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NBME 21 Answers

nbme21/Block 2/Question#43

A 78-year-old woman is brought to the emergency ...

Embolectomy

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Irrerugularly Irregular rhythm = Afib Afib --> stasis of blood in the Heart ---> Thrombus formation Thrombus will embolize to the (likely) the popliteal artery leading to acute limb ischemia

194orbust  why would an embolectomy be favored over clopidogrel? +2  
194orbust  oh nvm......it's bc clopidogrel won't bust a clot, just prevents them from forming. +8  
chandlerbas  also the way i see it is the hommie has so much pain as indicated by "sudden onset of severe pain" so you want something fast and effective. surgery time! grab my scalpel! drugs could be indicated but arent an option even then heparin takes 20 to 60 minutes to work so +