A 47-year-old woman comes to the emergency department after coughing up 2 cups of bright red blood. A CT angiogram of the chest shows active extravasation from the right bronchial artery. A coil embolization is planned to stop the bleeding. During this procedure, a catheter is first inserted into the right femoral artery. Which of the following represents the correct subsequent order of the catheter route?
AThoracic aorta, right superior epigastric artery, right bronchial artery
BThoracic aorta, right bronchial artery
CThoracic aorta, left ventricle, left atrium, pulmonary artery, right bronchial artery
DThoracic aorta, brachiocephalic trunk, right subclavian artery, right internal thoracic artery, right bronchial artery
EThoracic aorta, right subclavian artery, right internal thoracic artery, right bronchial artery
A 62-year-old man comes to the physician because of a 5-day history of swelling in his left arm. Two months ago, he was diagnosed with a deep venous thrombosis in the left calf. He has had a 7-kg (15-lb) weight loss in the last 3 months. He has smoked 1 pack of cigarettes daily for the past 25 years. His only medication is warfarin. Physical examination shows warm edema of the left forearm with overlying erythema and a tender, palpable cord-like structure along the medial arm. His lungs are clear to auscultation bilaterally. Duplex sonography shows thrombosis of the left basilic and external jugular veins. Which of the following is the most appropriate next step to confirm the underlying diagnosis?
ACT scan of the chest
BX-ray of the chest
CTransesophageal echocardiography
DSerum antiphospholipid antibody level
ESerum D-dimer level
A 67-year-old woman presents with right leg pain and swelling of 5 days’ duration. She has a history of hypertension for 15 years and had a recent hospitalization for pneumonia. She had been recuperating at home but on beginning to mobilize and walk, the right leg became painful and swollen. Her temperature is 37.1°C (98.7°F), the blood pressure is 130/80 mm Hg, and the pulse is 75/min. On physical examination, the right calf is 4 cm greater in circumference than the left when measured 10 cm below the tibial tuberosity. Dilated superficial veins are present on the right foot and the right leg is slightly redder than the left. There is some tenderness on palpation in the popliteal fossa behind the knee. Which of the following is the best initial step in the management of this patient’s condition?
AInternational normalized ratio (INR)
BThrombophilia screen
CWells’ clinical probability tool
DComputerized tomography (CT) with contrast
EActivated partial thromboplastin time (aPTT)
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