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bluemoon

What investigation will you do to confirm his diagnosis:

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An elderly man admitted to a medical ward is experiencing agitation, confusion. He has a cardiac pacemaker. What investigation will you do to confirm his diagnosis:

a) CT

b MRI

c) SPECT

d)EEG

e) LP

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ok, may be u are rightand itis infection butwhy did she mention pace maker which makesnyou think it i something embolic because he must be on anti coagulants with the pace maker

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I thnk it is CT scan.

With traditional pacemakers, MRI scans can pose associated device-related risks. The extremely strong magnetic fields used in MRI procedures could affect the pacemaker’s normal functions; therefore, patients with traditional pacemakers should not have MRIs.

However, you can safely have a CT scan, chest and dental x-rays, diagnostic ultrasound, mammography and fluoroscopy.

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I thought pacemaker - could be source of infection. I may also be totally wrong.

usually CTscan would be for space occupying lesion - and theme they mention one side weakness etc.

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I thnk it is CT scan.

With traditional pacemakers, MRI scans can pose associated device-related risks. The extremely strong magnetic fields used in MRI procedures could affect the pacemaker’s normal functions; therefore, patients with traditional pacemakers should not have MRIs.

However, you can safely have a CT scan, chest and dental x-rays, diagnostic ultrasound, mammography and fluoroscopy.

agreed

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MRI is contraindicated as it can cause damage to the MRI machine.

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If fever then sure LP otherwise it should be CT

Edited by siaad

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Are we sure fever was mentioned?? Then LP would be the choice i suppose

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even for LP one needs to ensure ICP is not raised with CT scan first.

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