they r C.I then emblectomy

Most accurate test is angiography (gold stander )

these all what u need to know to solve q
Good solid answer!

Do you have any tricky clinical senarios to share?
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Old 06-10-2011
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Quote:
Originally Posted by 1TA2B View Post
Good solid answer!

Do you have any tricky clinical senarios to share?
if iwill find one iwill be glad to post it
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