EM M4 SAEM EXAM 2024 QUESTIONS AND ANSWERS

EM M4 SAEM EXAM 2024 QUESTIONS AND ANSWERS treatment of PE - Answer ️️ -Anticoagulation may be started before imaging confirmation in patients with a high pre-test probability of the disease. Either unfractionated heparin or low- molecular weight heparins (e.g. enoxaparin) may be used in most cases. Warfarin (Coumadin) has a transient hypercoagulable effect; therefore, patients starting warfarin are placed on heparin until warfarin reaches a therapeutic level (INR 2-3). DOAC (rivaroxaban, apixaban, dibigatran) ideal for outpatient treatment of DVT/PE because they require no additional monitoring and have a quick onset of action, providing anti- coagulation much sooner than warfarin therapy. contraindications to anticoagulation - Answer ️️ -- Active pathological bleed - Coagulation disorder - Hepatic dysfunction w/ hi PT or INR - Severe thrombocytopenia - Malignant HTN - Hypersensitivity to meds what are massive and submassive PE - Answer ️️ -ICU admission is warranted for patients with "massive" PE and should be considered in patients with "submassive" PE. Massive PE is defined as causing persistent hypotension (including relative hypotension in patients with a history of hypertension) and does not refer to the size of the thrombus