Podcast
Questions and Answers
Why is the D-dimer assay considered a useful initial diagnostic tool for thromboembolic diseases despite its limitations?
Why is the D-dimer assay considered a useful initial diagnostic tool for thromboembolic diseases despite its limitations?
- It is non-invasive and can be repeated frequently without risk to the patient.
- It has high sensitivity, effectively ruling out thromboembolism when negative. (correct)
- It has high specificity, accurately confirming the presence of thromboembolism.
- It has a low cost and rapid turnaround time, making it easily accessible.
A patient presents with symptoms suggestive of a pulmonary embolism (PE). The D-dimer assay is positive. What is the MOST appropriate next step in diagnosis, considering the characteristics of available tests?
A patient presents with symptoms suggestive of a pulmonary embolism (PE). The D-dimer assay is positive. What is the MOST appropriate next step in diagnosis, considering the characteristics of available tests?
- Immediately start the patient on anticoagulation therapy to prevent further clot formation.
- Proceed with pulmonary angiography to definitively diagnose or exclude PE. (correct)
- Order lower limb ultrasonography to look for the source of the embolism.
- Perform ventilation-perfusion scintigraphy to confirm the diagnosis.
Which of the following diagnostic tests for thromboembolic disease is characterized by high specificity but low sensitivity?
Which of the following diagnostic tests for thromboembolic disease is characterized by high specificity but low sensitivity?
- D-dimer assay
- Lower limb ultrasonography (correct)
- Pulmonary angiography
- Ventilation-perfusion scintigraphy
Why is pulmonary angiography considered the gold standard for diagnosing pulmonary embolism, despite the existence of other diagnostic tests?
Why is pulmonary angiography considered the gold standard for diagnosing pulmonary embolism, despite the existence of other diagnostic tests?
A patient has a suspected pulmonary embolism, but is also at high risk for contrast-induced nephropathy. Which test might be LEAST appropriate as the initial diagnostic test?
A patient has a suspected pulmonary embolism, but is also at high risk for contrast-induced nephropathy. Which test might be LEAST appropriate as the initial diagnostic test?
Which test for thromboembolic disease might be most useful for excluding the diagnosis in a low-risk patient, but requires a more specific test if positive?
Which test for thromboembolic disease might be most useful for excluding the diagnosis in a low-risk patient, but requires a more specific test if positive?
A patient presents with leg swelling and possible DVT. What is the MOST appropriate initial diagnostic test?
A patient presents with leg swelling and possible DVT. What is the MOST appropriate initial diagnostic test?
If a V/Q scan result indicates a low probability of PE, how should treating physicians interpret and act on this finding, given the test's known limitations?
If a V/Q scan result indicates a low probability of PE, how should treating physicians interpret and act on this finding, given the test's known limitations?
What is a MAJOR limitation of using ventilation-perfusion scintigraphy (V/Q scan) as a primary diagnostic tool for pulmonary embolism?
What is a MAJOR limitation of using ventilation-perfusion scintigraphy (V/Q scan) as a primary diagnostic tool for pulmonary embolism?
How does the clinical context influence the selection of diagnostic tests for suspected thromboembolic disease, considering the limitations of each test?
How does the clinical context influence the selection of diagnostic tests for suspected thromboembolic disease, considering the limitations of each test?
Flashcards
D-dimer assay
D-dimer assay
A blood test that measures the amount of D-dimer, a protein fragment, in the blood. Elevated levels may indicate the presence of a blood clot.
Ventilation-perfusion (V/Q) scintigraphy
Ventilation-perfusion (V/Q) scintigraphy
A diagnostic test that uses radioactive material to assess airflow and blood flow in the lungs. Used to detect pulmonary embolisms.
Lower limb ultrasonography
Lower limb ultrasonography
A non-invasive imaging technique using sound waves to visualize blood clots in the deep veins of the legs.
Pulmonary angiography
Pulmonary angiography
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Study Notes
- Diagnostic tests for thromboembolic disease include the D dimer assay, ventilation perfusion scintigraphy, lower limb ultrasonography and pulmonary angiography.
- The D dimer assay has a high sensitivity but poor specificity.
- Ventilation perfusion scintigraphy, has a high sensitivity but very poor specificity.
- Lower limb ultrasonography has a high specificity but low sensitivity.
- Pulmonary angiography is becoming the standard of care for the evaluation of patients with suspected pulmonary embolism.
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