Pulmonary Vascular Disease

Question 1

Pulmonary embolism definition

Answer 1

blockage of an artery in the lungs

Question 2

Clinical pulmonary embolism

Answer 2

thrombus forms in the venous system - usually in deep veins of the legs and embolisms to the pulmonary arteries

Question 3

a massive PE can be fatal - although a minor PE can be traced with

Answer 3

anticoagulation

and has a very good prognosis

Question 4

Major risk factors for venous thromboembolism

Answer 4

Recent major trauma

Recent surgery

cancer

pregnancy

MI (other significant cardiopulmonary disease)

Question 5

venous thromboembolism

Answer 5

when a part of a blood clot breaks off and travels in the bloodstream

Question 6

DVT

Answer 6

deep vein thrombosis

Question 7

Pulmonary embolism symptoms

Answer 7

Pleuritic chest pain

cough

haemoptysis

isolated acute dyspnoea

syncope or cardiac arrest

Question 8

syncope

Answer 8

temporary loss of consciousness

Question 9

Pulmonary embolism signs

Answer 9

pyrexia

pleural rub

stony dullness to percussion at base (pleural effusion)

Question 10

Signs of pulmonary embolism (patient)

Answer 10

tachycardia

tachypnoea

hypoxia

hypotension

Question 11

Pre-test probability for pulmonary embolism

Answer 11

wells score

revised geneva score

Question 12

Pulmonary embolism investigations

Answer 12

FBC
CXR
ECG
D-dimer
CT pulmonary angiogram 
V/Q scan 
Echocardiography

Question 13

D-dimer

Answer 13

a product of fibrin degradation (a small protein present in the blood after a blood clot is formed by fibrinolysis)

Question 14

CT pulmonary angiography

Answer 14

images the pulmonary arteries

Question 15

echocardiogram

Answer 15

echo/ sonogram of the heart (creates images of the heart)

Question 16

PE prognosis

Answer 16

Mortality at 30 days (varies from 0 - 25%)

Question 17

Pe treatment

Answer 17

oxygen

low molecular weight
heparin

Direct oral anticoagulants (DOAC)

Thrombolysis

Pulmonary embolectomy

Question 18

example of low molecular weight heparin

Answer 18

dalteparin

warfarin

Question 19

Thrombolysis

Answer 19

dissolution of a blood clot by artificial infusion of an enzyme into the blood

Question 20

Pulmonary embolectomy

Answer 20

emergency procedure - removes clotted blood from pulmonary arteries

Question 21

Pulmonary Hypertension

Answer 21

elevated blood pressure in the pulmonary arterial or tree

(either primary or secondary to other conditions)

fairly rare condition (1-2 million population)

Question 22

Aetiology of pulmonary hypertension

Answer 22

idiopathic

secondary to chronic respiratory disease

secondary to left heart disease

Question 23

Pulmonary hypertension symptoms

Answer 23

exertional dyspnoea

chest tightness

exertional presyncope or syncope

Question 24

Signs of pulmonary hypertension

Answer 24

elevated JVP

right ventricular heave

loud pulmonary heart sound

ankle oedema

Question 25

Pulmonary hypertension investigations

Answer 25

ECG lung function tests CXR echocardiogram V/Q scan

Question 26

Pulmonary hypertension GENERAL treatment

Answer 26

Treat the underlying condition that has lead to PH oxygen anticoagulation diuretics

Question 27

Pulmonary hypertension SPECIFIC treatment

Answer 27

calcium channel antagonist prostacyclin endothelin receptor antagonists

Question 28

Pulmonary hypertension EXTREME treatments

Answer 28

thromendarerectomy lung or heart lung transplant