Which of the following tests/procedures are used to diagnose a pulmonary embolism (PE)? (Select all that apply.)
a. Spirometry
b. D-dimer
c. Angiogram
d. Ventilation-perfusion lung scan
e. Spiral computed tomography (CT) scan
f. Bronchoscopy
ANS: B, C, D, E
A spiral CT scan is a new and fast type of CT scan that is noninvasive and can diagnose PE quickly. If this is not available, a lung scan (ventilation-perfusion scan) is done to assess the extent of ventilation of lung tissue and the areas of blood perfusion. A pulmonary angiogram can outline the pulmonary vessels with a radiopaque dye injected via a cardiac catheter. D-dimer is a fibrin fragment that is found in the blood after any thrombus formation. It can be present in a number of disorders, but if it is negative, PE can be eliminated as a possible cause of the patient's symptoms. Bronchoscopy is not used to determine PE.
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