Pulm 3 Flashcards
PE
blood clot that travels to 1 or more arteries in the lungs
PE - clinical pres may range from
2
asympotamic to sudden death
PE - ask about
8
- unilateral leg swelling
- recent long distance travel
- hormonal BC
- pregnancy
- malignancy
- tobacco use
- coagulopathy hx of blood clots
- recent surgeries
PE - clinical presentation
7
- dyspnea
- acute CP (pleuritic - CP that is sharp or stabbing that increases with coughing, breathing, or sneezing)
- palpitations
- hemoptysis
- lightheadedness
- dizziness
- syncope
PE - vital signs may show
4
- tachypnea
- hypoxia
- hypotension
- fever
PE - CV finding
1
tachycardia
PE - pulmonary findings can include
2
- increased WOB
- crackles/rales
PE - extremity findings can include
3
- unilateral extremity edema (likely lower)
- erythema
- warmth
PE - img/testing
4
- Wells’ Criteria/PERC to stratify risk
- EKG - sinus tachy, right heart strain
- cxr
- pregnancy test
PE - DD
4
- ACS
- pneumothorax
- PNA
- costochondritis
PE - if low risk per Wells’ criteria then use
PERC rule
PE - PERC rule negative tx
consider discharge
PE - PERC rule positive tx
send to ER
PE - when to refer to ER
3
- hemodynamic instability i.e. SBP <90
- PE cannot be r/o
- hypoxia
pneumothorax
air in pleural space surrounding the lungs (spontaneous or traumatic)
air in pleural space surrounding the lungs (spontaneous or traumatic)
pneumothorax
pneumothorax - clinical pres
2
- acute dyspnea
- pleuritic unilateral chest pain
primary spontaneous pneumothorax
high prevalence in young, tall, athletic males
secondary spontaneous pneumothorax
underlying lung disease i.e. COPD, Marfan syndrome
pneumothorax - hx may include
1
trauma
pneumothorax vital signs PE
2
- tachypnea
- hypoxia
pneumothorax CV PE findings
1
tachycardia
pneumothorax pulmonary PE findings
5
- increased WOB
- decreased/absent breath sounds
- hyperresonance
- decreased chest wall expansion
- chest wall/rib tenderness
pneumothorax img/testing if stable
3
- cxr
- EKG
- bedside US to assess for lung sliding
