22 Pulmonary Embolism Flashcards Preview

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Flashcards in 22 Pulmonary Embolism Deck (17)
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1

What is a pulmonary embolism?

Obstruction of a pulmonary artery or one of its branches

2

Where do pulmonary emboli commonly originate?

Deep veins of lower limb, pelvis or abdomen

3

What can the embolism be made up of (ie what can embolise)? (6)

Fat embolism due to long bone fracture 

4

How are fat emboli usually caused?

Fat emboli commonly occur after fractures to the long bones of the lower body

5

How are cerebral air emboli usually caused?

6

Where do the majority of pulmonary emboli come from?

90% from DVT in legs

Esp: popliteal vein and pelvic veins

7

What are the risk factors for a pulmonary embolus?

Same as for DVT:

  1. Stasis / turbulence of blood flow
  2. Blood hypercoagulability 
  3. Endothelial injury 

Vichow Triad

8

List some risk factors that increase someones risk of developing a thromboembolism (eg pregnancy).

 

  • Increased age- increased risk (culmination of factors) 
  • HRT
  • Longhaul travel: stasis, dehydration

9

If someone with a DVT has no identifiable risk factors, what needs to be considered?

Undetected malignancy

  • Eg. Cancer might secrete pro-thrombotic factors 

10

Give examples of conditions that should be screened for if a patient is in hypercoagulable state.

  • Deficiency of natural blood thinners
    • Antithrombin III deficiency
    • Protein C or Protein S deficiency/resistance  
  • Lupus anticoagulant
  • Homocystinuria
  • Malignancy 

11

What % of people with pulmonary emboli will suddenly die?

20%

12

What are the symptoms of a pulmonary embolism?

Patient can look and feel asymptomatic- make sure to check if high risk 

13

What are the physical signs of a pulmonary embolism?

Diaphoresis= sweating

Thrombophelbitis= (inflammation of a vein due to thrombus) 

14

If a patient presents with the symptoms of a pulmonary embolism, what might be the diffential diagnoses?

Pleurisy= pleuritis (sharp chest pain) 

15

What investigations can be done if a patient has a suspected pulmonary embolism? 

16

Outline the how pulmonary emboli are treated.

  • Oxygen
  • Low molecular weight heparin
    • Stop thmobus propagatin and allows body to lyse thrombus
      • BUT watch out for heparin induced thrombocytopenia
  • Percutaneous catheter- thrombectomy
  • Surgical pulmonary embolectomy

17

What can we do to prevent the occurence of pulmonary emboli in patients?

  • Manage risk factors (eg HRT, obesity, travelling etc)
  • DVT prophylaxis after surgery/for malignancy