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Blood & Clots Series: Subsegmental PE – To Treat or Not To Treat?

In Blood & Clots, Medical Concepts by Eric TsengLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical expert, scholar Main Messages   Improved technology has led to an increase in the detection of subsegmental PE (SSPE)   An algorithmic approach can help identify patients who will benefit from anticoagulation: generally those with concomitant DVTs and patients with additional risk factors for progression  There is clinical equipoise regarding the decision to anticoagulate in this case, and …

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Blood & Clots Series: Is Fecal Occult Blood Testing helpful in deciding whether it’s safe to prescribe anticoagulants?

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All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert, Leader Case Description You have just diagnosed a 55-year-old male with an acute proximal deep vein thrombosis in the emergency department. The event was unprovoked, and he has symptoms of leg swelling and pain. He is otherwise healthy and takes no regular medications. He has no symptoms suggestive of PE, and his blood pressure and oxygen …

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Blood & Clots Series: How do I manage acute VTE in pregnancy?

In Blood & Clots, Medical Concepts by Eric Tseng1 Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert, Collaborator Case Description You’re an EM resident seconded off-service on your internal medicine rotation,  and it’s your night on call. The emergency physician asks you to see a pregnant patient with acute pulmonary embolism. Your patient is a 32 year old G3P2 female at 33 weeks gestational age. Her previous pregnancies were uneventful spontaneous vaginal …

Blood and Clots Series: Diagnosing pulmonary embolism in pregnancy

In Blood & Clots, Medical Concepts by Eric Tseng3 Comments

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert Case Description  A pregnant 32 year old female presents to the ER with chest pain. She is 33 weeks gestational age, and this is her third pregnancy (two prior uneventful deliveries). Her pain started 3 hours ago while she was watching television. It is sharp, worse with inspiration, and located along the right costal margin. …

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Blood and Clots Series: My patient has a pulmonary embolism. Should I screen them for cancer?

In Blood & Clots, Medical Concepts by Eric TsengLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert, Leader Case Description An 83 year old female presents for follow-up after completing 3 months of oral anticoagulant therapy with Rivaroxaban for her unprovoked deep vein thrombosis. She did some research online and heard about a link between venous thrombosis and cancer, and asks why you are not getting a CT scan to rule out malignancy. …

Blood and Clots Series: Which antithrombotic therapy should I start for my patient with acute VTE?

In Blood & Clots, Medical Concepts by Eric Tseng7 Comments

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert Case Description You diagnose an 83 year old female patient with an acute DVT. Her comorbidities include hypertension, diabetes, mild chronic kidney disease  (CrCL 55), osteoarthritis, and early mild cognitive impairment for which she is taking Ramipril 10 mg daily, Hydrochlorothiazide 25 mg daily, Metformin 500 mg TID, Donepezil 10 mg daily, and Ibuprofen 200 mg …