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Surgery 2 - Third Year BHMS

Contents

Surgery 2 - Third Year BHMS

Contents

CoursesBHMSSurgery 2 - Third Year BHMSPULMONARY EMBOLISM

PULMONARY EMBOLISM

Content

PULMONARY EMBOLISM

  • Definition: A blockage of an artery in the lungs by a substance that has traveled from elsewhere in the body through the bloodstream.

Causes:

  • Deep vein thrombosis (DVT)
  • Pulmonary valve disease
  • Cardiac arrhythmias
  • Congenital anomalies of the heart or lungs
  • Cancer
  • Trauma
  • Surgery

Pathophysiology:

  • A blood clot forms in a vein, usually in the legs
  • The clot breaks loose and travels to the lungs
  • The clot blocks the flow of blood through the pulmonary artery
  • The lungs do not receive enough oxygen, leading to respiratory distress

Types:

  • Massive pulmonary embolism: blockage of a large artery in the lung
  • Submassive pulmonary embolism: blockage of a medium-sized artery in the lung
  • Small pulmonary embolism: blockage of a small artery in the lung
  • Multiple pulmonary embolism: blockage of multiple small arteries in the lung

Clinical Features:

  • Sudden onset of shortness of breath
  • Chest pain or discomfort
  • Coughing up blood or pink frothy mucus
  • Rapid or shallow breathing
  • Blue discoloration of the skin and mucous membranes (cyanosis)
  • Low blood pressure
  • Rapid heart rate
  • Weakness or fatigue
  • Confusion or loss of consciousness

Diagnostic Modalities:

  • Chest X-ray
  • Computed Tomography (CT) scan
  • Pulmonary Angiography
  • Echocardiography
  • Ventilation-Perfusion scan

Investigations:

  • D-dimer test
  • Prothrombin time (PT)
  • Activated partial thromboplastin time (aPTT)
  • Arterial Blood Gas (ABG)
  • Electrocardiogram (ECG)

Complications:

  • Respiratory failure
  • Cardiac arrest
  • Shock
  • Pulmonary hypertension
  • Recurrent pulmonary embolism

Management:

  • Anticoagulation therapy
  • Thrombolytic therapy
  • Surgical removal of the clot (thrombectomy)
  • Oxygen therapy
  • Mechanical ventilation
  • Cardiac monitoring

Treatment:

  • Heparin
  • Warfarin
  • Low molecular weight heparin
  • Thrombin inhibitors
  • Antiplatelet agents
  • Aspirin

Homoeopathic Therapeutic Medicines:

  • Arnica Montana: for pain and inflammation
  • Belladonna: for fever and respiratory symptoms
  • Bryonia: for cough and respiratory symptoms
  • Calcarea carbonica: for fatigue and weakness
  • Nux vomica: for nausea and vomiting
  • Phosphorus: for respiratory symptoms and fatigue
  • Sanguinaria: for respiratory symptoms and fatigue
  • Silica: for pain and inflammation