ACCP pulmonary medicine board review by American College of Chest Physicians

By American College of Chest Physicians

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Initial test for suspected PE compared with the V/Q lung scan because of its greater sensitivity for PE and its ability to identify alternative diagnoses to PE. In addition, the use of CT scanning for the estimation of clot burden and right ventricular function is emerging as a useful prognostic measure in patients with documented acute PE. The use of magnetic resonance angiography for the detection of PE is in the initial testing phases. However, the initial results are promising, especially with gadolinium enhancement of the vasculature.

Most current, comprehensive clinical review of pulmonary nocardiosis (including expanded sections on newer diagnostic techniques and new therapeutic options). McGeinness G, Naidich DP. CT of airways disease and bronchiectasis. Radiol Clin North Am 2002; 40:1–19 This article discusses HRCT findings associated with medium-sized and small airways diseases, focusing on bronchiectasis of both infectious and noninfectious causes. McMullen AH, Pasta DJ, Frederick PD, et al. Impact of pregnancy on women with CF.

Embolus location affects the sensitivity of a rapid quantitative ddimer assay in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 2002; 165:345−348 d-dimer concentration and the accuracy of d-dimer assays are dependent on embolus location; smaller, subsegmental emboli may be missed when d-dimer assays are used as the sole test to exclude PE. Douketis JD, Kearon C, Bates S, et al. Risk of fatal pulmonary embolism in patients with treated venous thromboembolism. JAMA 1998; 279:458−462 Among patients with symptomatic PE or DVT who are treated with anticoagulation therapy for 3 months, the occurrence of fatal PE is rare during and after anticoagulant therapy.

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