Term
| cardiovascular indication of a massive PE: |
|
Definition
| hypotension; systolic <90 amy be with venous distensions |
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|
Term
| of the patients with DVT more than __ will develop PE: |
|
Definition
|
|
Term
|
Definition
thrombosis in the veins is trigered by: 1. venoustasis
2. hypercoagubility
3. vessel wall inflammation |
|
|
Term
| how would a PE affect the heart? |
|
Definition
| increase the right ventricular afterload and decrease pressure going into the left atrium. may lead to heart failure. |
|
|
Term
| embolism may also cause the release of _______, _______ & __________ leading to increased vascular resistance and the work of the right ventricle. |
|
Definition
| histamine, prostaglandin, serotonin (vasoconstrictors) |
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Term
|
Definition
1. Hx of DVT/PE
2. recent surgery
3. recent pregnancy
4. prolonged immobilization
5. malignancy
6. Obesity
7. smoking
8. HTN |
|
|
Term
| 2 most prevalent Sx of PE: |
|
Definition
| Dyspnea and Pleuritic chest pain |
|
|
Term
| 3 most prevalent signs of PE: |
|
Definition
| Tachypnea, rales, tachycardia |
|
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Term
|
Definition
|
|
Term
| which labs may be elevated with PE: |
|
Definition
WBC,ESR,LDH,AST,BNP,DDIM,TROP
ABG = RESP ALK |
|
|
Term
| which of the labs is most diagnostic of PE: |
|
Definition
| DDIM; <500 will rule out PE, |
|
|
Term
| what is the Gold Standard test for PE: |
|
Definition
|
|
Term
| EKG will most often show what in a PE? |
|
Definition
|
|
Term
| in what instances are the Trop enzymes elevated assoc with PE? |
|
Definition
| prolonged hypotension leading to HF |
|
|
Term
| EKG abnormalities exist in __% of patients with PE: |
|
Definition
|
|
Term
| Atelectasis noted in __% of PEs |
|
Definition
|
|
Term
| Pleural Effusion detected in __% of PEs |
|
Definition
|
|
Term
| What are the "classic findings" on radiographs for PEs |
|
Definition
| Hampton's Hump & Westermark's Sign |
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Term
|
Definition
|
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Term
|
Definition
| radioactive compound inhaled and injected radiograph shows V/Q of the lungs. |
|
|
Term
| when is a V/Q scan indicated? |
|
Definition
| when the patient has allergies to contrast, pregnancy, < kidney clearance , that would not allow for CT |
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Term
| The gold standard aniography is being replaced by: |
|
Definition
|
|
Term
| what is the best way to Dx or RO PE? |
|
Definition
| algorithm that incorporates: clinical probabbility, DDIM, CT-PA |
|
|
Term
| List the 7 Well's Criteria and their points: |
|
Definition
1. Sx of DVT = 3.0
2. other Dx less likely than PE = 3.0
3. HR >100 = 1.5
4. immobilization/surgery wn<4wks = 1.5
5. Hx of DVT/PE = 1.5
6. Hemoptysis = 1.0
7. Malignancy = 1.0 |
|
|
Term
| what is the simplified clinical probability assesment of the Wells Criteria? |
|
Definition
PE likely = >4.0
PE unlikely = |
|
|
Term
| explain the algorithm for PE Dx: |
|
Definition
1. likelyhood of PE w Wells Criteria
2. DDIM
3. Spiral CT (CT-PA)
PE likely>CT>yes or no
PE unlikely>DDIM>(<500)>no, , >500>CT>yes or no |
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Term
|
Definition
|
|
Term
|
Definition
1. <50
2. HR <100
3. sO2% >/= 95%
4. no hemoptysis
5. no estrogen use
6. no Hx of DVT/PE
7. no s/sx of DVT
8. no surgery/trauma requiring hospitalization wn <4wks |
|
|
Term
| 3 prevention methods for PE: |
|
Definition
1. antithrobotics in at risk pts
2. graduated compression stockings
3. pneumatic compression |
|
|
Term
|
Definition
LMWH>consider throbolytic if indicated for survival>if can't do thrombolytic & it is needed then embolectomy.
If LMWH is contraindicated then IVC filter considered |
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|
