Pulmonary Embolism

Question 1

Symptoms of PE

Answer 1

Pleuritic chest pain, dyspnoea, haemoptysis

Question 2

Signs of PE

Answer 2

Tachycardia, tachypnoea, crackles (50%), sometimes fever

Question 3

What is the PERC rule

Answer 3

Criteria put in place to exclude the chances of a patient having a PE

Question 4

What test is carried out if a PE is suspected

Answer 4

2level PE wells score

Question 5

Investigations for suspected PE

Answer 5

CTPA, if not available then interim therapeutic anticoagulation should be given until scan performed (apixiban or ribaroxiban)

Question 6

Advantages of VQ scan over CTPA

Answer 6

Speed, easier to perform out of hours, reduced need for further imaging and possibility of alternate diagnosis if PE is excluded

Question 7

ECG changes seen in PE

Answer 7

Large S wave in lead I, large Q wave in lead III and invarted wave in lead III. RBBB and right axis deviation also associated, and sinus tachy

Question 8

First line treatment of VTE

Answer 8

DOACs

Question 9

First line treatment of massive PE

Answer 9

Thrombolysis

Question 10

How long should all patients recieve anticoagulation for

Answer 10

At least 3 months