Respiratory - Pulmonary Embolism

Question 1

Pathophysiology

Answer 1

A pulmonary embolism (PE) is a deadly medical emergency!
It is when a blood clot obstructs a pulmonary vessel within the lung (typically the pulmonary artery), this blockage prevents blood flow to the alveoli where gas exchange occurs, eventually leading to

DEADLY hypoxemia (low oxygen).

HIGHEST PRIORITY:
* Impaired gas exchange r/t imbalance of ventilation & perfusion

Question 2

Signs & Symptoms

Answer 2

1 Sign = Hypoxemia

-Chest pain
-Dyspnea & SOB
-Tachypnea
-Tachycardia
-Anxiety

Question 3

Manifestation (signs & symptoms) worsen depending on size of clot:

Answer 3

• Sudden dyspnea, chest pain (constant),
• hemoptysis (coughing blood)
• Anxiety & restlessness
• Severe crushing chest pain, Hypotension, Loss of consciousness

Question 4

Causes

Answer 4

A PE is usually caused by a DVT blood clot that loosens from another part of the
body (typically the leg). The clot travels to the lung & blocks a pulmonary artery.

Question 5

Risk Factors

Answer 5

• Smoking, Obesity, Immobility, & some cardiac issues like Atrial Fibrillation or valve disorders
  (where the blood swirls in the heart, causing clots)

Most Tested:
Estrogen birth control “oral contraceptives” leads to increased risk for blood clots

Question 6

Risk Factor Memory Trick

Answer 6

E - Estrogen
E - Emboli (blood clots)

Question 7

Diagnostics

Answer 7

• High D-dimer - High risk for blood clots in the body

Question 8

Diagnostic MEMORY TRICK

Answer 8

• D - Dimer (Positive)
• D - Dime-sized clot
  in body

Question 9

Pharmacology

Answer 9

Anticoagulants
- Heparin
-Warfarin
Thrombolytics
-tPA
-Alteplase
-Streptokinase

Question 10

Treatments

Answer 10

Surgery
* Embolectomy: surgical removal of the clot
* Vena Cava filter: acts like a net to catch any new clots