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Medicine

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Respiratory

Question
8 out of 11
 

D-dimer is the most useful diagnostic test for which condition ? (AIIMS May 2011)­



A Pulmonary embolism

B Acute pulmonary oedema

C Cardiac tamponade

D Acute myocardial infarction

Ans. A

Pulmonary embolism

Blood Test

The D-dimer assay is a very sensitive for pulmonary embolism with a sensitivity of greater than 95%.

Dimmer Assay in P.E (and DVT): (Ref. Hari-18th ed., Pg- 2172)

1). D-Dimer is a fibrin degradation product

2). Elevation of D-Dimer thus indicates that a endogenous fibrinolytic process is taking place.

3). Elevation indicates endogenous and often clinically ineffective thrombolysis D-Dimer assays are highly sensitive for presence of Thromboembolic Disease

4). D-Dimer test is useful as a 'test for exclusion' or a 'rule out test' and is not a diagnostic test.

5). D-dimers: only perform in those patients without a high probability of a PE. A negative D-dimer test excludes a PE in those with a low or intermediate clinical probability, and imaging is NOT required. However, a positive test does not prove a diagnosis of a PE, and imaging is required.

D-Dimer Assays

Highly sensitive for presence of

Thromboembolic Disease

1). PE (Sensitivity>95%)

2). DVT (Sensitivity>80%)

3). DIC

Not specific for presence of

Thromboembolic Disease

Levels are also increased in

1). MI

2). Pneumonia

3). Sepsis

4). Cancer

5). Pregnancy

6). Heart failure

7). Postoperative state

Respiratory Flashcard List

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