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<3 > DVT and Pulmonary embolism > Flashcards

DVT and Pulmonary embolism Flashcards

1
Q

_____ is a common condition caused by the formation of venous clots

A

DVT

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2
Q

what is Virchow’s triad

A

(a) Venous stasis
(b) Hypercoagulable state
(c) Injury to vessel wall

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3
Q

Most common life threatening consequence of DVT is what

A

Pulmonary Embolism

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3
Q

Most common life threatening consequence of DVT is what

A

Pulmonary Embolism

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4
Q

These factors put you at risk for what?

a) Trauma, Travel
(b) Hypercoagulable, Hormones
(c) Recreational IV drugs
(d) Age > 60
(e) Malignancy
(f) Birth control
(g) Obesity, Obstetrics
(h) Surgery, Smoking
(i) Immobilization
(j) Sickness

A

THROMBOSIS

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5
Q

What are some Symptoms of DVT

A

Pain, redness, swelling, warmth, and tenderness.

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6
Q

True/False

During the PE you don’t need to measure leg circumference and compare to unaffected leg.

A

False….

Measure dat shit

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7
Q

If unilateral leg swelling then you MUST rule out DVT, if you cant what do you do?

A

transfer to somewhere that can.

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8
Q

What are some DDx for DVT

A

(1) Peripheral edema
(2) Varicose veins
(3) Cellulitis
(4) Thrombophlebitis
(5) Peripheral arterial disease affecting opposite leg

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9
Q

Labs/Studies to order for DVT

A

D-dimer

Ultrasound

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10
Q

All patients with signs or symptoms of DVT need to

undergo an what study?

A

Ultrasound

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11
Q

WHAT IS… one of the protein fragments produced when a blood clot gets dissolved in the body. It is normally undetectable or detectable at a very low level unless the body is forming and breaking
down blood clots.

A

D-dimer

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12
Q

what is the primary goal in treating DVT

A

Prevention of PE

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13
Q

What Meds are you going to treat DVT with?

A 
Aggressive anticoagulation
-Lovenox 1mg/kg SC q 12 hours
or
-Heparin: 80 units/kg IV loading dose, then initiate continuous infusion 18 units/kg/hr
Pain control
Tylenol, Morphine
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14
Q

DVT Pt’s will need long term anticoagulation for how long

A

3-6 Months min

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15
Q

Initial Care for DVT

A

ABCs, IV, O2, Monitor

IF you suspect this then anticoagulate right away and MEDEVAC

16
Q

Complications for DVT

A

PE

Death

17
Q

If a pulmonary embolism is large enough and lodges in the main pulmonary artery or at the branch point of the left and right main pulmonary artery then this causes what cascade of events

A

this enormous pressure back up to the RV
the RV goes into failure
then the patient becomes hypotensive
then cardiac arrests.

18
Q

What is a PE

A

clot that travels and lodges into a pulmonary artery.

usually from the LE veins

19
Q

PE is a common and potentially fatal complication of what issue

A

DVT

20
Q

Risk factors for PE are

A

Virchow’s Triad
Stasis
hypercoagulability
injury to vessel wall

21
Q

True/False

PE can be very easy to make a clinical diagnosis

A

FALSE

It is VERY difficult to Dx in a clinical setting

22
Q

What are the S/s for PE

A

Chest pain, tachypnea, and tachycardia.
Hypoxemia
SOB
Signs of DVT

23
Q

Your pt has:

Chest pain, tachypnea, and tachycardia, SOB, Signs of DVT you must consider it to be what?

A

PE until proven otherwise and treated as such.

24
Q

What are some DDx for PE

A

(1) AMI
(2) Pneumonia
(3) OSA
(4) Pulmonary HTN
(5) Anxiety
(6) Infection
(7) Pericarditis
(8) Pericardial effusion/Tamponade
(9) COPD
(10) Asthma

25
Q

CXR for a PE will show up as what?

A

Normal…

26
Q

Labs/Studies/EKG to order for PE

A
  • CXR
  • EKG: Sinus Tachycardia; non-specific ST and T wave changes
  • Helical CT pulmonary angiography is the imaging study of choice
  • Ultrasonography of extremities to look for DVT
27
Q

What is the Goal whan treating PE

A

prevent further PE propagation or further clot burden due to DVT

28
Q

What type of med tx would you use for PE

A

Aggressive anticoagulation
-Lovenox 1mg/kg SC q 12 hours
or
-Heparin: 80 units/kg IV loading dose, then initiate continuous infusion 18 units/kg/hr

29
Q

Initial Care for PE

A

(1) ABCs, IV, O2 if saturation < 94%.
(2) Anticoagulated
(3) MEDEVAC

30
Q

What are the complications of PE

A

(1) Pulmonary HTN
(2) RV failure
(3) Cardiac Arrest
(4) Death

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