Lecture 6 Pulmonary Vascular Disease Flashcards Preview

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Flashcards in Lecture 6 Pulmonary Vascular Disease Deck (30):
1

A swan catheter measures what?

LA pressure aka pulmonary capillary wedge pressure

2

Pulmonary arterial hypertension:
elevation of pulm arterial pressure to more than ____ at rest and with a pulmonary capillary wedge pressure less than ____ mm hg

25, 15

3

what generally causes pulmonary arterial hypertension? Who is the classic patient? (according to pathoma)

generally idiopathic (IPAH);
young women

4

IPAH is heritable, due to a inactivating mutation in ____ gene, which normally inhibits ____ proliferation. Other gene mentioned in notes is ____

BMPR2;
vascular smooth muscle;
ALK1

5

what connective tissue disease is associated with PAH?

systemic sclerosis (Associated with poor prognosis)

6

_____ may be the most prevalent cause of PAH worldwide

shistosomiasis

7

clinical findings in PAH:
increased ___ (heart sound). ____ lift. ____ regurg. late ____.

P2 (closing of pulmonic);
parasternal; tricuspid, cyanosis

8

2 drugs associated with pulm HTN (mentioned in notes/FA)

cocaine, anorexigens (also meth)

9

Give one particularly common example of Pulm HTN due to left heart disease

mitral stenosis (or regurg);

ie LV dysfunction, Aortic stenosis

10

Pulm HTN due to hypoxemia:
disease such as ____ cause hypoxemic _____ of blood vessels, leading to general vaso____ of pulmonary vessels

COPD (or sleep apnea, high altitdue);
vasoconstriction, constriction

11

Recurrent pulmonary _____ can cause pulm HTN due to ____ and decreased cross sectional area of the vascular bed

emboli; reorganization (of emboli)

12

Pulm Aterial HTN pathological changes:
medial ____ due to increased ___ ____;
____ fibrosis;
_____ arteriopathy (High Yield as per pathoma)

hypertrophy, smooth muscle;
intimal;
plexiform

13

what does scleroderma look like on CT (mentioned a few times in class)

honeycomb

14

Path of HTN:
name 2 vasodilators that are decreased;
name a vasoconstrictor that is increased

prostacyclin, NO;

endothelin

15

What should be given first to a patient with PAH?

Oxygen

16

______ syndrome can cause pulmonary HTN secondary to congenital heart defect

Eisenmenger's

17

single classic symptom of Pulm HTN mentioned in pathoma

exertional dyspnea;

other symptoms = fatigue, syncope, cough

18

gold standard of diagnosing PAH:

right heart catheterization (Swan)

19

heart changes in pulm HTN:
initially _____, then death from decompensated ___ ___

RVH; cor pulmonale

20

With RVH, large ___ waves are seen in leads V1 and V2

R

21

2 biomarkers of PAH (Associated with survival)

BNP; hyponatremia

22

treatment of PAH:
endothelin receptor agonists such as ____.
PDE-5 inhibitors such as ____.
Prostacyclin analogs such as ____

bosentan;
sildenafil;
epoprostenol (or iloprost)

23

3 side effects of epoprostenol mentioned in FA:

flushing, jaw pain, hypotension

24

Virchow triad associated with developing DVT

SHE:

Stasis; hypercoaguability, endothelial damage

25

Pulmonary embolus presents as sudden-onset ____, chest pain, ______, and _____.

dyspnea; tachycarida, tachypnea (according to FA)

26

How would you treat a pulmonary embolus causing hemoptysis?

blood thinners (mentioned in lecture)

27

What happens to the V/Q ratio in PE?

obstruction-->moves ratio towards affinity (because very low Q)

28

prophylaxis/acute management of PE (according to FA)

LMWH or unfractionated heparin

29

long term prevention of PE (According to FA)

oral anticoagulants such as warfarin

30

CT pulmonary angiography of a patient with PE shows what?

filling defects (according to FA)