Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Patho Midterm 2 > Pulmonary Embolism > Flashcards

Pulmonary Embolism Flashcards

1
Q

Thrombus?

A

Blood clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Embolism?

A

Blood clot (thrombus) or air/other things obstructing blood flow that mobilizes within vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pulmonary embolism?

A

Thrombus in a pulmonary vessel (within he pulmonary circuit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the mortality rate for PE?

A

> 30% mortality (if a large vessel is obstructed, death will occur very quickly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Does pulmonary embolism go away after it is treateD?

A

Yes, but there is a high rate of recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiology of pulmonary embolism

A
  • Majority is d/t DVT
  • Fat embolism from fracture
  • Air embolism
  • Amniotic fluid from ruptured amniotic sac
  • saddle embolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which veins does a thrombus from a DVT typically occur in?

A

iliac, femoral, popliteal, great saphenous veins of the leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain how DVT causes a PE

A

Thrombus within the iliac, femoral, popliteal, great saphenous veins of the leg that embolisms and reaches the pulmonary circuit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is a DVT life-threatening?

A

Not necessarily, it is only a major problem when the clot travels to a vital organ circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain the route of a thrombus if it were coming from the the lower body.

A

Into inferior vena cava -> R atrium -> R ventricle -> pulmonary artery -> pulmonary capillaries -> pulmonary vein (cloth gets caught in one of the smaller vessels of the pulmonary circuit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Explain how a fracture causes pulmonary embolism

A

Fatty bone marrow is released during orthopaedic surgery or if a bone is fractured in trauma -> fat enters the circulation and moves as an emboli, reaching the pulmonary circuit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does an Air embolism occur?

A

From syringe or tubing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does amniotic fluid from a ruptured amniotic sac cause pulmonary embolism?

A

Amniotic fluid enters circulation during trauma or delivery through severed blood vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Saddle embolus?

A

Named after the saddle-like appearance of an embolus created by a thrombus settling at the area where pulmonary vessels bifurcate, attracts platelets, causing the thrombus to increase in size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Explain the pathology of a pulmonary embolism. Assume that the P.E. was caused from a DVT.

A

DVT -> embolus -> R side of heart -> pulmonary circulation -> thrombus in arterial bed -> decreased perfusion ->. platelets attracted to the site of the thrombus d/t abnormality in vessel -> platelets degranulate to release mediators to attract more platelets but the degranulation also causes brachial and pulmonary artery constriction. There is hemodynamic instability d/t obstruction and further constriction of vessel and the nervous system reflexively causes bronchoconstriction. This results in a ventilation: perfusion imbalance (hypoxemia & systemic hypoxia). Decreased CO & decreased surfactant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why do platelets degranulate?

A

To release mediators to attract more platelets (but here, the degranulation also causes bronchial and pulmonary artery constriction)

17
Q

In a pulmonary embolism, why does the nervous system reflexively cause bronchoconstriction?

A

It is just a reflex, not beneficial

18
Q

Why does the CO decrease in a pulmonary embolism?

A

There is an obstruction in the lungs -> decreased blood flow into the left side of the heart = less blood to pump out into the systemic circuit

19
Q

What is the normal function of surfactant?

A

It decreases adhesion forces and prevents walls of alveoli from sticking together on exhalation

20
Q

What is surfactant composed of?

A

Phospholipids, cholesterol, proteins and fluid (which is taken from the blood)

21
Q

Why is there decreased surfactant during an pulmonary embolism?

A

With impeded circulation, there is decreased fluid available to form the surfactant. Also, the T2 alveolar cells that produce surfactant are ischemic and have decreased function, furthering the decrease in surfactant levels

22
Q

What the decrease in surfactant in pulmonary embolism result in?

A

Atelectasis d/t walls sticking together

23
Q

What is a complication of pulmonary embolism?

A

Right-sided HF

24
Q

Why is right-sided HF a result of Pulmonary embolism?

A

Obstruction in the pulmonary circuit, which receives blood from the right side of the heart, so the right ventricle is pumping against increased resistance = increased workload on the right side of the heart = failure

25
Q

Manifestations of pulmonary embolism?

A
  • depends on the site of obstruction (aka. size of vessel obstructed and severity)
  • Usually cardio and resp symptoms
  • hypoxemia & hypoxia -> dyspnea, tachypnea (compensatory), chest pain
  • tachycardia (compensatory for decreased CO)
  • fever in the absence of infection
26
Q

Diagnostics of pulmonary embolism

A
  • hx, px
  • ABG’s
  • D-dimer
  • LDH3 (lactate dehydrogenase)
  • Lung Scan (131 I-HSA, IV)
  • CT Chest
  • Pulmonary angiogram
27
Q

What is D-dimer testing?

A

it is a fibrin degradation product (breakdown of the fibrin component of the clot releases components, d-dimer being on of them)

28
Q

What is d-dimer used to diagnose?

A

DVT, DIC, PE

29
Q

What does LDH3 stand for?

A

lactate dehydrogenase

30
Q

What is LDH3?

A

a protein released when cells die

31
Q

If LDH3 is high, what does it indicate?

A

It is because there is an increased in damaged lung cells

32
Q

131 I?

A

Isotope for iodine

33
Q

HSA?

A

Human serum albumin

34
Q

Explain lung scan (131 I-HSA, IV)

A

Albumin is labeled with iodine 131 and allowed to flow freely through the circulatory system and into the pulmonary circuit. The isotope can be detected once in the circuit and will show the point of obstruction (less invasive than an angiogram)

35
Q

What is a disadvantage of a pulmonary angiogram?

A

It is invasive because an instrument is introduced into the vessel and a mediator/dye is released

36
Q

What is beneficial when a pulmonary angiogram is in the vessel?

A

You can provide treatment

37
Q

Treatment for pulmonary embolism?

A
  • STAT treatment = better prognosis
  • thrombolytics and anticoagulants
  • maintain cardiopulmonary support
  • Address the underlying cause to decrease recurrence (eg. DVT)

Patho Midterm 2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions