resp medicine - PE Flashcards
1
Q
what is virchows triad?
A
- abnormal vessels
- stasis
- hypercoagulable state
2
Q
WELLs score criteria?
A
Clinical signs/symptoms of DVT - 3 PE is most likely diagnosis - 3 Tachycardia - 1.5 Immbolization/surgery in past 4 weeks - 1.5 Prior DVT/PE - 1 Hemoptysis - 1 Active malignancy - 1
3
Q
Interpretation of WELLS SCORE?
A
0-4 PE unlikely
>4 PE likely
4
Q
what to do if someone has a wells score of >4 ?
A
CT-pulmonary angiogram
5
Q
what to do if someone has a wells score of <4
A
Get a D-Dimer
6
Q
What does PERC stand for?
A
PE rule out criteria
7
Q
PERC criteria?
A
- Hormones -OCP, HRT
- AGE > 50
- DVT/PE history
- Coughing blood
- Leg swelling
- Oxygen < 95%
- Tachycardia
- Surgery/trauma < 4 weeks
8
Q
how to interpret the PERC?
A
If anyone of the criteria is positive, a PE cannot be ruled out
9
Q
Management of PE?
A
- ABCS
- focused history and examination
- Lab tests: ABG, bloods, coag screen, BNP, troponin
- Initial rescusc: 2 large bore IVs with IV fluids
- Supplemental oxygen
- Anticoagulation -LMWH - tinzaparin 175 units/kg/SC
- remove precipitant/cause if possible
- Thrombolysis for massive PE in someone who is unstable
- Consider embolectomy for massive PE
10
Q
How long should a patient be on anticoags after a PE?
A
- If provoked - 3 months
- If unprovoked 6 + months (review for possible lifelong treatment)
