Pulmonary Embolism Flashcards

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1
Q

what is an embolus?

A

foreign component that mobilizes in blood vessel could be air or neoplastic cells or moving blood clot

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2
Q

what is a thrombus?

A

-blood clot

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3
Q

pulmonary has a _______ mortality rate

A

greater than 30% mortality rate and this is dictated by size of embolus, if small embolus obstructs small vessel, if large obstruct in large vessel causing serious damage

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4
Q

pulmonary embolism has an approx _____% recurrence

A

approx 10% recurrence

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5
Q

what is pulmonary embolism

A

a thrombus in pulmonary vessel

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6
Q

what is the etiology (cause) of pulmonary embolism?

A
-usually from DVT
others are:
-Fat embolus 
-air
-amniotic fluid
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7
Q

where do DVT’s usually from? in what veins

A

usually in limbs

vein: iliac, popliteal, femoral

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8
Q

what does DVT stand for?

A

deep vein thrombosis

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9
Q

what usually causes a fat embolus with then causes pulmonary embolism?

A

a fracture,
the fracture severs blood vessel, bone is richly vascularized when you fracture bone, blood vessel is severed, there is a substantial amount of fat in bone marrow which then gets into circulation

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10
Q

how does amniotic fluid cause pulmonary embolism?

A

during a delivery,
amniotic space membrane will severe & blood vessel will sever, particular components of amniotic fluid enter circulation, causes platelet agglutination then embolus forms

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11
Q

what is the patho of pulmonary embolism?

A
  • DVT
  • becomes an embolus
  • thrombus in arterial bed
  • decreased perfusion when embolus becomes stationary, platelets immediately come & send out mediators to invite other platelets, these mediators also affect mucus in airway causing
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12
Q

what are the manifestations of pulmonary embolism? and what are they based on?

A
  • based on size & site
  • usually dyspnea, tachycardia (increased RR), chest pain
  • tachycardia (compensatory mechanism from decreased cardiac ouput)
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13
Q

Diagnosing Pulmonary embloism?

A
  • Hx, Px
  • ABGS
  • D-Dimer: when blood has clotted,fibrinolysis and a by product is D-dimer, which will be measured in pulmonary embolism, DVT, clotting disorders, after surgery, DIC (disseminated intravascular disorder)
  • LDH3: Lactate dehydrogenase an enzyme in lung tissue, when a cell is damaged it releases its contents, so when lung is damaged this is released and elevated in the blood
  • Lung scan (131 I-HSA, IV): Isotope, Iodine-Human serum albumin, label albumin which have alot of in blood, take label with iodine and introduce in circulation, movement will occur until hit an obstruction not exact as pulmonary angiogram
  • pulmonary angiogram (very invasive)
  • CT chest
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14
Q

treatment of pulmonary embolism?

A
  • stat treatment equals increased prognosis
  • thrombolytics & anticoagulants (prevent clot & stop party-platelet agglutination)
  • Maintain cardiopulmonary function
  • deal with underlying cause, most cases DVT
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15
Q

when blood has clotted you break up fibrin(called fibrinolysis) what is a by-product of this?

A

D-dimer

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16
Q

what is Lactate dehydrogenase?

A

lactate in dehydrogenase is an enzyme in lung tissue when cell is damaged release contents, so when lung is damaged this is released and elevated in the blood