EXAM #1: PE & PULMONARY HTN Flashcards
Where do PE’s typically originate?
Deep veins of the leg i.e. the:
1) Femoral vein
2) Iliac vein
3) Popliteal vein
What is a saddle embolism?
Large PE at the bifurcation of the pulmonary artery
What is the Well’s Score?
Pre-test probability for a PE
What labs are used in the diagnosis of a PE?
1) D-dimer
2) ABG
- Respiratory alkalosis with hypoxemia
3) BNP
4) Troponin
*BNP and Troponin may be elevated but are obviously not specific for a PE
What ECG patterns are commonly associated with a PE?
1) SQT133 pattern
2) RV strain/RVH
3) Incomplete RBBB
4) A-fib
What is the SQT133 pattern?
- Prominent S in V1
- Prominent Q in V3
- Inverted T in V3
What are the classic CXR findings associated with a PE?
1) Westermark’s sign= loss of vascular markings in region of PE
2) Hampton’s hump= wedge shaped density associated with pulmonary infarction
How is the diagnosis of a PE made?
1) CT pulmonary angiogram
2) V/Q scan
3) Pulmonary angiography
How are PEs treated?
1) Anticoagulation
- Heparin
- Oral anticoagulants
2) Thrombolytic therapy
What is the indication for thrombolytic therapy in the setting of a PE?
Massive PE with hypotension (less than 90 mmHg systolic)
What is the indication for an IVC filter?
Proximal DVT with an ABSOLUTE contraindication to anticoagulation
*Note that these are overused
How long should a patient with a recurrent PE be treated?
Extended or lifelong therapy
What is the definition of pulmonary HTN?
mPAP of 25 mmHg or more
What is Group 1 PH?
precapillary PH
What is Group 2 PH?
pulmonary venous HTN from left-sided heart failure
