Correct!
5. All of the above
All of the above are appropriate measures. Ventilation-perfusion scintigraphy is appropriate for suspected pulmonary embolism evaluation, given the patient’s elevated D-dimer levels. Transplant consultation is also appropriate in the context of liver transplantation, particularly considering a recent liver surveillance biopsy showing cellular rejection, which must be managed in the context of possible pneumonia. Pulmonary Medicine consultation is also appropriate. An echocardiographic examination of the heart is also reasonable given the elevated BNP levels.
Ventilation-perfusion scintigraphy was performed and interpreted as low probability of acute pulmonary embolism. Echocardiography showed normal left ventricular function. Pulmonary Medicine was consulted, and the Transplant service was engaged to manage the patient’s immunosuppression considering the presumption of RSV pneumonia. Coccidioidomycosis testing was negative. Review of the patient’s CT scan obtained in the Emergency Room, and comparing to the study two years earlier (Figure 7), was conducted.
Figure 7. Comparison of recent (A-D) chest CT scan performed in the Emergency Room with the chest CT(E-H) 2 years earlier. To view Figure 7 in a separate enlarged window, click here.
Which of the following represents an appropriate conclusion for the-review examination? (Click on the correct answer to be directed to the ninth of 12 pages)
