42 yr old lady presents to your ED.complaints of pleuritic left sided chest pain that started earlier that day.she has breathlessness on minimal exertion. She gives recent history of long flight journey and that her mother died bcos of blood clot in the lungs .she also complaints of right leg swelling. Vitals pr of 113 and rr of 30 ,spo2 97%, bp of 114/72.physical exam reveals a tender right leg swelling.
1. Important dd is pe. What is the most useful initial investigation in this pt and y??
2. What r the possible ecg changes that one can expect?
3. Her blood gas shows ph 7.38,paco2 -3kpa ,pao2 -10kpa ,hco3 - 28 mmol/l, she s breathing 60% O2 via venturi mask, Whats her A-a gradient?
4. Whats her wells score ??
(Place your answers in Comments Section)
(Question Courtesy: Dr Ram NG, Mumbai)
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