Pulmonary Embolism

Question 1

What is the reaccurance rate of a pulmonary embolism

Answer 1

10%

Question 2

What is a pulmonary embolism

Answer 2

thrombus in pulmonary vessel (artery)

Question 3

PE are usually caused from

Answer 3

DVTs

Question 4

Where are these DVTs commonly found

Answer 4

iliac, popliteal, femoral

Question 5

thrombus can also be caused by

Answer 5

fat (fracture through the bone marrow)
air (iatrogenic)
particles (from amniotic fluid during delivery)

Question 6

Main patho of a PE

Answer 6

DVT - becomes an embolus - and then becomes a thrombus in the arterial bed of the lungs - causes impaired perfusion - hypoxemia

Question 7

How does hemodynamic instability occur

Answer 7

platelets degranulate - bronchial/ pulmonary constrictions = hemodynamic instability (inadequate blood pressure)

Question 8

Why does a decrease CO occur

Answer 8

dt decreased input to the L atrium

Question 9

What does ischemia cause in an PE

Answer 9

kills the surfactant producing cells - causing atelectasis - and right sided HF dt having to pump against the thrombus

Question 10

Manifestations

Answer 10

Chest pain (ischemia)
Tachypnea (compensatory)
Dyspnea
Tachycardia

Question 11

what serum markers are used to diagnosis a pulmonary embolism

Answer 11

serum markers for infarction (LDH3)

lactate dehydrogenase

Question 12

Describe the lung scan used for diagnosis in pulmonary embolism

Answer 12

uses 131 I-HSA (human serum albumin) to detect thrombus. its a radioactive marker that stops when reaches a thrombus

Question 13

Other diagnostics for diagnosis

Answer 13

Hx
Px
ABGs
Chest CT
pulmonary angiogram (invasive)

Question 14

Treatment

Answer 14

Stat treatment
Anticoagulants and thrombolytics
maintain cardiopulmonary function to avoid shock