Pulmonary HTN

Question 1

What is normal pulmonary BP?

Answer 1

8-15 mmHg at rest

Question 2

Pulmonary HTN is considered pressure above what?

Answer 2

Above 20mmHg at rest

Question 3

What is the usual cause of pulmonary HTN?

Answer 3

Increased pulmonary vascular resistance

Question 4

What is WHO functional class I defined as?

Answer 4

No physical limitations

Question 5

What is WHO functional class II defined as?

Answer 5

Slight limitation of physical activity but comfortable at rest

Question 6

What is WHO functional class III defined as?

Answer 6

Marked limitation of physical activity but comfortable at rest

Question 7

What is WHO functional class IV defined as?

Answer 7

Unable to carry out physical activity without sx; may have sx at rest

Question 8

In addition to a PAP above 20, what other two diagnostic criteria are required for arterial pulmonary HTN?

Answer 8

PCWP less than or equal to 15, PVR greater than or equal to 3

Question 9

Syncope may occur in which WHO functional class?

Answer 9

Class IV

Question 10

What can a bubble study show you?

Answer 10

Structural defects in the heart

Question 11

What study should you do to tell if a PE is causing pulmonary HTN?

Answer 11

A VQ scan

Question 12

Why should you get a sleep study for a pt with pulmonary HTN?

Answer 12

To rule out sleep apnea, which can cause pulm HTN

Question 13

What is the gold standard diagnostic test for pulmonary HTN?

Answer 13

Right heart cath

Question 14

When should you do a vasoreactivity test?

Answer 14

If you suspect pulmonary arterial HTN

Question 15

What does it mean if a pt responds to vasoreactivity test?

Answer 15

That they would respond to calcium channel blockers

Question 16

A right atrial pressure above what is a poor prognostic indicator?

Answer 16

Above 20

Question 17

You should give calcium channel blockers only if a pt is what?

Answer 17

Vasoreactive

Question 18

How is prostacyclin given?

Answer 18

As a round the clock infusion therapy

Question 19

What is WHO group IV due to?

Answer 19

Chronic PE

Question 20

Which WHO group should have surgery?

Answer 20

Group 4

Question 21

Should pts with pulmonary arterial HTN be on anticoagulants?

Answer 21

Yes

Question 22

Pts with PAH due to what should not be on anticoagulants?

Answer 22

Connective tissue disease

Question 23

Should systemic pressures ever exceed pulmonary pressures in pulmonary HTN?

Answer 23

No

Question 24

Why should you avoid intubation in pulmonary HTN?

Answer 24

Increases pressure which can worsen pulm HTN

Question 25

What is the only definitive treatment for pulmonary HTN?

Answer 25

Lung transplant