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HANNA
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Diagnostic test for patients presenting with chest pain
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06.17.04 (4 years ago)
#1
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Theme: Diagnostic test for patients presenting with chest pain
Options
A Abdominal ultrasound'
B Blood culture
C Bronchoscopy
D Cardiac enzymes
E Chest x -ray
F CT
G ECG
H Full blood count (FBC)
I Lumbar puncture
J Oesophago-gastro-duodenoscopy
K Ventilation / Perfusion scan
Instructions
For each patient described below, choose the single next most appropriate test from the above list of Options. Each option may be used once, more than once, or not at all.
431 A 68-year-old man has had malaise for five days & fever for two days .He has a cough & you find dullness to percussion at the left lung base.
432 A 50-year-old woman returned by air to the UK from Australia
. Three days later she presents with sharp chest pain & breathlessness. Her chest x-ray & ECG are normal.
433 A tall, thin, young man has a sudden pain in the chest & left shoulder & breathlessness while cycling.
434 A 45-year-old manual worker presents with a two-hour H/O chest pain radiating into the left arm. His ECG is normal.
435 A 52-year-old obese man has had episodic anterior chest pain, particularly at night, for three weeks. Chest x-ray & ECG are normal.
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sajida
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06.17.04 (4 years ago)
#2
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1--e
2--k
3--e
4--d
5--j
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ria_siz18
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03.13.06 (2 years ago)
#3
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431 A---- E
432A-----K
433 A----G
434 A------E
435 A------J
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nazia_k
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06.15.06 (2 years ago)
#4
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431-E
432-K
433-E
434-D
435-J
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Saleel
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06.22.06 (2 years ago)
#5
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I don't think you'd do a CXR in:
433 A tall, thin, young man has a sudden pain in the chest & left shoulder & breathlessness while cycling.
it could be a tension pneumo, in which case you'd want to aspirate and drain immediately, rather than waste time doing a CXR.
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oct8
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06.23.06 (2 years ago)
#6
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431-E
432-K
433-E
434-D
435-J
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AAAAAA
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06.25.06 (2 years ago)
#7
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| Saleel wrote: |
I don't think you'd do a CXR in:
433 A tall, thin, young man has a sudden pain in the chest & left shoulder & breathlessness while cycling.
it could be a tension pneumo, in which case you'd want to aspirate and drain immediately, rather than waste time doing a CXR. |
Do CXR and put a needle in the right 2nd intercostal space.
(after 25 years of real ER experience in US, the answer is still CXR !)
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AAAAAA
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06.25.06 (2 years ago)
#8
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| Saleel wrote: |
I don't think you'd do a CXR in:
433 A tall, thin, young man has a sudden pain in the chest & left shoulder & breathlessness while cycling.
it could be a tension pneumo, in which case you'd want to aspirate and drain immediately, rather than waste time doing a CXR. |
I have put in many, many chest tubes in the ICU and ER for spontaneous pnemo not tension but the EM textbooks said, you wait and observe if the spontaneous pnemo is less than 10-15%
So the answer is still CXR
25 years experience in ER but still the emergency medicine book said otherwise.
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AAAAAA
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06.26.06 (2 years ago)
#9
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Please they ask you moe than CXR in the exam.
They want you to tell them the physical findings of tension pnemothorax !
urgent, this wll be in the exam !
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AAAAAA
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06.26.06 (2 years ago)
#10
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Management of a tension pnemothorax should include chest X ray (CXR) before needle decompression !!!!!!!!!
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