Podcast #249: D-Dimer

Podcast #249: D-Dimer

Author: Michael Hunt, M.D.

Educational Pearls

  • In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification. The goal of the study was to show that CT scan usage could safely reduced using this screening method.
  • The Wells Criteria measures they used to stratify risk were: PE mostly likely dx, hemoptysis, and evidence of DVT. If the d-dimer was 1, but the patient had none of the Wells criteria, the patient did not get a CT. If the patient had any of the criteria, but the d-dimer was only 0.5, the patient did not get a CT scan.
  • The investigators reduced CT usage by 14% using the new criteria, with no significant increase in morbidity and mortality.

References: van der Hulle et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. The Lancet. 2017

Episoder(1150)

Podcast #290: The Biochemistry of DKA

Podcast #290: The Biochemistry of DKA

Author: Dave Rosenberg, M.D. Educational Pearls DKA commonly causes hyperkalemia, leading to peaked T-waves on ECG. However, DKA causes hypokalemia at the same time. In DKA, glucose cannot be taken i...

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Podcast #289: Cannabinoid Hyperemesis

Podcast #289: Cannabinoid Hyperemesis

Author: Dylan Luyten, M.D. Educational Pearls Cannabinoid Hyperemesis syndrome is a relatively new diagnosis that presents with vomiting and abdominal pain without a clear etiology in the setting of ...

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Podcast #288: Diarrhea

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Author: Peter Bakes, M.D. Educational Pearls Chronic diarrhea is defined as 3 or more loose, watery stools lasting more than 2-3 weeks. Look for clues in the history, including travel (could suggest...

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Podcast #287: Sepsis Bundles

Podcast #287: Sepsis Bundles

Author: Aaron Lessen, M.D. Educational Pearls Treatment "bundles" are a popular approach to the rapid resuscitation of septic patients. A recent study in New York, where sepsis bundles are mandatory,...

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Podcast #286: Coronary Vascular Conditions that aren't STEMI

Podcast #286: Coronary Vascular Conditions that aren't STEMI

Author: Don Stader, M.D. Educational Pearls While we usually associate the coronary vasculature with STEMIs, there are other pathologies that can affect the heart's blood supply. Kounis syndrome: an ...

3 Jan 20184min

Podcast #285: C Diff

Podcast #285: C Diff

Author: Aaron Lessen, M.D. Educational Pearls While C. difficile infections are generally thought of as nosocomial, there is a subset of patients who acquire the infection in the community. One rece...

1 Jan 20182min

Podcast #284: Plane Emergencies

Podcast #284: Plane Emergencies

Author: Erik Verzemneicks, M.D. Educational Pearls 1/600 flights has an on-board request for medical assistance. Most common complaints on board include: syncope, respiratory complaints, and GI compl...

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Podcast #283: Snow Blindness

Podcast #283: Snow Blindness

Author: John Winkler, M.D. Educational Pearls Photokeratitis is a UV burn of the sclera and cornea, which can cause blindness. UV light causes eyelid swelling with diffuse scarring of the eye (wides...

27 Des 20173min

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