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CVPR Pulmonary (Exam 3) > Pulmonary Circulation > Flashcards

Flashcards in Pulmonary Circulation Deck (28)
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1

What are the test findings of precapillary pulmonary HTN disorders?

  • abnormally low DLCO with normal lung function otherwise
  • no PE or evidence of disease on CXR

2

What is the pulmonary capillary wedge pressure approximately equal to?

the left atrial pressure and the left ventricle end-diastolic pressure

2

Since pre-capillary causes of pulmonary hypertension do not increase pressure in the microcirculation (i.e. pulmonary capillary bed), ______ does not develop.

pulmonary edema

3

When standing upright at rest, most of the cardiac output goes to ______ due to _____.

the bases of the lung; gravity

4

In chronic pulmonary inflammatory states (like chronic bronchitis and bronchiectasis), the bronchial arteries _______.

enlarge and provide increased blood flow

5

What is a normal RA pressure?

2-5

5

Mean pulmonary arterial pressure can be elevated by what three mechanisms?

  1.  PLA (such as in heart failure or mitral stenosis)
  2. PVR
  3. cardiac output (not usually causative)

7

The lung has two arterial blood supplies: _____ and the ______.

the bronchial circulation; pulmonary circulation

7

What do the bronchial arteries supply?

  • the trachea
  • the airways down to the terminal bronchioles
  • parts of the esophagus
  • the vaso-vasorum of the aorta

7

What gene mutation is associated with idiopathic pulmonary arterial HTN (IPAH)?

bone morphogenic protein receptor type 2 (BMPR2)

8

The hydrostatic pressure gradient is opposed by _____.

the oncotic pressure gradient

9

What is a normal PAOP pressure?

10-12

11

This measurement is approximately equal to the left atrial pressure and the left ventricle end-diastolic pressure.

pulmonary capillary wedge pressure

12

How is idiopathic pulmonary arterial hypertension (IPAH) treated?

  • vasodilators such as calcium channel blockers
  • endothelin-1 blockers
  • phosphodiesterase-5 inhibitors
  • prostanoids

13

A difference of more than 5 mmHg between the PA diastolic pressure and the PCWP suggests ______.

pulmonary vascular disease

15

The source of most bleeding in the lung (hemoptysis) is ______.

the bronchial circulation

16

Use of ______ is contraindicated in post-capillary pulmonary hypertension.

pulmonary arterial vasodilators

18

The presence of a wedge pressure less than 15 mmHg with coexistent pulmonary edema is consistent with ______ pulmonary edema.

non-cardiogenic

19

What are the main subcategories of Group 1 PAH? (5)

  • idiopathic
  • heritable
  • drugs/toxins
  • connective tissue disease
  • portal hypertension

20

Use of pulmonary arterial vasodilators is contraindicated in ______.

post-capillary pulmonary hypertension

21

Since ______ causes of pulmonary hypertension do not increase pressure in the microcirculation (i.e. pulmonary capillary bed), pulmonary edema does not develop.

pre-capillary

22

What is the tx for hydrostatic pulmonary edema?

diuretics inotropic drugs (increase C.O.)

23

With exercise, cardiac output increases and the increased flow goes to the _____ in the lung.

upper lobe vessels

24

What is the tx for non-cardiogenic pulmonary edema?

  • mainly supportive care
  • supplemental O2

25

The bronchial circulation is important in ______ and also protects the lung against _____.

fetal lung development; the infarcting effects of pulmonary emboli

26

The hydrostatic pressure gradient (Pmv-Pi) drives fluid from the pulmonary microcirculation into the _____.

interstitium

27

What is a normal PA pressure?

30/10

28

What is a normal RV pressure?

30/2