Pulmonary Vascular Disease

Question 1

Pulmonary hypertension is a mean pulmonary arterial pressure of what?

Answer 1

mPAP >20-25mmHg

Question 2

WHO groups 2-3 that are the most common type of pulmonary hypertension

Answer 2

PH due to left HF; & PH due to lung disease

Question 3

Which WHO group is the most severe, & what is the mortality rate if left untreated?

Answer 3

Group 1, Pulmonary arterial hypertension; Prognosis of 3 years till death if left untreated

Question 4

Pulmonary hypertension and elevated pulmonary vascular resistance in the absence of heart or lung disease

Answer 4

Pulmonary arterial hypertension

Question 5

What comorbidity is seen in a patient with PAH?

Answer 5

Scleroderma (an autoimmune connective tissue disorder)

Question 6

Description of condition: remodeling that causes thickening of the vessel walls and increased vascular resistance and pressure in the LUNGS

Answer 6

Peripheral arterial hypertension

Question 7

What procedure should be preformed in a patient with suspected PAH?

Answer 7

Right heart catheterization

Question 8

Exertional Dyspnea, fatigue, syncope;
ECG shows Right ventricular hypertrophy, right atrial enlargement, right axis deviation

Answer 8

Clinical signs of Pulmonary Hypertensionm

Question 9

CXR showing: prominent pulmonary arteries and ventricular enlargement (name this disorder)

Answer 9

Pulmonary hypertension

Question 10

BNP level will be high or low in a patient with pulmonary hypertension?

Answer 10

High

Question 11

If a PT with PAH doesn’t have severe Right HF & responds to vasodilators, what drug class should you prescribe to them?

Answer 11

Calcium channel blocker; Specifically nifedipine

Question 12

A patient with pulmonary arterial hypertension in the highest risk group, class IV (Emergency) should be treated with what class of drug in what route?

Answer 12

continuous IV Prostacyclin Derivative

Question 13

A PT with less sever pulmonary arterial hypertension (class II or III; Acceptable or caution) should be TX with what two classes of drugs?

Answer 13

PDE5 inhibitor & Endothelia Receptor Agonist

Question 14

A patient presents with dyspnea and lightheadedness on exertion, low extremity and abdominal edema, fatigue, lethargy, syncope, chest pain. What is the likely diagnosis?

Answer 14

Cor Pulmonale

Question 15

Treat patient with oxygen therapy and diuretics to improve oxygenation and Right Ventricular FXN for this disorder

Answer 15

Treatment for Cor pulmonale

Question 16

Right ventricular enlargement secondary to a lung disorder that causes pulmonary arterial hypertension

Answer 16

Cor Pulmonale

Question 17

Physical exam of a patient shows ankle swelling, jugular venous distension, hepatomegaly, and a heart gallop

Answer 17

Signs and physical exam findings of Cor Pulmonale

Question 18

Cor Pulmonale is a condition that causes something to happen to the heart?

Answer 18

Right side of the heart to fail

Question 19

Right ventricular failure in the setting of lung disease

Answer 19

Cor Pulmonale