08.25 - Venous Thromboembolism (Muthiah) - Questions Flashcards
(53 cards)
S1Q3T3
Right Ventricular Strain - Pathognomonic for PE
2 classic tumors that grow into venous system
Renal Cell Carcinoma, Lung Primary
3 important congenital hypercoagulabilities that predispose to PE
Factor V Leiden, Prothrombin Mutation, Proteins C and S deficiency
Most common cause of thrombocytopenia in the ICU
DIC
Commonest cause of DIC
Sepsis
What is our concern in Heparin Induced Thrombocytopenia
Even though platelet count low, can still clot
2 Actions of Warfarin
Blocks vit-K-dependent factors; Decreases production of Proteins C and S
2 important acquired hypercoagulabilities
HIT, Nephrotic
Pulmonary Vascular resistance after PE
Increased - serotonin, endothelin
Gas Exchange after PE
Increased dead space (v/q mismatch), low DLCO, shunting in massive PE
PaCO2 after PE
Hypocapnea, trying to maintain oxygenation, and CO2 diffuses more readily than O2
Alveolar ventilation after PE
Alveolar Hyperventilation - reflex stimulation of irritant receptors
Airway resistance after PE
Increased - Bronchoconstriction - Serotonin
Pumonary Compliance after PE
Decreased - Edema, Hemorrhage, Loss of Surfactant
Circulatory Compensation after PE
Vasodilation of uninvolved vasculature helps decr the incr in PVR, also improves V/Q relationship
Gas Exchange abnormalities after PE
Hypocapnia, Hypoxemia, Wide A-a
Blood pressure after PE
Pulmonary HTN, Systemic Hypotension
When might patients get bradycardia after PE
Beta Blocker
What causes BNP release
Ventricular Stretch (higher BNP associated with adverse outcomes)
Commonest arrhythmias after PE
A Fib, A Flutter
Sign of RV strain
S1Q3T3
Most common complaint from patient with acute PE
SOB
2 most common complaints after PE other than Dyspnea, Tachypnea, and Tachycardia
Pleuritic Pain, Loud P2
Heparin Antidote
Protamine Sulfate
