Pulmonary embolism Flashcards
Which diagnostic imaging study is considered the gold standard for diagnosing pulmonary embolism?
Chest CT with Pulmonary angiography.
Which blood test can be used as an initial step in the evaluation of a suspected pulmonary embolism?
D-dimer.
What is the most common early complication of a pulmonary embolism?
Recurrent embolization.
What is a common symptom of pulmonary embolism?
Sudden onset of shortness of breath.
Which medication is primarily used as the initial treatment for pulmonary embolism?
Anticoagulants.
What is the name of the score used to clinically assess the probability of pulmonary embolism?
The Wells Score.
What is the role of the D-dimer test in the context of pulmonary embolism?
To rule out pulmonary embolism in patients with a low probability, as it detects fibrin degradation products.
Which type of ultrasound is typically used to detect DVT in patients suspected of having pulmonary embolism?
Doppler ultrasound.
What complication can arise from untreated pulmonary embolism?
Pulmonary hypertension (group III PH, s.CTEPH - chronic thromboembolic pulmonary hypertension)
What is the recommended treatment for pulmonary embolism causing hemodynamic instability?
Thrombolytic therapy.
What blood test is routinely performed to monitor the therapeutic level of warfarin?
INR (International Normalized Ratio).
Which blood test is essential for monitoring the therapeutic effect of unfractionated heparin?
aPTT (activated partial thromboplastin time).
What is the target INR range for a patient on warfarin therapy for pulmonary embolism?
2.0 to 3.0.
Which blood test is used to monitor kidney function before starting low molecular weight heparin for pulmonary embolism treatment?
Creatinine clearance.
What complication related to heparin therapy must be monitored by regular blood tests?
Heparin-induced thrombocytopenia (HIT).
What baseline blood tests are recommended before initiating anticoagulant therapy for pulmonary embolism?
Liver function tests, renal function tests, and a complete blood count.
What is a major surgical risk factor for pulmonary embolism?
Hip or knee replacement surgery.
How does pregnancy influence the risk of developing pulmonary embolism?
Pregnancy increases the risk of PE due to higher levels of estrogen and reduced blood flow from the legs to the pelvis.
How does the use of combined oral contraceptives influence the risk of PE?
They increase the risk due to higher estrogen levels, which can lead to blood clot formation.
What impact does a previous venous thromboembolism (VTE) have on the risk of pulmonary embolism?
A previous VTE significantly increases the risk of subsequent PE.
What role does heart failure play in increasing the risk of pulmonary embolism?
Heart failure can lead to blood pooling and stasis, particularly in the lower limbs, enhancing the risk of clot formation.
How does long-term immobility contribute to the risk of pulmonary embolism?
It leads to stasis of blood in the lower extremities, increasing the likelihood of clot formation.
What are Direct Oral Anticoagulants (DOACs) commonly used for treating acute pulmonary embolism?
Rivaroxaban, Apixaban, Edoxaban, and Dabigatran.
How does the treatment approach with DOACs differ from traditional warfarin therapy in pulmonary embolism?
DOACs do not require routine blood monitoring and have fewer dietary restrictions compared to warfarin.
What is the initial treatment for a hemodynamically stable patient diagnosed with pulmonary embolism?
Anticoagulation therapy, typically starting with parenteral agents like heparin or using DOACs directly.
In the treatment of pulmonary embolism, when is an inferior vena cava (IVC) filter indicated?
When anticoagulation is contraindicated or has failed, and the patient is at high risk for further emboli.
What is the recommended duration of anticoagulation therapy for a first-time pulmonary embolism?
At least 3 to 6 months, with a reassessment afterward to consider the risk of recurrence versus the risk of bleeding.
