Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

cardiovascular > pulmonary heart disease - pulmonary hypertension, PE > Flashcards

pulmonary heart disease - pulmonary hypertension, PE Flashcards

(68 cards)

Start Studying
1
Q

what is mean pulmonary artery pressure

A

14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is pulmonary hypertension

A

mPAP >25 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when is pulmonary hypertension measured

A

on right heart catheterisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what changes are seen in pulmonary arteries of pulmonary hypertension

A
  • hypertrophy
  • proliferation
  • fibrotic changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what mutations cause pulmonary hypertension

A

boen morphogenetic protein receptor type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what drugs cause pulmonary hypertension

A
  • fenfluramine
  • dexfenfluramine
  • toxic rapeseed oil
  • anorectic agents aminorex and benfluorex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

symptoms of pulmonary hypertension

A
  • SOB
  • fatigue
  • weakness
  • angina
  • syncope
  • abdominal distension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

sings of pulmonary hypertension

A
  • left parasternal heave
  • loud P2 heart sound
  • soft pan systolic murmur
  • tricuspid regurgitation
  • early diastolic murmur
  • pulmonary regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does right heart failure lead to

A
  • jugular venous distension
  • ascites
  • peripheral oedema
  • hepatomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what investigation can be done for pulmonary hypertension

A
  • blood test
  • CXR
  • ECG
  • echo
  • liver ultrasound
  • right heart catheterisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is seen on blood test for pulmonary hypertension

A

check for underlying rheumatic disease, HIV, hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is seen on CXR for pulmonary hypertension

A
  • enlargement of pulmonary arteries
  • marked tapering of peripheral arteries
  • lung fields are Lucent
  • right atrial enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is seen on ECG of pulmonary hypertension

A
  • right ventricular hypertrophy

- right atrial enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is seen on echo of pulmonary hypertension

A
  • tricuspid regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is on ultrasound for pulmonary hypertension

A

exclude liver cirrhosis and portal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is done to confirm diagnosis

A

right heart catheterisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is done as treatment for pulmonary hypertension

A
  • anticoagulation
  • diuretics
  • digoxin
  • calcium channel blockers
  • prostanoids
  • PDE 5 inhibitor
  • ballon atrial septostomy
  • cardiac transplantation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is done for physical treatment of pulmonary hypertension

A

remain physically active but avoid exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what precaution during pregnancy for pulmonary hypertension

A

there is a high mortality rate

should be counselled on conception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what precautions during travel for pulmonary hypertension

A

supplementary oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what vaccination should be given for a patient with pulmonary hypertension

A

influenza and pneumococcal pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what precautions during surgery for patient with pulmonary hypertension

A

anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when are diuretics used in pulmonary hypertension

A

when patients haver right heart failure and fluid overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when is digoxin given in pulmonary hypertension

A

people with tachyarrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is prostanoids
potent vasodilator that inhibits platelet aggregation and cell proliferation
26
what can prostanoids increase in patients iwht pulmonary hypertension
exercise capacity
27
what is endothelin-1
potent vasoconstrictor
28
what do PDE-5 inhibitor produce
vasodilatation in pulmonary vasculature
29
is cardiac transplantation give a good prognosis for pulmonary hypertension
not really 5 year survival is only 50%
30
where does pulmonary embolism thrombus form and where do they dislodge
in systemic veins rarely in the right heart - dislodge and embolism into pulmonary arterial system
31
where do most clots come from that cause PE
pelvic and abdominal veins
32
why do clots form
as a result of combination of sluggish blood flow, local injury or compression of the vein and a hypercoaguable state think Virchow's triad
33
what can emboli occur from
- tumour - fat - amniotic fluid - foreign material during IV misuse
34
what happens to lung tissue after PE
lung tissue is ventilated but not perfused producing intrapulmonary dead space
35
what does the lung no longer produce if it is not perfused
surfactant
36
how can right ventricular ischaemia be detected
with elevations of troponin and creatine kinase
37
what does distal embolisation lead to
alveolar haemorrhage with haemoptysis, pleural inflammation and effusion
38
symptoms of PE
- sudden onset SOB (unexplained) - pleuritic chest pain - haemoptysis
39
what is usually the only symptoms present in PE
SOB
40
what is seen on examination of PE
- tachypnoeic - localised pleural rub - coarse crackles - fever
41
what can develop because of PE
exudative pleural effusion (blood stained)
42
what happens to patient if there is a massive PE
- sudden collapse - severe central chest pain - shocked - pale - sweaty - syncope - death
43
what JVP wave is seen in massive PE
prominent a-wave
44
what is cardiovascular signs of massive PE
- right ventricular heave - gallop rhythm - split second heart sound
45
what investigation are done for PE
- CXR - ECG - blood gases - cardiac troponin - D-dimer - V/Q scan - ultrasound - CTPA - MRI - echo
46
what is seen on CXR for PE
- often normal but - linear atelectasis - blunting of costophrenic angle - wedge shaped pulmonary infarct
47
what is seen on ECG of PE
- sinus tachycardia - right atrial dilatation - tall peak P waves in lead II - right ventricular strain with right axis deviation - T wave incursion in right precordial leads
48
when are cardiac troponin elevated in PE
when it is severe
49
when is plasma D-dimer elevated in PE
when patients have thromboembolism elevated doesn't always mean there is a PE as it can be elevated by cancer, pregnancy, elderly
50
what is a good diagnostic investigation for PE
V/Q mismatch
51
what can ultrasound detect in PE
clots in pelvic or iliofemoral veins
52
what is another good investigation that can exclude PE
CTPA
53
what should be done for a pregnant mother
CTPA exposes the mother to greater radiation risk than V/Q scan but delivers lower radiation to the foetus
54
what can be seen in echo for PE
good for evidence of right ventricular dysfunction
55
what is first line investigation if no shock for PE
D-dimer
56
if D-dimer is positive what is done next for PE
CT angiography
57
what is useful when CTPA cannot be done for PE
echo
58
what is done for a massive PE
thrombolysis
59
what are treatments for PE
- high flow oxygen - initial anticoagulation - IV fluids - thrombosis - surgical embolectomy
60
who should get oxygen in PE
everyone unless significant chronic lung disease
61
what anticoagulation should be given for PE
LMWH or fondaparinux | or IV heparin
62
what can improve perfusion quicker than anticoagulant
thrombolysis
63
is surgical embolectomy necessary
rarely
64
what is given to precent further emboli
anti coagulated with vitamin K antagonist = warfarin for 3-6 months or dabigatran, rivaroxaban are used in patients with venous thromboembolism (they are safer than warfarin)
65
what is given to pregnant ladies and those with cancer to precent emboli
long term LMQH
66
what is given to patients when anticoagulation is contraindicated
vena cava filter inserted via the femoral vein to above the level of the renal veins
67
what type of respiratory failure is a PE
type 1 respiratory failure
68
what are the ABG's for PE
respiratory acidosis

cardiovascular (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions