PE Flashcards

1
Q

What is hip pinning and what complications can occur?

A

Hip pinning fixes a broken hip using pins, screws and plates

Comp = infection, blood clots, DVT

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2
Q

Why do people who have hip pinning have increased risk DVT?

A

Reduced movement and mobility

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3
Q

What is PE and how does it form?

A

Usually derived from fragment DVT

Fragments become detached from site and travel via venous return via RHS to pulmonary arteries

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4
Q

Does size of PE change clinical outcome?

A

Large PE can become lodged at bifurcation of pulmonary artery = sudden death
Smaller PE can become lodged in peripheral branch leading to infarction

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5
Q

Symptoms see w/ PE?

A

SOB, chest pain and sometimes cough up blood

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6
Q

What ECG finding see w/ PE?

A

Sinus tachycardia - reduced blood flow to lung cause SOB increased HR

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7
Q

What is heparin?

A

In family glycosamingoglycans

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8
Q

How does heparin work?

A

Action antithrombin III - inhibit thrombin and inactivate prothrombin

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9
Q

How measure effect heparin?

A

Kaolin-cephalin clotting time

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10
Q

How to reverse effect heparin?

A

Protamine sulphate

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11
Q

How is heparin related PE?

A

Low molecular weight heparin given as immediate anticoagulation
Can be given as prophylaxis to those at risk DVT/PE - slow progression DVT

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12
Q

What is Well’s score

A

Number that reflect risk of developing DVT

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13
Q

What is CTPA and its purpose?

A

CT pulmonary angiogram

Obtain imagine pulmonary arteries - diagnostic tool for PE

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14
Q

How is CTPA performed and contraindication?

A

IV injection of iodine-containing contrast agent (dark mass can show embolism)

  1. Pregnancy - concern effect thyroid gland foetus
  2. Renal disease - risk contrast induced nephropahy
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15
Q

Why is renal function test needed before CTPA?

A

Contraindicated in those w/ renal disease - unable to clear medium and can put at risk of nephropathy

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16
Q

Anticoagulation therapy for someone w/ PE?

A

Immediate anticoagulation injection for at least 5 days (usually heparin)
Managed as outpatient using warfarin - at least 3 months

17
Q

Explain heparin dose in hospital setting

A

IV heparin every 4-6 hours

Heparin administered at provisional diagnosis - if hospital dose given at 6, amount worked out as top up dose

18
Q

Risk factor PE

A

OCP, long haul flight, increased drinking, immobility