NBME 21 Answers ↦
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A 78-year-old woman is brought to the ...
why would an embolectomy be favored over clopidogrel?
oh nvm......it's bc clopidogrel won't bust a clot, just prevents them from forming.
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
Yeah I dont think is going for a DVT though, the patient is presenting with "coolness and paleness" in her LE with absence of pulses". This is basically implying an arterial occlusion and thus an embolus in the ARTERIAL system. In a DVT we can say arterial supply is normal so we would feel a warm extremity with normal presentation. Either way I guess at the end of the day you could embolize the DVT clot too.
And the mention of irregularly irregular rhythms clues you in that a clot was formed in the heart and embolized to the lower extremity arteries.