101

Question 1

Majority of emboli that go to form PE’s arise in the

Answer 1

Pelvis and abdomen

Question 2

PE common in which side of the heart?

Answer 2

Left

Question 3

Once emboli arrive in the lungs

Answer 3

impede gaseous exchange - intrapulmonary dead space. Ventilated but not perfused
Tissue ceases to produce surfacant - leads to alveoli collapse
Hypoxemia exacerbated

Question 4

Causes of PE

Answer 4

Virschow’s triad
Venous compression
Acquired - pregnancy,cancer, nephrotic syndrome, heparin induced thrombocytopenia, use of oral contraceptive pill, IBD and congenital

Question 5

Clinical symptoms of PE

Answer 5

Dysponea
Pleuritic chest pain
Haemoptysis

Question 6

Clinical signs of PE

Answer 6

Low O2 sats
Tachycardia
Signs of DVT

Question 7

Well’s score

Answer 7

Suspected DVT +3
PE most likely +3
HR >100bpm +1.5
immobilization/surgery 4 wks previous +1.5
Previous DVT/PE +1.5
Haemoptysis +1
Malignancy past 6months +1
0-2 Low, 3-6 moderate, >6 High

Question 8

If CXR normal but patient hypoxic?

Answer 8

Think PE

Question 9

PE findings on CXR

Answer 9

Hampton’s Hump - infarction of lung tissue, enlargement of descending PA

Question 10

D-dimer in PE

Answer 10

Negative more useful than positive

Raised in - Recent surgery, Shock, Cancer

Question 11

Management of PE

Answer 11

Supportive treatment of Hypoxia 
Analgesia
Antiacoagulation therapy 
Short term - LMWH
Long term - N/DOAC
Treat underlying cause