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PULMONARY EMBOLISM-ALGORITHM

Respiratory

PULMONARY EMBOLISM-ALGORITHM

1. Use clinical prediction rules to determine pretest probability of PE in symptomatic patients.

2. In patients with low pretest probability, a negative highly sensitive D-dimer indicates a low likelihood of PE and essentially excludes the diagnosis.

3. U/S of lower extremities is recommended for patients with intermediate-to-high pretest probability for PE.

4. If high pretest probability and proximal (ileofemoral or higher) thrombi, treat for PE.

5. CTPA, V/Q scan, or standard pulmonary angiography is recommended in patients with intermediate or high pretest probability if lower extremity U/S does not show clot.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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