Pulmonary Embolus Flashcards
1
Q
Where are thrombus’s typically formed?
A
Systemic circulation (veins) 10% - R atrium
2
Q
Name the seven specific items that may form an embolism?
A
Thrombo-embolism (most common) Infective vegetations Amniotic fluid Fat (broken bones) Gas (C.diff) Atheroma Tumour
3
Q
Describe the three constituents within Virchow’s triad?
A
Wall (endothelial damage)
Constituents (hypercoagulability)
Flow (abnormal blood flow)
4
Q
Name eight risk factors for the development of DVT?
A
Recent surgery Prolonged bed rest/long haul flight Pregnancy OCT Thrombophillia Leg fracture Malignancy Hx of previous DVT/PE
5
Q
Describe the features of a ‘small’ PE?
A
Clinically silent 60-80%
If multiple and loads = cor pulmonale and pulmonary hypertension
6
Q
Describe the features of a ‘medium’ PE?
A
Often leads to infarction and subsequent necrosis
Pleuritic chest pain
Dyspnoea
Haemoptysis (30%)
7
Q
Describe the features of a ‘large’ PE? (6 symptoms)
A
Effectively occludes circulation (saddle pulmonary A) Severe chest pain Shocked/pale/sweaty Dyspnoea Heamoptysis Syncope Nausea 5% = sudden cardiac death
8
Q
What investigations would be most appropriate with suspected PE?
A
Plasma D-dimer - if negative definitely EXCLUDES PE
CT-pulmonary angiogram
V/Q scan
