Pulmonary Embolism, D Kinder, DSA Flashcards
definition PE
obstruction of pulmonary a through blood stream
soureces of PEs
DVT, fat, amniotic fluid, air, tumor cells, talc in venous drug users and medical devices
Risk factors venous thromboembolism
advanced age, history previous VTE, obesity, active cancer
limit activity
What are the triggering factors for VTE
surgery, pregnancy immobiliazation or estrogen therapy
What is virchows triad
vascular damage, stasis and hypercoagulability
what are genetic hypercoaguable states
factor V ledien, prothrombin 20210 gene mutation
antithrombin deficiency
protein C deficiency
protein S deficiency
most PE come from what
DVT
what is risk factor for DVT from UE
indwelling catheter
signs and Sx PE
dyspnea, tachypnea, hypoxemia, pleuritic chest pina, cough, hemoptysis, leg pain, swelling, palpiations, syncope, split second heart sounds with loud pulmonic componenent
Ddx PE
pneumonia, COPD excacerbation, asthma, pleurisy, CHF, acute coronary syndrome, pericarditis and MSK disorders
What are the tests for PE
D-dimer CT pulm angiography VQ scan pulm angiography venous compression US of LE EKG echo
what is D-dimer test
negative predictive value in patients with low-moderate pre-test probability PE
what is the gold standard now for PE
CT pulm angiography
what are the parts of VQ scan
inhale xenon or tecnetium
IV injection of technetium labeled macroaggregates of albumin
what is preferred test for PE in pregnant women
VQ scan
