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Resp - mine > Pulmonary thromboembolic Disease > Flashcards

Pulmonary thromboembolic Disease Flashcards

1
Q

what is pulmonary oedema

A

fluid accumulation in the tissue and airspaces of the lungs

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2
Q

what does pulmonary oedema lead to with regards to gas exchange

A

impaired gas exchange

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3
Q

is pulmonary oedema restrictive or obstructive

A

restrictive

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4
Q

pulmonary oedema is a cardinal feature of what condition

A

congestive (L)HF

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5
Q

what are the causes of pulmonary oedema (4)

A

LV HF (cardiogenic)
injury (non-cardiogenic)
aspiration
severe infection/inflammation

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6
Q

what type of pulmonary oedema is caused by pneumonia

A

localised

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7
Q

what type of pulmonary oedema is caused by ARDS

A

generalised

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8
Q

how is pulmonary oedema diagnosed

A

CXR = presence of fluid

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9
Q

treatment of pulmonary oedema (2)

A

improve resp function (O2)

treat underlying cause

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10
Q

what is PE

A

blockage of a pulmonary artery by a blood clot (most common), fat, tumour, or air

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11
Q

what causes PE

A

DVT of lower limbs

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12
Q

presentation of LARGE PE (4)

A

cardiovascular shock
low BP
central cyanosis
sudden death/collapse

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13
Q

presentation of SMALL, RECURRENT PE (3)

A

progressive SOB
pulmonary hypertension
RH failure

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14
Q

what type of pain is associated with PE

A

pleuritic

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15
Q

what general symptoms are associated with PE (2)

A

haemoptysis

SOB

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16
Q

risk factors for PE

A

VIRCHOW’S TRIAD

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17
Q

risk factors for DVT

A

VIRCHOW’S TRIAD

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18
Q

what is VIRCHOW’S TRIAD

A
  1. stasis of blood flow
  2. endothelia injury
  3. hyper coagulability
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19
Q

first line investigation for PE

A

CTPA

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20
Q

first line investigation for PE + renal impairment

A

V/Q scan

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21
Q

what should D dimers be if PE is present

A

high

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22
Q

what other investigations could be done in suspected PE (excluding CTPA, V/Q scan, D-dimers)

A

CXR
ECG
Ultrasound

23
Q

treatment of PE and DVT

A

anticoagulation

24
Q

list anticoagulation medications (3)

A
  1. LMW heparin
  2. NOAC
  3. oral warfarin
25
Q

1st line treatment of LARGE PE

A

thrombolysis

26
Q

1st line treatment for RECURRENT PE

A

IVC filter

27
Q

give examples of NOACs

A

Dabigatran

Rivaroxaban/Apixaban

28
Q

mechanism of action of Rivaroxaban/Apixaban

A

direct inhibitor of activated factor Xa

29
Q

mechanism of action of Dabigatran

A

direct thrombin inhibitor

30
Q

give an example of thrombolysis

A

tissue plasminogen activator (tPA) = tenecteplase

31
Q

mechanism of action of oral warfarin

A

antagonises vitamin K dependent prothrombin

32
Q

clinical presentation of DVT

A

hot
swollen
red
tender

33
Q

1st line investigation of DVT

A

ultrasound doppler leg scan

34
Q

investiagtions for DVT (excluding US)

A

CT scan

35
Q

what would you take a CT of in a suspected DVT (3)

A

ileo-femoral veins
IVC
pelvis

36
Q

method of prevention of DVT (5)

A 
early post-op mobilisation
TED compression stocking
calf muscle exercises
LMW heparin peri-op
NOACS
37
Q

what is a pulmonary infarction

A

pulmonary tissue death due to compromised blood flow and oxygen supply

38
Q

what causes pulmonary infarction

A

emboli + compromised bronchial supply

39
Q

what is cor pulmonale

A

RH disease secondary to lung disease

usually RHF due to chronic pulmonary hypertension

40
Q

clinical signs of cor pulmonale

A

RV hypertrophy
RV distension
RV failure

41
Q

what genetic condition is associated with cor pulmonale

A

Cystic fibrosis

42
Q

describe the pulmonary system (flow and pressure)

A

HIGH flow

LOW pressure

43
Q

what is normal mean pulmonary arterial pressure

A

12-20mmHg

44
Q

what value(s) is pulmonary hypertension

A

> 25mmHg

45
Q

causes of pulmonary VENOUS hypertension (3)

A

LV ischaemic disease
mitral regurgitation/stenosis
cardiomyopathy

46
Q

causes of pulmonary arterial hypertension (7)

A 
primary 
hypoxic (COPD, fibrosis)
multiple PE
vasculitis
drugs
HIV
cardiac L to R shunt (ASD, VDS)
47
Q

describe PRIMARY pulmonary hypertension

A

rare

occurs in young women

48
Q

how is PRIMARY pulmonary hypertension diagnosed

A

exclusion of other secondary causes

49
Q

symptoms of PRIMARY pulmonary hypertension

A

progressiveSOB

signs of RH failure

50
Q

treatment of PRIMARY pulmonary hypertension (3)

A

anti-cogulation
pulmonary vasodilators (Ca2+ blockers)
lug translant

51
Q

investigations of pulmonary hypertension

A

ECG

CXR

52
Q

clinical signs of pulmonary hypertension

A

central cyanosis
dependent oedema
raised JVP

53
Q

what conditions commonly cause Cor pulmonale

A

COPD

emphysema (alveolar collapse)

54
Q

what would Cor pulmonale look like on CXR

A

enlarged pulmonary arteries

R atrial/ventricular enlargement

Resp - mine (18 decks)

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