Pulmonary Embolus Flashcards
1
Q
What is a pulmonary embolus (PE)?
A
- blockage of one or more pulmonary a. (large or small)
2
Q
Where do 5% of PE’s occur?
A
- bifurcation of the pulmonary a.
3
Q
What is the MC source of PE?
A
- pelvic/deep thigh v. clot
4
Q
What are the other uncommon causes of PE?
A
- air
- amniotic fluid
- fat
- FB/septic
- parasite eggs
- tummor
5
Q
How do 50% of PE patients present?
A
- asymptomatically
6
Q
What is the pathophysiology of PE?
A
- clot obstructs pulm a. which increases pulm vascular resistance
- vasoactive substances released which further increase pulm vascular resistance
- increased pulm vascular resistance leads to V/Q mismatch
- V/Q mismatch impairs gas exchange
7
Q
signs and symptoms of PE
A
- dyspnea (shortness of breath, SOB)
- pleuritic chest pain-
- hemoptysis
- cough
- LE pain/swelling
- sense of impending doom
- syncope
- palpitations
8
Q
What are the risk factors for PE?
A
- Virchow triad (venous stasis, vessel wall injury, hypercoagulability)
9
Q
What are the general findings on PE exam?
A
- dyspnea or pleuritic pain
- anxious
- cyanosis
10
Q
What are the vital finding on PE exam?
A
- tachypnea
- tachycardia
- hypotension
11
Q
What are the ascultative findings on PE exam?
A
- nothing vs. wheezing/rales
- tachycardia
12
Q
What are the findings on the extremities on PE exam?
A
- pain
- swelling
- Homan’s sign
13
Q
How is a diagnosis of PE made?
A
- PERC
- Wells Criteria
14
Q
What are the CXR findings on PE exam?
A
- Fleischner sign
- Westermark sign
- Hampton hump
15
Q
What is Fleischner sign?
A
- seen on CXR
- distended central pulmonary artery d/t presence of a large clot
