A 65-year-old man has an acute left leg pain for 1 day, the pain is progressive around the knee, increased with movement and partially relieved with paracetamol. There is an associated redness and hotness. He does not recall trauma and is fully functional. His BP 120/60, HR 80 regular, temp 36, RR 16, O2 sat 95%. Localized swelling, redness and hotness obvious over knee joint. Lab work is impressive for elevated uric acid level According to DVT risk scoring criteria, what is the next appropriate test?
سؤال مجاني 3 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: B. D dimer
A red, hot, swollen knee with high uric acid suggests gout; with no DVT risk factors and a more likely alternative diagnosis, the DVT pretest probability (Wells) is low. In low probability the next test is a D-dimer: if negative, DVT is excluded; only if positive go to ultrasound. Duplex US first is for intermediate/high probability, so the old bank key (D) is not supported by the sources.
ليش كل خيار صح أو غلط
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B
ليش صح
With low or moderate pretest probability, D-dimer comes first: it rules DVT out if negative, and only if elevated do you go on to ultrasound.
✓ Step Up To Medicine 6th Edition 2024( PE).pdf · p. 2 -
C
ليش غلط
PTT is used to monitor heparin therapy, not to screen for DVT.
✓ Step Up To Medicine 6th, 2024 (anticoagulation).pdf · p. 1 -
D
ليش غلط
Ultrasound is the immediate next step only when pretest probability is high; with low or moderate probability, D-dimer comes first.
✓ Step Up To Medicine 6th Edition 2024( PE).pdf · p. 2 -
E
ليش غلط
Venography is the most accurate test for calf-vein DVT but it is invasive and infrequently used, so it is not the next test.
✓ Step Up To Medicine 6th Edition 2024( PE).pdf · p. 2
- المصدر
- Step Up To Medicine 6th Edition 2024( PE).pdf · p. 2
UQU VTE 3.pdf · p. 14 - المحاضرة
- Venous Thromboembolism · Pulmonology · Module B
- ظهر في
- Respi bank