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Flashcards in PE Deck (18)
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What is hip pinning and what complications can occur?

Hip pinning fixes a broken hip using pins, screws and plates
Comp = infection, blood clots, DVT


Why do people who have hip pinning have increased risk DVT?

Reduced movement and mobility


What is PE and how does it form?

Usually derived from fragment DVT
Fragments become detached from site and travel via venous return via RHS to pulmonary arteries


Does size of PE change clinical outcome?

Large PE can become lodged at bifurcation of pulmonary artery = sudden death
Smaller PE can become lodged in peripheral branch leading to infarction


Symptoms see w/ PE?

SOB, chest pain and sometimes cough up blood


What ECG finding see w/ PE?

Sinus tachycardia - reduced blood flow to lung cause SOB increased HR


What is heparin?

In family glycosamingoglycans


How does heparin work?

Action antithrombin III - inhibit thrombin and inactivate prothrombin


How measure effect heparin?

Kaolin-cephalin clotting time


How to reverse effect heparin?

Protamine sulphate


How is heparin related PE?

Low molecular weight heparin given as immediate anticoagulation
Can be given as prophylaxis to those at risk DVT/PE - slow progression DVT


What is Well's score

Number that reflect risk of developing DVT


What is CTPA and its purpose?

CT pulmonary angiogram
Obtain imagine pulmonary arteries - diagnostic tool for PE


How is CTPA performed and contraindication?

IV injection of iodine-containing contrast agent (dark mass can show embolism)

1. Pregnancy - concern effect thyroid gland foetus
2. Renal disease - risk contrast induced nephropahy


Why is renal function test needed before CTPA?

Contraindicated in those w/ renal disease - unable to clear medium and can put at risk of nephropathy


Anticoagulation therapy for someone w/ PE?

Immediate anticoagulation injection for at least 5 days (usually heparin)
Managed as outpatient using warfarin - at least 3 months


Explain heparin dose in hospital setting

IV heparin every 4-6 hours
Heparin administered at provisional diagnosis - if hospital dose given at 6, amount worked out as top up dose


Risk factor PE

OCP, long haul flight, increased drinking, immobility