PULMONARY EMBOLISM Flashcards
1
Q
What is a pulmonary embolism?
A
- obstruction with in the pulmonary arterial tree
2
Q
What is the obstruction in PE usually caused by?
A
-emboli
3
Q
What types of emboli are there? (4)
A
- thrombosis
- fat
- amniotic fluid
- air
4
Q
Where does a thrombus in the lung usually arise from and how does it travel to the lung? (2)
A
- a distant vein in the leg
- via the venous system
5
Q
When does a fat emboli form? (2)
A
- following a long bone fracture
- following orthopaedic surgery
6
Q
When does an air emboli form? (2)
A
- neck vein cannulation
- bronchial trauma
7
Q
What causes a PE? (5)
A
- venous thrombus arises from the legs or pelvis
- clots breaks off
- clot passes through the veins
- travels to the right hand side of the heart
- and enters the pulmonary circulation
8
Q
What are the risk factors for PE? (8)
A
- surgery - abdo, hip, pelvic, knee
- thrombophillia
- leg fracture
- prolonged bed rest
- reduced mobility
- malignancy
- pregnancy
- previous PE
9
Q
What are the symptoms? (5)
A
- acute breathlessness
- pleuritic chest pain
- haemoptysis
- dizziness
- syncope
10
Q
What are the signs of PE? (9)
A
- pyrexia
- cyanosis
- tachypnoea
- tachycardia
- hypotension
- raised JVP
- pleural rub
- pleural effusion
- DVT
11
Q
Differential diagnosis (6)
A
- acute coronary syndrome
- aortic dissection
- cardiac tamponade
- pneumonia
- pneumothorax
- sepsis
12
Q
Investigations (7)
A
- FBC
- U&Es
- Baseline clotting
- D-dimers
- ABG
- CXR
- ECG
13
Q
What would the ABG results show? (2)
A
- decreased PaO2
- decreased PaCO2
14
Q
What would the CXR show? (6)
A
- normal
or
- show oligaemia
- dilated pulmonary artery
- linear atelectasis
- small pleural effusion
- wedge shaped opacities
15
Q
What would the ECG show? (1 and 3)
A
- normal
or
- tachycardic
- right bundle heart block
- right ventricular strain
