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RESPIRATORY > [pulmonary embolism] > Flashcards

[pulmonary embolism] Flashcards

1
Q
A

pelvis

leg

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2
Q
A

pulmonary circulation

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3
Q
A

right ventricular thrombus

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4
Q
A

right sided infective endocarditis

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5
Q
A 
surgery
thrombophilia
malignancy
pregnancy/pill/HRT
prolonged rest
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6
Q
A 
pyrexial 
pleural rub
tachypnoea
cyanosis
raised JVP
hypotensive
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7
Q
A

ECG
CXR
ABG

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8
Q
A

tachycardia
right bundle branch block
right ventricular strain

(or normal!)

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9
Q
A 
oligaemia of affected segment 
dilated artery
linear atelectasis
wedge shaped cavities
small pleural effusion
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10
Q
A

reduction in blood volume

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11
Q
A

minimal degree of collapse cf. lobular atelectasis

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12
Q
A

to the lungs

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13
Q
A

inflamed pleural surfaces rubbing together

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14
Q
A

low PaCO2
low PaO2

hyperventilation + poor gas exhange

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15
Q
A

PE occurence (many causes of raised D-Dimer)

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16
Q
A

there is no PE

i.e. high sensitivity low specificity

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17
Q
A

CTPA (CT pulmonary angiography)

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18
Q
A

LMWH
TED stockings (thromboembolic deterrent)
vena caval filters

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19
Q
A

contraceptive pill

20
Q
A

LMWH (tinzaparin 175u/kg/24h SC)
OR
UFH 10,000 IU bolus IV (then IVI guided by APTT)

21
Q
A

Warfarin 5-10mg PO (*if BP >90mmHg)

22
Q
A

colloid infusion

23
Q
A

colloid infusion

24
Q
A

alteplase 50mg bolus

i.e. immediate thrombolysis

25
Q
A

colloid infusion 500mL

26
Q
A

Dobutamine 2.5-10ug/kg/min IV

27
Q
A

b1 agonist - increased CO and increased renin release

28
Q
A

combined contraceptive pill

29
Q
A

b1 agonist - increased CO and increased renin release

30
Q
A

minimum of 3 months

31
Q
A

Wells

32
Q
A

an alternative Dx is likely or more likely than DVT

33
Q
A 
cancer within last 6 months
lower limb immobility
major surgery in last 4 weeks/bed ridden >3days
localised tenderness along veins
entire leg swollen
increased calf circumference >3cm 
pitting oedema in asymptomatic leg
collateral superficial veins
alternative Dx likely (-2)
34
Q
A

1-2

35
Q
A

> =3

36
Q
A

there is no PE

i.e. high sensitivity low specificity

37
Q
A

high (>=3)

38
Q
A

0

39
Q
A

imaging (CTPA)

40
Q
A

+ D-Dimer test

high clinical probability (Wells score)

41
Q
A

yes if high clinical risk (Wells score)

42
Q
A

+ D-Dimer test

43
Q
A

no

44
Q
A

noradrenaline IV

45
Q
A

circulatory collapse

hypotensive, raised JVP

RESPIRATORY (20 decks)

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