S1 L4.2: Pulmonary Embolism Flashcards
T/F. Pulmonary Embolism
and Deep Venous Thrombosis
- encompass one disease entity: VTE (venothrombo embolism)
- DVT occurs about 2 times more often than PE
TF
(3 times)
T/F.
PE (pulmonary embolism) can be fatal or can cause chronic thromboembolic
pulmonary hypertension
- Patients with PE are more likely to suffer recurrent
VTE than patients with DVT alone
TT
Identify the wrong statement about DVT
Postphlebitic syndrome.
A. major adverse outcome of DVT alone, without PE
B. occurs in less than half of patients with DVT
C. a late adverse effect of DVT
D. caused by permanent damage to the venous valves of the leg
E. valve incompetence and exudation of interstitial
fluid
B. occurs in more than half of patients with DVT
Identify the wrong statement about DVT
Postphlebitic syndrome.
A. may not become clinically manifest until several years after the initial DVT
B. no effective medical therapy
C. chronic ankle swelling and calf swelling
and aching (especially after prolonged
standing), skin ulceration
D. None of the above
D
True about Pulmonary Embolism and DVT, except:
A. afflict millions of individuals worldwide
B. account for hundred thousand deaths
annually in the US
C. 15% mortality rate, exceeds mortality rate of AMI
D. still remain difficult to detect
E. None of the above
E
True about Pulmonary Embolism and DVT, except:
A. death rate from PE increases with age
B. higher in African-american than in whites
C. men > women
D. ≈50% are idiopathic
C. men = women
Choose the wrong letter about Pulmonary Infarction.
A. Pleuritic chest pain that may be unremitting or may wax and wane
B. Hemoptysis
C. Embolus lodges in the contralateral pulmonary arterial tree, near the pleura
D. Tissue infarction occurs 3-7d after embolism
E. Fever, leukocytocis, elevated ESR and radiologic evidence of infarction
C. Embolus lodges in the peripheral pulmonary arterial tree, near the pleura
Identify the wrong letters about pulmonary infarction syndrome
A. Cause by a tiny peripheral PE
B. Pleuritic chest pain, often responsive to narcotics
C. High-grade fever
D. Pleural rub
E. Occasional scant hemoptysis
F. Leukocytosis
B. Pleuritic chest pain, often not responsive to narcotics
C. Low-grade fever
T/F. The 5 Most Common Co-morbidities in PE are:
- hypertension
- surgery within 3 months
- immobility within 30 days
- cancer
- obesity
T
T/F in Classic Dichotomy in PE Pathogenesis
* inherited/ primary – uncommon
* acquired/secondary - usual
FF
inherited/ primary – unusual
* acquired/secondary - common
What are the virchow’s triad
Circulatory stasis
Endothelial injury
Hypercoagulable state
T/F. The ff. Are major acquired risk factors for VTE:
- advancing age
- arterial disease including carotid & coronary disease
- obesity
-cigarette smoking
- COPD
- personal/family hx of VTE
-recurrent surgery, trauma/immobility including stroke
- acute infarction
-long haul air travel
-cancer
-pregnancy, oral contraceptive pills/hormone replacement therapy
- pacemaker, implantable cardiac defibrillator leads/indwelling central venous catheter
T
Identify the major thrombophilias associated with venous thromboembolism
- Factor V Leiden resulting in activated protein C resistance
- prothrombin gene mutation 20210
- antithrombin III deficiency
- protein C&S deficiency
A. Inherited
B. Acquired
A
Identify the major thrombophilias associated with venous thromboembolism
- antiphospholipid antibody syndrome
-hyperhomocysteinemia
A. Inherited
B. Acquired
B
The ff. Results to increased pulmonary vasculature resistance except
A. Vascular obstruction
B. Neurohormonal agents
C. Pulmonary artery baroreceptor
D. Hypoxemia
D. Hypoxemia
T/F. Impaired gas exchange are caused by:
*Increased alveolar dead space
*Hypoxemia
T
