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What is the most common presenting complaint for a patient with a PE? • Chest pain • Cough • Dyspnoea • Leg pain • Syncope
Which item is not a Wells criterion for DVT? • Active cancer • Lower limb paralysis • Varicose veins • Previous DVT • None. All are Wells criteria for DVT.
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Which item is not a Wells criterion for PE? • Sinus tachycardia • Haemoptysis • Recent abdominal surgery • Previous DVT • None. All are Wells criteria for PE
What is the best use of a D-Dimer test? • Rule out an unlikely PE • Confirm a suspected PE
Key investigations for suspected PE in a patient in shock are ECG and CTPA (CT pulmonary angiography) How do you decide which to do first?
What are you looking on the ECG? Remember – patient is in shock Right heart failure Left heart failure Ventricular tachycardia Supraventricular tachycardia
Prothrombin time is a laboratory test used to assess a) the extrinsic thromboplastin system. b) vitamin K deficiency. c) liver damage. d) dose of oral anti-coagulant medication. e) dose of vitamin K required.
People suffering from disorders that prevent absorption of fat from the intestine may suffer uncontrollable bleeding because a) the fat-soluble vitamin K cannot be absorbed, so levels of prothrombin and other clotting factors drop. b) fat droplets in the blood normally help platelets and other formed elements stick together during hemostasis. c) vitamin B12 cannot be absorbed, so there are inadequate formed elements present to produce a clot. d) fatty acids are necessary for the complete synthesis of fibrin. e) fat prevents the complete inactivation of plasmin.
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Rana thinks she should exercise more, and is checking out treadmills on eBay. Ming is feeling guilty for smoking at a party last night again after 3 smoke free months. Cruella blows smoke in your face and says “You can take my Marlboroughs from my cold, dead hands.” Angie knows she drinks more than she should, but she is afraid that she won’t be able to enjoy her nights out with friends if she cuts back. Tahsin and his wife have made a healthy meal plan with the help of a dietitian.
Aspirin therapy • Disseminated Intravascular Coagulation • Haemophilia • Thrombocytopenia • Von Willebrand disease • Warfarin therapy / Vitamin K deficiency ?? ?? ?? ?? ?? ??