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pulmonary emboli

Current Issues in Management of VTE

Mark Blostein, MD FRCP(C)
Associate Professor of Medicine
Director, Clinical Investigator Program
McGill University
Director, Coagulation Laboratories and Anticoagulation Clinic
SMDB-Jewish General Hospital

 

 

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    The Symptoms:

    • This is a case report series based on real patients, built around a graphic backbone.
    • Much of the communication is visual. The graphic forms an image of the teaching points.
    • The characters are based on needs and more than one case will unfold with each episode.
    • The teaching points are folded into the graphics, the images, references, reports and the quiz.
    • The episodes allow you, as the narrative progresses, to reflect , consult the references and if you wish to form a self study project.
    • The series is intended to promote reflection and the sharing of ideas in a community linked by the forum. (you need a password for this)
    • The graphics are by Jesse Bochner, the author of the series is Michael Rosengarten

    How to use the Symptoms:

    • Follow the evolution of the cases (Enjoy Jesse Bochner's great graphics)
    • Reflect on the narrative, the differential diagnosis, the tests , and the actions you would take.
    • Visit the references and explore the online resources to reflect on and deepen your knowledge.
    • Take the quiz (you will need a password for this)
    • Reflect on your answers.
    • Share your ideas on the forum (don't be a lurker!), stimulate others to reflect, and be stimulated in turn.
    • Give us feedback and fill out the evaluation form at least once.

    N.B:

    The teaching points are in the Quiz, so it is important to take the Quiz.

    Disclaimer:

    By viewing the material on this site you understand and accept that:


    · The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of McGill.
    · The hosting of material on the McGill CME site does not signify endorsement of this material by McGill.
    · The material is solely for educational purposes for qualified health care professionals.
    · McGill University is not liable for any decision made or action taken based on the information contained in the material on this site.
    · The information cannot be used as a substitute for professional care.
    · The information does not represent a standard of care.
    · No physician-patient relationship is being established.
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    In this episode:

    • George has been released from the hospital and is on 10 mg of coumadin.
    • On this dose he is remarkably stable and has a INR which is in the range of 2.4 to 2.7.
    • He develops a toothache and visits his dentist.
    • The dentist finds the tender spot!
    • George will have to have a root canal and a crown but there is a problem.
    • The base of tooth that can be saved is very near the gum line and the tooth behind it, the last molar will have to go!

     

    How to use this module:

    • Read the graphic novel strip
    • Watch the video with Dr. Blostein.
    • Take the quiz ***
    • Checkout the references
    • Join the forum***

    ***you need to have a password for this
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Take the quiz

 

Note: a password is required.

 

 

 

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·      Büller HR et al for Matisse Investigators. Ann Intern Med. 2004;140:867-873.

·      Büller HR et al. Chest. 2004;126(3 Suppl):401S-428S.

·      Carrier M, Righini M, Djurabi RK, Huisman MV, Perrier A, Wells PS, Rodger M, Wuillemin WA, Le Gal G. VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism. A systematic review of management outcome studies. Thromb Haemost. 2009 May;101(5):886-92.

·      Heit JA, O’Fallon WM, Petterson TM, et al. Prevention of Venous ThromboembolismRelative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med 2002; 162:1245–1248

·      Hirsh J, Raschke R. Chest 2004;126(3 Suppl):188S-203S..

·      Kearon C et al; for McMaster Diagnostic Imaging Practice Guidelines Initiative. Ann Intern Med. 1998;128:663-677.

·      Kearon et.al 2001; Bates et.al 2003; Anderson et.al 2003; Schutgens et.al 2003; Wells et al, 2003.

·      Lensing AW et al. N Engl J Med. 1989;320:342-345.

·      Scarvelis D, Wells PS. Diagnosis and treatment of deep-vein thrombosis. CMAJ. 2006;175:1087-1092

·    William H. Geerts, David Bergqvist, Graham F. Pineo, John A. Heit, Charles M. Samama, Michael R. Lassen and Clifford W. Colwell
Prevention of Venous Thromboembolism. http://chestjournal.chestpubs.org/content/133/6_suppl/381S.f ull.html

 

More references are available on PubMed

 

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