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Respiratory System > Pulmonary Embolism > Flashcards

Pulmonary Embolism Flashcards

1
Q

What is an embolus?

A

Blockage of a blood vessel at a site by a solid/liquid/gas distant from its origin

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2
Q

What can make up an embolus?

A 
Thrombus
Tumour
Air 
Fat
Amniotic fluid
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3
Q

What is the most common origin of a PE?

A

DVT

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4
Q

What are the risk factors for a PE?

A 
Pregnancy 
Prolonged immobilisation
Contraceptive pill 
Long travel 
Obesity 
Surgery 
Previous VTE
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5
Q

What is the pathophysiology of a PE?

A

Right ventricular overload
Respiratory failure
Pulmonary infarction

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6
Q

What causes right ventricular overload?

A

Pulmonary artery pressure increases - causes RV dilatation + strain

Inotropes released to attempt to maintain BP - causes pulmonary artery vasoconstriction - makes it worse

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7
Q

What causes respiratory failure?

A

Areas of V/Q mismatch - low RV output

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8
Q

What causes pulmonary infarction?

A

Small distal emboli may cause alveolar haemorrhage

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9
Q

What are the symptoms of PE?

A

Dyspnoea
Pleuritic chest pain
Cough +/- haemoptysis

Leg pain - if caused by DVT

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10
Q

What are the signs of PE?

A

Dyspnoea
Tachycardia
Low BP
Raised JVP

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11
Q

What are differentials for a suspected PE?

A 
Pneumothorax
Pneumonia 
Pleurisy 
MSK pain 
MI 
Pericarditis
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12
Q

What investigations should you do for a suspected PE?

A 
ECG 
CXR
Bloods - FBC, troponin, D dimer
ABG
CTPA
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13
Q

What would an ABG show with a PE?

A

Respiratory alkalosis

  • hypoxaemia
  • hypocapnia
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14
Q

What would a CXR show with a PE?

A

Commonly = normal

Wedge sign
Knuckle sign

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15
Q

What would an ECG show with a PE?

A

Sinus tachycardia = common

Right heart strain - T wave inversion in V1-4, II, III, aVF

S1Q3T3

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16
Q

What score system is used for assessing PE risk?

A

Wells for PE

17
Q

What are the Wells criteria?

A 
Clinical signs/symptoms
PE likely?
HR >100
Immobilisation/recent surgery
Previous DVT/PE
Haemoptysis 
Malignancy
18
Q

What does a Well’s score of 0-4 indicate?

A

PE unlikely

19
Q

What does a score of 4+ indicate?

A

PE likely

20
Q

How do you manage a patient with PE?

A

Immediate heparinisation
O2
Thrombolysis

21
Q

How does heparinisation reduce mortality?

A

Stops thrombus propagation - at source and in lungs

Respiratory System (23 decks)

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