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

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Author: Michael Hunt, M.D. Educational Pearls: Children under age of 6 are at greatest risk of accidental nicotine overdose from ingestion. Biphasic presentation: Hyperadrenergic = nausea, vomiting...

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Author: Sam Killian, M.D. Educational Pearls: "The Rabbit Has Died" is a lesser used phrase to denote finding out one is pregnant. During a test used in the 1930s, the "Rabbit's Test," a rabbit was i...

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Podcast #208: Vocal Cord Dysfunction

Podcast #208: Vocal Cord Dysfunction

Author: Martin O'Bryan M.D. Educational Pearls: Vocal cord dysfunction can mimic other causes of stridor, such as asthma and upper airway obstruction. Patients are often very anxious because of the d...

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Podcast #207: Boxer's Fracture

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