pulmonary embolism

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  • 1. Common diseasewww.medicinemcq.com1

2. Myocardialinfarction Stroke PEwww.medicinemcq.com2 3. 1. 2.3.Where do 95% of pulmonary thromboemboli originate? What are the risk factors for pulmonary thromboemboli? What hemodynamic changes are brought about by significant pulmonary thromboemboli?www.medicinemcq.com3 4. 4.5. 6.What changes in ventilation/perfusion relationships are brought about by significant pulmonary thromboemboli? What are the causes of hypoxemia in pulmonary thromboembolism. What are the clinical manifestations of pulmonary thromboembolism?www.medicinemcq.com4 5. Includes Pulmonary embolism (PE) Deep venous thrombosis (DVT)www.medicinemcq.com5 6. www.medicinemcq.com6 7. Predisposeto VTE Vascular endothelial injury Hypercoagulability Venous stasiswww.medicinemcq.com7 8. Acquired Account for the majority of VTE cases Inheritedwww.medicinemcq.com8 9. >60 years Most significant acquired risk factor for VTEwww.medicinemcq.com9 10. Mostsignificant risk factor for recurrentVTEwww.medicinemcq.com10 11. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.Obesity Malignancy Surgery Trauma Pregnancy Oral contraceptives Postmenopausal hormone replacement Long-haul air travel Heparin-induced thrombocytopenia Antiphospholipid antibody syndrome Cigarette smoking www.medicinemcq.com11 12. FactorV Leiden mutation Activated protein C resistance Prothrombin gene mutation Elevated factor VIII levelswww.medicinemcq.com12 13. Physiological1. 2. 3.anticoagulants Antithrombin Protein C Protein Swww.medicinemcq.com13 14. Synthesizedby the liver Converted to an active protease by thrombin Protein C becomes an anticoagulant when it isactivated by thrombin.www.medicinemcq.com14 15. Proteinproduced by endothelial cells Enhances thrombin activation of protein Cwww.medicinemcq.com15 16. www.medicinemcq.com16 17. Inactivatesfactors V and VIII Stimulates the release of tPA from endothelial cellswww.medicinemcq.com17 18. Enhancesanticoagulatory function ofprotein Cwww.medicinemcq.com18 19. ProteinsC and S Reduced blood levels Dysfunctional www.medicinemcq.com19 20. Makesfactor V resistant to protein C inhibition Hypercoagulable state Many patients with venous thromboembolism have this defect For rest of the slides visit Respiratory systemwww.medicinemcq.com >www.medicinemcq.com20