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Respiratory > Pulmonary Embolism > Flashcards

Pulmonary Embolism Flashcards

1
Q

What drug is used as VTE prophylaxis?

A

Low molecular weight heparin

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2
Q

What are some risk factors of VTE? (9)

A

• Immobility
• Recent surgery
• Long haul flights
• Pregnancy
• Hormone therapy with oestrogen
• Malignancy
• Polycythaemia
• Systemic lupus erythematosus
• Thrombophilia

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3
Q

What is the presentation of a PE? (8)

A

• Shortness of breath
• Cough with or without blood (haemoptysis)
• Pleuritic chest pain
• Hypoxia
• Tachycardia
• Raised respiratory rate
• Low grade fever
• Haemodynamic instability causing hypotension

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4
Q

What score is determined the likelihood of PE?

A

Wells score

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5
Q

You suspect PE what do you do if wells score is positive? And negative?

A

Positive = perform ctpa
Negative = perform d dimer and if positive perform ctpa

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6
Q

What is the wells score

A

The Wells score predicts the risk of a patient presenting with symptoms actually having a DVT or pulmonary embolism. It takes in to account risk factors such as recent surgery and clinical findings such as tachycardia (heart rate >100) and haemoptysis.

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7
Q

What does an ABG show in a PE?

A

Resp alkalosis
Low PO2

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8
Q

What is the initial treatment of PE?

A

Apixaban or ribaroxaban

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9
Q

What anticoagulation is given in PE if someone has antiphospholipid syndrome?

A

Warfarin

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10
Q

What anticoagulant is given in PE if patient is pregnant?

A

LMWH

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11
Q

How long do you continue anticoagulation in PE if there is an obvious cause?

A

3 months

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12
Q

How long do you continue anticoagulation in pe if cause is unclear?

A

6 months

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13
Q

How long do you continue anticoagulation in PE in active cancer?

A

6 months

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14
Q

What treatment is given in PE with haemodynamic instability?

A

Thrombolysis

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15
Q

Give 3 examples of thrombolytics

A

Streptokinase
Alteplase
Tenectoplase

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16
Q

When are doacs contraindicated? (3)

A

Severe renal impairment where creatinine clearance is <15ml/min
Antiphospholipid syndrome
Pregnancy

17
Q

What are imaging options in PE? (3)

A

• CT pulmonary angiogram (the usual first-line)
• Ventilation-perfusion single photon emission computed tomography (V/Q SPECT) scan
• Planar ventilation–perfusion (VQ) scan

18
Q

When is a V/Q scan used instead of a CTPA for PE diagnosis? (3)

A

Renal impairment
Contrast allergy
Risk of radiation

19
Q

What is the PERC rule?

A

Pulmonary embolism rule out criteria
<15% probability of PE is decided
When all criteria is met then don’t have to investigate further

Respiratory (18 decks)

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