PE

Question 1

Simplified Wells

Answer 1

Clinical signs/symptoms of DVT - 3 points
No alternative diagnosis more likely than PE - 3 its
Pulse > 100/min - 1.5 pts
immobilization/surgery in prior 4 weeks - 1.5 pts
previous hx of DVT/PE - 1.5 its
Hemoptysis - 1 pt
Cancer actively tx - 1

Question 2

Pretest probability

Answer 2

low 6 its

Question 3

Investigations

Answer 3

Contrast-enhanced CT - CT angio

V/Q mismatch - totally normal V/Q excludes PE

Question 4

Treatment

Answer 4

Hemodynamically stable - Unfractionated Heparin, LMWH

Question 5

Hemodynamic instability

Answer 5

result of acutely elevated PA resistance which could lead to:

• RV strain
• ischemia
• cardiac dysfunction