PE

Question 1

Define an embolism

Answer 1

Obstruction of a blood vessel by a foreign substance or clot

Question 2

Name 3 things that can embolise

Answer 2

Thrombus, tumour, air, fat, amniotic fluid and bullet

Question 3

What is fat embolism syndrome?

Answer 3

Triad of ft emboli in lungs brain and skin

Question 4

What percentage of PEs arise from DVT?

Answer 4

90%

Question 5

What is Virchow triad?

Answer 5

Endothelial injury, stasis or turbulence of blood flow and blood hypercoagulability

Question 6

Name 3 risk factors for thromboembolism

Answer 6

Pregnancy, prolonged immobilisation, long haul travel, contraceptive pill, previous VTE, cancer

Question 7

Which cancer gives the highest risk of DVT/PE?

Answer 7

Pancreatic cancer

Question 8

What is Factor V Leiden mutation?

Answer 8

Resistance to activated protein C, a natural blood thinner , most common risk factor in younger people

Question 9

What are the 3 pathophysiologies of outcomes in PE?

Answer 9

Acute right ventricular overload, Respiratory failure and pulmonary infarction

Question 10

Name 3 symptoms of PE

Answer 10

Dyspnoea, pleuritic chest pain, cough, haemoptysis and syncope

Question 11

Name 3 signs of PE

Answer 11

Tachpnoea, decreased breath sounds, loud P2 heart sound, tachycardia, fever and diaphoresis

Question 12

Name 2 investigations for suspected PE

Answer 12

Blood gas, CXR (exclude other diagnoses), ECG (ventricular strain) and D-dimers

Question 13

What is the best imaging for PE?

Answer 13

CT Pulmonary Angiography (CTPA)

Question 14

What treatment do you give for PE of high and low risk?

Answer 14

Oxygen and Heparin

Question 15

What is the treatment for high risk patients?

Answer 15

Respiratory support, Tissue plasminogen activators and possibly surgery

Question 16

How can DVT/PE be prevented?

Answer 16

Recognise and treat risk factors, prophylaxis after surgery and for patients with malignancy