11 modules that Dr Iliana will cover during #online ⚡️Flash HO Induction on 1st August 2025 😇
Enroll for #Departmental Welcoming session NOW at Medicorp’s Teachable school; https://medicorp-class.teachable.com
You will learn;
✅ HO role in each posting,
✅ must-know #diseases for each posting; the common cases & #emergencies
✅ few case discussions as kickstart #revision for each posting!
.
It’s FREE with unlimited access so that you can learn whenever you want!
You will learn;
✅ HO role in each posting,
✅ must-know #diseases for each posting; the common cases & #emergencies
✅ few case discussions as kickstart #revision for each posting!
.
It’s FREE with unlimited access so that you can learn whenever you want!
Please read the full dengue CPG as well ✅
Alternatively, you can read the simplified version of the CPG on CPG Made Easy e-book;
https://medicorp.onpay.my/order/form/ebookcpgmadeeasy
Alternatively, you can read the simplified version of the CPG on CPG Made Easy e-book;
https://medicorp.onpay.my/order/form/ebookcpgmadeeasy
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More session #available for physical #workshop in April 2025 😇;
▶️ Clinical Skills 🙌🏻 ; practice 17 procedures in just 1 day ✅
.
▶️ Blood taking, #branula insertion & blood culture 💉🩸workshop
.
▶️ #Episiotomy repair & basic #suturing workshop ✂️🪡
.
Let’s brush up our clinical skills 👋🏻 before HOship soon;
https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop
▶️ Clinical Skills 🙌🏻 ; practice 17 procedures in just 1 day ✅
.
▶️ Blood taking, #branula insertion & blood culture 💉🩸workshop
.
▶️ #Episiotomy repair & basic #suturing workshop ✂️🪡
.
Let’s brush up our clinical skills 👋🏻 before HOship soon;
https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop
1️⃣ Wells' score for deep vein thrombosis (DVT) [Online calculator (MD Calc)]
🔹Active cancer (treatment ongoing or within previous 6/12 or
palliative): 1 pt
🔹Paralysis, paresis or recent immobilization of lower extremities: 1 pt
🔹Recently bedridden more than 3/7 or major surgery within 4/52: 1 pt
🔹Localized tenderness along the distribution of the deep venous
system: 1 pt
🔹Entire leg swollen: 1 pt
🔹Calf swelling >3 cm than asymptomatic side (measured 10 cm below tibial tuberosity): 1 pt
🔹Pitting odema, greater in the symptomatic leg: 1 pt
🔹Collateral superficial veins (non-varicose): 1 pt
🔹Previously documented DVT: 1 pt
🔹Alternative diagnosis* to DVT as likely or more likely: MINUS 2 points
*Alternative Dx such as:
- Cellulitis
- Superficial phlebitis
- Post-thrombotic syndrome
- Chronic venous insufficiency
- Muscle strain/tear
- Dependent oedema in paralysed limb
- Oedema due to liver cirrhosis/CHF
- External venous obstruction (eg compression by tumour)
- Pseudoaneurysm
- Haematoma
🔹Active cancer (treatment ongoing or within previous 6/12 or
palliative): 1 pt
🔹Paralysis, paresis or recent immobilization of lower extremities: 1 pt
🔹Recently bedridden more than 3/7 or major surgery within 4/52: 1 pt
🔹Localized tenderness along the distribution of the deep venous
system: 1 pt
🔹Entire leg swollen: 1 pt
🔹Calf swelling >3 cm than asymptomatic side (measured 10 cm below tibial tuberosity): 1 pt
🔹Pitting odema, greater in the symptomatic leg: 1 pt
🔹Collateral superficial veins (non-varicose): 1 pt
🔹Previously documented DVT: 1 pt
🔹Alternative diagnosis* to DVT as likely or more likely: MINUS 2 points
*Alternative Dx such as:
- Cellulitis
- Superficial phlebitis
- Post-thrombotic syndrome
- Chronic venous insufficiency
- Muscle strain/tear
- Dependent oedema in paralysed limb
- Oedema due to liver cirrhosis/CHF
- External venous obstruction (eg compression by tumour)
- Pseudoaneurysm
- Haematoma
====== ====== ====== ======
2️⃣ Wells' score for pulmonary embolism (PE) [Online calculator (MD Calc)]
🔹Clinical signs & symptoms of DVT (minimum of leg swelling & pain with palpation of deep vein): 3 points
🔹An alternative diagnosis is less likely than PE: 1 point
🔹 Tachycardia > 100 beats/min: 1.5 point
🔹Immobilization or surgery in previous 4 weeks: 1.5 point
🔹Previous DVT/PE: 1.5 point
🔹Haemoptysis: 1 point
🔹Malignancy (on treatment, treated in the last 6 months or palliative): 1 point
⭐️ Clinical probability score: PE likely if ≥4 points, PE unlikely if ≤4 points
References:
1. CPG Prevention and Treatment of Venous Thrombosis 2013
#GIM@nota_perubatan
2️⃣ Wells' score for pulmonary embolism (PE) [Online calculator (MD Calc)]
🔹Clinical signs & symptoms of DVT (minimum of leg swelling & pain with palpation of deep vein): 3 points
🔹An alternative diagnosis is less likely than PE: 1 point
🔹 Tachycardia > 100 beats/min: 1.5 point
🔹Immobilization or surgery in previous 4 weeks: 1.5 point
🔹Previous DVT/PE: 1.5 point
🔹Haemoptysis: 1 point
🔹Malignancy (on treatment, treated in the last 6 months or palliative): 1 point
⭐️ Clinical probability score: PE likely if ≥4 points, PE unlikely if ≤4 points
References:
1. CPG Prevention and Treatment of Venous Thrombosis 2013
#GIM@nota_perubatan
Forwarded from Nota Perubatan
Algorithm for diagnosis of pulmonary embolism (PE) and deep vein thrombosis (DVT)
❓ What is the role of d-dimer in the diagnosis of DVT or PE?
- D-dimer has high negative predictive value, which helps to rule out DVT / PE.
- D-dimer is useful when Wells score suggests DVT / PE is unlikely. Negative Wells' score + negative D-dimer = low risk for DVT / PE = imaging is NOT required
- D-dimer is sensitive but not specific to thromboembolism. A positive d-dimer test is not helpful due to many causes of false positive d--dimer.
- If Wells' score suggests PE or DVT is likely, the next step would be imaging (CUS or CTPA), instead of sending blood for D-Dimer test in such cases.
❓ Tips when requesting USG doppler for lower limbs / CTPA:
- Always mention the relevant risk factors and Wells' score
- "Any d-dimer sent?" Answer: d-dimer was not sent because Wells' score is high
CUS: compression ultrasound
References:
1. CPG Prevention and Treatment of Venous Thrombosis 2013
2. Sarawak Handbook of Medical Emergencies 4th ED
Related post:
▶️ D-dimer
https://t.me/nota_perubatan/1126
#GIM@nota_perubatan
- D-dimer has high negative predictive value, which helps to rule out DVT / PE.
- D-dimer is useful when Wells score suggests DVT / PE is unlikely. Negative Wells' score + negative D-dimer = low risk for DVT / PE = imaging is NOT required
- D-dimer is sensitive but not specific to thromboembolism. A positive d-dimer test is not helpful due to many causes of false positive d--dimer.
- If Wells' score suggests PE or DVT is likely, the next step would be imaging (CUS or CTPA), instead of sending blood for D-Dimer test in such cases.
- Always mention the relevant risk factors and Wells' score
- "Any d-dimer sent?" Answer: d-dimer was not sent because Wells' score is high
CUS: compression ultrasound
References:
1. CPG Prevention and Treatment of Venous Thrombosis 2013
2. Sarawak Handbook of Medical Emergencies 4th ED
Related post:
▶️ D-dimer
https://t.me/nota_perubatan/1126
#GIM@nota_perubatan
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⬆️ Well's score for DVT & PE
Must know for HOs at surgical based dept, esp when you need to #request for;
✅ USG Doppler of lower limb TRO DVT
✅ Pulmonary CT angiogram TRO PE
.
All these notes - Credit to Channel Nota Perubatan
Must know for HOs at surgical based dept, esp when you need to #request for;
✅ USG Doppler of lower limb TRO DVT
✅ Pulmonary CT angiogram TRO PE
.
All these notes - Credit to Channel Nota Perubatan