6.2 Pulmonary Embolism Flashcards Preview

Yr 2 Sem 1 Resp > 6.2 Pulmonary Embolism > Flashcards

Flashcards in 6.2 Pulmonary Embolism Deck (22):
1

Define embolism

Movement of material rom one part of the circulation to another

2

Define pulmonary embolism

Thrombus entering the right side of the heart and pulmonary arteries

3

What things can be embolised?

Thrombus
Air
Fat
Tumour
Amniotic fluid
Bullet

4

What happens if AF gets into lung?

Causes an inflammatory response which can lead to acute respiratory distress

5

What % of PE arise from DVT in legs?

90%

6

Which veins for DVTs usually arise from?

Popliteal vein
(And more proximal veins including pelvic veins

7

What are some risk factors for thromboembolism?

Age >40 years, surgery >30 mins, obesity, cancer, pregnancy, long haul travel >4hrs, prolonged immobilisation, previous thromboembolism, heart failure, contraceptive pill, HRT, thrombophilia

8

What three things could cause PE?

Right ventricular overload
Respiratory failure
Pulmonary infarction

9

What happens in right ventricular overload?

>30% of pulmonary arterial bed occluded
Pulmonary artery pressure increases
Leads to RV dilation and stain
Inotropes released to maintain BP cause pulmonary artery vasoconstriction

10

Why may someone get respiratory failure?

Areas of ventilation perfusion mismatch
Low RV output

11

What is a feature of pleuretic pain?

Worse on inspiration

12

What are some symptoms of PE?

Dysopnea
Pleuretic chest pain
Cough
Substernal chest pain - RV struggling
Haemoptysis
Syncope
Unilateral leg pain

13

What are some differential diagnoses of PE?

MI
Pneumothorax
Pneumonia/pleurisy

14

What physical signs may be seen in PE?

Pleural rub
Raised JVP

15

What investigations should be done in PE?

CXR
ECG
Blood gases
D dimer

16

What are the classic signs of RV stain on ECG?

S1, Q3,T3

17

What is the most common finding on a PE X-ray?

Normal

18

Why may blood gases show hypoxemia and hypocapnia in PE?

Respiratory alkalosis due to hyperventilation

19

What is a d dimer?

Fibrin degradation product

20

What is the treatment for PE?

Oxygen
Immediate heparinisation

21

Is heparin a thrombolytic?

No

22

What extra treatment may be needed in high risk PE?

Haemoynamic support, respiratory support, exogenous fibrinolytics (streptokinase/tPA), thrombectomy, bypass