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Old 10-13-2012
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Arrow Gyrus Daily Questions; Internal Medicine #54

A 45 year old man comes to the emergency department after a motor vehicle accident resulting in a liver hematoma. On the third hospital day, he becomes suddenly short of breath. His chest X-ray is normal, and he is diagnosed with a pumonary embolus. What is the next best step in managment ?

a. Angiography.
b. Embolectomy.
c. Heparin
d. Inferior vena caval filter
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d. Inferior vena caval filter
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Answer C heparin.......

Sorry liver hematoma is contradication to heparin therapy, so it should be D
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Last edited by step_enhancer; 10-13-2012 at 04:08 AM.
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In my opinion if the patient is markedly unstable and impending death should perform Embolectomy other wise Inferior vena caval filter is indicated so if i should pick one answer I will follow K06100 and step_enhancer
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Major trauma precludes the use of anticoagulation. so IVC filters...D is my option
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well IVC filter is to prevent clot to form an embolus...what about the pulmonary embolus that is already causing problems???????? shudnt it be embolectomy to relieve the problem...............followed by IVC filter
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Quote:
Originally Posted by ts1234 View Post
well IVC filter is to prevent clot to form an embolus...what about the pulmonary embolus that is already causing problems???????? shudnt it be embolectomy to relieve the problem...............followed by IVC filter
Pulmonary embolectomy has high morbidity & mortality, so, you don't do it unless patient is hemodynamically unstable. In other words, it is a measure of last resort.
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Quote:
Originally Posted by K06100 View Post
d. Inferior vena caval filter
Quote:
Originally Posted by step_enhancer View Post
Answer C heparin.......

Sorry liver hematoma is contradication to heparin therapy, so it should be D

Quote:
Originally Posted by Novobiocin View Post
Pulmonary embolectomy has high morbidity & mortality, so, you don't do it unless patient is hemodynamically unstable. In other words, it is a measure of last resort.
Yes answer is
d. Inferior vena caval filter


Every one well contributed to the explanation ...Thanks...
Was confused as if should treat or prevent furthur episode..

Q is by Condrad Fisher...
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