Card Set Information
PE VQ dimer BNP
What is a embolus comprised of?
A thrombus, fat, mass of bacteria or a foreign body
What is an embolus?
Object circulating in the blood that occludes a vessel (pulmonary vasculature).
What is a thrombus?
formed within a blood vessel and remaining attached to its place of origin.
Risk factors for P.E.
Prolonged immobilization (3-4 hrs) venous stasis (trucker)
Birth control pills
Hypercoaguable states due to anticoagulant defeciancies (protein C & S)
Malignancy (breast, lung, colon) releases procoagulant hormones.
Autoantibodies (lupas anticoagulant)
Symptoms of PE
SOB, diaphoretic, tachypnic, tachycardia, hypotension
Tests to diagnose P.E.
: Pulmonary angiogram with IV contrast.
CT chest with IV contrast (easiest test), if pt has renal failure, or allergy then V/Q.
What is a D-dimer & it's reliability.
Fibrinogen>thrombin>(fibrin mesh)>factor XIII>
croslinked fiber mesh (d-dimer)
The d-dimer is towards the end of the clotting cascade making the D-dimer specific for a clot.
Has poor specificity becuase other inflammatory conditons other than PE can have elevations.
Test is only reliable if pt has no other comorbidities.
: D-dimer vs.BNP (see flashcard on BNP to not get these confused).
: dime (clot) stuck in the lungs.
When do you use a D-dimer?
False positive of D-Dimer
(dont need to know extra
False positive can be due to
: liver disease, high rheumatoid factor, inflammation,
malignancy,trauma, pregnancy, recent surgery as well as advanced age
What is BNP?
B-type natriuretic peptide (BNP) is a cardiac neurohormone that is released from the ventricles in response to volume or pressure overload, may differentiate congestive heart failure (CHF) from other
causes of dyspnea.
What does CT stand for?
computed tomography (to-MOG-rah-fee)
What is a V/Q scan?
A lung ventilation/perfusion scan shows how well oxygen and blood are flowing to all areas of the lungs.
The ventilation scan shows where air flows in your lungs by inhaling a small amount of radioisotope gas.
The perfusion scan shows where blood flows in your lungs, radioisotopes are injected into a vein in your arm.
Radioisotopes (a low-risk radioactive substance) create images of air and blood flow patterns in your lungs.
Treatment of P.E.
Antigoagulants x 3 months
: (unfractionated) IV
(low molecular weight)
: Lovenox BID SQ
Anti-thrombin III binder
Recurrent episodes require IVC filter greefield filter