PE Flashcards
PEs usually embolize from
DVT proximal to popliteal
which of the following review of systems should make you think of PE?
Prolonged upright sitting (travel, etc)
Virchow’s triad
hypercoaguability, stasis, venous injury
Which of the following modalities is the gold standard for dx of PE
Pulmonary Angiography
Which of the following modalities is typically done for dx of PE
spiral CT
EKG findings for PE
S1Q3T3, sinus tach
ABG with PE
Hypoxemia, respiratory alkalosis
D-Dimer
Inaccurate if >72hrs post PE, helpful if negative, but lacks specificity
Hamptons Hump on CXR
wedge shaped consolidation with base against pleura
Westermark sign on CXR
see disappearance of pulmonary vasculature
Tx for PE
LMWH (enoxaparin), fondaparinux, heparin, TPA
Absolute contraindications to anti-coagulation therapy
- bleeding disorder
- hemorrhagic stroke
- ischemic stroke within 6 months
- CNS cancer being tx
- major trauma, surgery
- head injury within past 3 wks
- GI bleeds within past month
- significant bleeding
Relative contraindications to anti-coagulation therapy
- TIA/ischemic stroke within past 6 months
- If on vit K antagonist
- If taking Coumadin
- Preggo or 1 wk post partum
- Non-compressible puncture site
- Advanced liver dx—worry about varices
- Infective endocarditis
- Active peptic ulcer dx
Tx for pts who cannot be on anticoagulants
IVC filter or Manual Thombectomy
Cancer risk for PE
HYPERCOAGUABLE STATE
