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16 Cards in this Set
- Front
- Back
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In the lung, 2/3 of resistance occurs at the level of the ___________.
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Arterioles
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Normal right atrial presssure
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0-6 mmHg
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Normal right ventricle pressure
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25/8 mmHg
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Normal pulmonary artery pressure
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25/12 mmHg
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Normal Pulmonary CWP
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6-12 mmHg
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What is the gold standard for the detection of a venous thrombosis?
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Contrast venography or venogram
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What is the test of choice for detection of a deep vein thrombosis?
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Compression ultrasound
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What is the main source of pulmonary emboli?
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80% are from ileofemoral or deep veins of the legs; remaineder from pelvis, vena cava, and less than 2% are from the right atrium.
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What are the most common symptoms for a pulmonary embolism?
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Dyspnea (81%), pleural pain, apprehension, cough, and hemptysis
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What are the most common signs for a pulmonary embolism?
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Increased RR > 16 (87%), rales, increased P2, increased pulse > 100 bpm, increased fever > 37.8, S3 and S4
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What is the most common ECG finding in pulmonary embolism?
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Sinus tachycardia
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What are the most common arterial blood gas findings in pulmonary embolism?
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Respiratory alkalosis and hypoxemia with an elevated alveolar-arterial gradient, although this is not sensitive or specific.
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What is the gold standard for diagnosing pulmonary embolic disease?
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Pulmonary angiography
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What is the test of choice for diagnosing pulmonary embolic disease?
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V/Q scans - much less invasive and involve less risk
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What is the treatment for thromboembolic disease?
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Anticoagulation
This is done by IV heparin infusion followed by conversion to oral warfarin (if pregnant, heparin is used). All heparins act by activating antithrombin to inhibit thrombin. Duration of treatment depends upon the clinical situation, but is usually for 3 to 6 months. Patients with multiple events or unexplained venous thromboembolism may need indefinite anticoagulation. |
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What is a Greenfield filter and when is it used?
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It is used for venal caval interruption and is indicated if there is a contraindication to anticoagulation (bleeding, surgery), and perhaps with massive venous thromboembolism and a poor cardiopulmonary reserve.
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