Lecture PE, Pneumothorax and Pleural Effusion

Question 1

What are the investigative tests to be done if PE is suspected?

Answer 1

CTPA - CT Pulmonary Angiogram

and VQ scan - Ventilation Perfusion scan

Question 2

What are the contraindications of Warfarin?

Answer 2

Warfarin is contraindicated in pregnancy, as it is teratogenic.

Question 3

What are the MAJOR risk factors of PE?

Answer 3

DVT, Previous DVT or PE, Active cancer, Recent surgery especially hip pelvic surgery, and pregnancy in particularly 6 weeks postpartum.

Question 4

When is thrombolysis initiated?

Answer 4

Thrombolysis is initiated as soon as possible, ideally within 1 - 2 hours after onset of symptoms, to dissolve blood clots which can cause stroke, MI, or PE.

Question 5

What is another term for thrombolysis?

Answer 5

Thrombolytic therapy.

Question 6

What are the differences between Pneumothorax and Pleural Effusion?

Answer 6

Pneumothorax: Dyspnoea is acute
Pleural effusion: Dyspnoea is insidious

Pneumothorax: Pleuritic pain is relatively common
Pleural effusion: Pleuritic pain is relatively rare

Pneumothorax: Cough is relatively rare
Pleural effusion: Cough is relatively common

Pneumothorax: Hyper-resonant on percussion
Pleural effusion: Stony dull on percussion

Both present with reduced breath sounds, vocal resonance and fremitus.

Question 7

What is the target INR value for patients on anti-coagulants?
What does this INR value mean?

Answer 7

2 - 3.

This means that the prothrombin time is 2 - 3 times as long as the normal person,using standardised conditions.

Question 8

Which drug will lead to a decrease in the INR value?
A) Clopidogrel
B) Amiodarone
C) Rifampicin
D) Co-trimoxazole

Answer 8

Rifampicin

Question 9

What is thoracocentesis?

Answer 9

Thoracocentesis is pneumothorax aspiration

Question 10

Which 2 conditions are highly associated with transudative pleural effusions?

Answer 10

Congestive Heart failure and Liver cirrhosis