Pulm

Question 1

Acute vasoreactivity testing

Answer 1

For group 1 htn (mPAP>25+ elevated PVR (>3 woods units)+ normal PW)

Positive if mPAP decreases by 10 to <40

Question 2

poor prognosis in acute PE

Answer 2

Right ventricular (RV) dysfunction and/or failure

tricuspid regurgitation 
RV enlargement or dysfunction 
RV diameter/left ventricular diameter >0.9 
New RBBB
S1Q3T3

Question 3

CTEPH diagnosis

Screen for

Treatment

Answer 3

V/Q scan-> confirm with PA gram

Thrombophilia with antiphospholipid antibodies

pulmonary endarterectomy. If inoperable, Riociguat

Question 4

Strongest indication for lytic in PE

Answer 4

associated hypotension or shock

Question 5

Surgery timeline for increased risk of PE

Answer 5

Within the past month

Question 6

Secondary echo criteria to diagnose pulm htn

Answer 6

early diastolic pulmonary regurgitation velocity of >2.2 m/sec, an IVC diameter >2.1 cm with >50% inspiratory collapse, or a pulmonary artery diameter >25 mm
Flattening of the septum

Question 7

Absolute contraindication to lysis

Surgical embolectomy

Answer 7

Recent intracerebral hemorrhage (catheter directed and AC are also CI)

If lysis CI+ massive PE