clear this trouble - vanco

[ArchivalUser]

IF U SUSPECT PE :

*********************1ST : CHEST X-RAY**************************************

IF NO CHANGE : V/Q SCAN***********IF ANY CHANGE OR CP DISEASE : HELICAL CTSCAN

1)IF V/Q SCAN IS EQUIVOCAL*********1)HIGH CLINICAL SUSPICION BUT -VE :
BUT LOW CLINICAL SUSPICION********PUL.ANGIO
: VENOUS STUDIES***************** 2)LOW CLINICAL SUSPICION BUT +:
2)IF V/Q SCAN IS EQUIVOCAL********** TREAT FOR PE
BUT HIGH CLINICAL SUSPICION
: PUL.ANGIOGRAPHY
3)IF V/Q SCAN IS -VE
: NO PE
4)IF +VE
: TREAT FOR PE

[ArchivalUser]

I hope it's clear..
if any mistakes plzz correct me

[ArchivalUser]

222 CHEST XRAY

[ArchivalUser]

I think when the question is asking for the next step we have to start with simplest test,,,,,so I go for CXR


where is the answer vanco???

[ArchivalUser]

V/Q,111

[ArchivalUser]

dear vanco ...where have you disappeared?

[ArchivalUser]

222

[ArchivalUser]

sir xray is answer.

chest xray very next step in P.E cases.

all the patients with dyspnea and noraml chest xray are considered as P.E.

than V/Q ratio is next step or if questin not giving xray in options.

chest xray to exclude other causes of chest pain and dypnea. i-e atelectasis, pulmoary effusion, pneumonia or any residual infections.

[ArchivalUser]

thanks vanco.....

when do you start with spiral CT in place of V/Q scan first????

[ArchivalUser]

you jump directly to spiral CT when u have some indicators of P.E on xray along with classic history.

u directly jump only to confirm and lable it as pulomonary embolism.

this is stage when u skip V/Q. this is also written in new 2008 kaplan.

most clinician directly prefer to go with spiral Ct, but usmle need academic steps.

xray. abgs, v/q , spiral ct, angiogram.