THE ACUTE MANAGEMENT OF THROMBOSIS AND EMBOLISM
Options
A Chest X-ray
B Full blood count
C D-dimer
D Renal and hepatic function test
E CTPA(computed tomography pulmonary angiogram)
F V-Qscan (ventilation-perfusion lung scan)
G Bilateral lower-limb Doppler
H Anti-Xa level
I Spirometry
J Lower-limb Doppler on the suspected side
What would be the most appropriate investigation
in each scenario?
1. A 35 year-old woman who is 32 weeks pregnant presents with shortness of breath, chest pain and
reduced oxygen saturations. You suspect a pulmonary nembolism, but the chest X-ray is normal. What would
be your next line investigation?
2. A 26 year-old woman who is 28 weeks pregnant is being treated for a confirmed deep vein thrombosis and
weighs 95 kg. This is her second deep vein thrombosis in the last five years. The haematologist requests an
investigation on this patient
AIR TRAVEL AND PREGNANCY
Options
A Noadditional risk
B Low-dose aspirin
C Graduated elastic compression stockings
D Low-molecular-weight heparin for the day of travel
E Low-molecular-weight heparin for the day of travel and
several days after
F High-dose low-molecular-weight heparin
G Avoid flight after 32 weeks of gestation
H Avoid flight after 37 weeks of gestation
I Avoid flight after 34 weeks of gestation
J Avoid flight altogether
Match the most appropriate advice
to each scenario:
3. A 25-year-old woman presents to the antenatal clinic when she is 27 weeks pregnant. She is concerned about
her risk of venous thromboembolism during her forthcoming six hour flight to the USA. She has no
additional risk factors or known thrombophilia.
4. A28-year-old woman is 26 weeks pregnant in her first pregnancy, carrying monochorionic diamniotic twins.
She wishes to fly to Australia.
5. A32-year-old woman is 28 weeks pregnant and wishes to fly to the USA. Her booking haemoglobin was 9.0
g/dl and she has been on iron; however, at 28 weeks, her haemoglobin is 7.0 g/dl.
EMQ- Set no.1 Answers – journey to be a specialist
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