Friday April 2, 2010

Case: 43 year old male with previous history of heart transplant found unresponsive and in asystole. Which regularly use 'code medicine' will not work on him?


Answer: Atropine

Patient has a transplanted heart and is denervated so atropine will not work. Immediate transcutaneous pacing (instead of atropine) should be placed.

Thursday April 1, 2010
CXR diagnosis in Pulmonary Embolism
Looking for Westermark’s and Palla’s Signs together

Answer: Chest radiograph showing

Westermark’s sign - focal oligemia in the right lung (area between white arrowheads) and

Palla’s sign - a prominent right descending pulmonary artery (black arrow).

Westermark’s and Palla’s signs in combination are rare but, when seen, can help confirm diagnosis of pulmonary embolism.


Reference: Westermark’s and Palla’s Signs in Acute Pulmonary Embolism - Circulation. 2007;115:e211.http://circ.ahajournals.org/cgi/content/full/115/8/e211