A 35-year-old woman with no significant risk factors presents to the emergency room with pleuritic chest pain 48 hours after prolonged airplane flight. Her examination is normal except for tachycardia. Chest X ray is normal. The correct course of action is?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Give heparin and order a lung ventilation perfusion scan
Pleuritic pain after a long flight with tachycardia and a normal CXR makes PE the most likely diagnosis (Wells: PE most likely 3 + HR>100 1.5 = PE likely). With significant suspicion and no bleeding risk, start heparin immediately and then confirm with imaging (V/Q here) rather than waiting for the scan (option A). NSAIDs, antibiotics or discharge would miss a potentially fatal PE.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Waiting for the V/Q result before treating is wrong: do not wait for studies to confirm PE when clinical suspicion is high.
✓ Step Up To Medicine 6th Edition 2024( PE).pdf · p. 10 -
D
ليش صح
With high suspicion of PE and no bleeding concern, start anticoagulation immediately without waiting for confirmatory studies, then order the scan.
✓ Step Up To Medicine 6th Edition 2024( PE).pdf · p. 10 -
E
ليش غلط
PE findings are often subtle, so a near-normal exam does not allow discharge; with high clinical suspicion you start treatment.
✓ Step Up To Medicine 6th Edition 2024( PE).pdf · p. 10
- المصدر
- Step Up To Medicine 6th Edition 2024( PE).pdf · p. 10
- المحاضرة
- Venous Thromboembolism · Pulmonology · Module B
- ظهر في
- Respi bank