1(E): PE Flashcards
Define a PE
Occlusion pulmonary arteries by solid, gas or liquid matter
What is the most common cause of PE
Thrombus from DVT
Explain incidence of PE with age
Increases with age
What factors increase incidence of PE
- Malignancy
- Active Inflammation: IBD
- Surgery - particularly to lower limbs
- Immobility
- pregnancy
- COCP
- HRT
what is the typical triad of symptoms in PE
- Haemoptysis
- Dyspnoea
- Pleuritic chest pain
what is a saddle embolus
Large embolus that occludes bifurcation of pulmonary arteries
how may a saddle embolus present
Shock
what is the most common sign of PE
Tachypnoea (90%)
what may be seen on observations in PE
- Tachypneoa
- Tachycardia
- Fever
what may be ausculated in PE
Crackles
Loud S2
Pleural Rub
what may be seen on palpation in PE
Raised JVP
Right ventricular heave
why does a pleural rube occur
Inflammation pleura cause loss fluid between and friction as they rub together
when should PE always be considered as a differential
Sudden-collapse in person two weeks after surgery
where do majority of PE’s arise
DVT above the knee
what should be done first in PE
decide whether individual is at high or low-risk of death
how is it deiced whether individual with a PE has a high or low risk of death
High risk of death includes:
- Systolic BP less than 90
- Decrease in systolic BP of 40 in 15m
if a low-risk of death, how is the person assessed
Modified wells score
what is mnemonic to remember components of the modified wells score
SHRIMPA
what are the components of the modified wells score
Signs and symptoms of DVT
Haemoptysis
Rate of heart >100
Immobility
Malignancy (Palliative, Treatment in past 6 months)
PMH DVT or PE
Alternative diagnosis less likely
in the modified wells score - what defines high risk of PE
More than 4
how are individuals with high probability of PE investigated
CTPA
what should be checked before CTPA
RFTs
what is a contraindication to CTPA
Contrast Allergy
Poor Renal Function
if GFR less than 35 or contrast allergy, what is used
V-Q scan
