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(1146)

Podcast # 343: Snake Bites

Podcast # 343: Snake Bites

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Podcast # 342: Scombroid

Podcast # 342: Scombroid

Author: Jared Scott, MD Educational Pearls: Scombroid is a type of food poisoning associated with dark fish (i.e. tuna, salmon, mackerel) that mimics anaphylaxis. Occurs through conversion of histi...

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Podcast # 341: Tenecteplase vs. Alteplase

Podcast # 341: Tenecteplase vs. Alteplase

Author: Rachel Beham, PharmD Educational Pearls: Tenecteplase is more specific for fibrin and has a longer half-life than alteplase. In setting of ischemic stroke, tenecteplase before thrombectomy ...

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Podcast # 340: Drowning

Podcast # 340: Drowning

Author: Chris Holmes, MD Educational Pearls: Epidemiology: 80% male, ages 1-4 at greatest risk, African-American > Caucasian. Freshwater and ocean water may have more bacteria than pool water. ...

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Podcast # 339: Ectopic Pregnancy Risk Factors

Podcast # 339: Ectopic Pregnancy Risk Factors

Author: Jared Scott, MD Educational Pearls: Data is mixed, but some studies show 1-2% of pregnancies are ectopic. Risk factors for ectopic pregnancies include: pelvic inflammatory disease, prior ec...

8 Jun 20185min

Podcast # 338: Mononucleosis predictors

Podcast # 338: Mononucleosis predictors

Author: Chris Holmes, MD Educational Pearls: Symptoms commonly seen with mononucleosis are palatal petechiae, posterior cervical lymphadenopathy, inguinal/axillary lymphadenopathy, splenomegaly, and/...

6 Jun 20182min

Podcast # 337: Airway Burn Inhalation

Podcast # 337: Airway Burn Inhalation

Author: John Winkler, MD Educational Pearls: Singed nasal hairs, soot around mouth, hoarse voice, drooling, and burns to head/face are signs suggestive of inhalation injury. Early intubation is cri...

4 Jun 20186min

Podcast # 336: Hypokalemia

Podcast # 336: Hypokalemia

Author: Dylan Luyten, MD Educational Pearls:   Most important questions to answer with low potassium are 1. What are their symptoms? 2. Can they take potassium by mouth? Oral repletion is faster, c...

31 Mai 20183min

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