(28) Pulm HTN

Question 1

What do you see in Left sided Heart failure

Answer 1

High PCWP

Question 2

What do you see in PAH

Answer 2

Normal PCWP

Question 3

What happens in PAH

Answer 3

increased PVR may be due to remodeling of pulmonary arteries

Question 4

What mutation do you see in PAH

Answer 4

BMPR2

Question 5

What causes PAH

Answer 5

fenfluramine

methamphetamine

Question 6

What happens in vascular tone in PAH

Answer 6

dec NO/cGMP

dec PGI2

Inc endothelien

Inc serotonin

Inc Ca channels/ dec K

Question 7

Symptoms of PAH

Answer 7

Dyspnea

Fatigue and weakness

cold hands/feet

second heart sound is closely split

Question 8

What do you want image wise in PAH

Answer 8

ECHO- shows dilated RV

Right heart catheterization is gold standard for diagnosis

Question 9

What should you avoid in PAH

Answer 9

exercise
pregnancy
high altitudes

Question 10

What therapy would you give to PAH

Answer 10

Diltiazem/Amlodipine

NOT verapimil

Question 11

Best choice drug PAH

Answer 11

Bosetan (endothelin receptor blocker)

Question 12

Side effects of Bosentan

Answer 12

Teratogenic

Hepatotoxic

Question 13

Second line for PAH drugs

Answer 13

PDE5 inhibitors (Sildenafil)

sGC activators (Riociguat)

**DO NOT USE TOGETHER

Question 14

3rd option for PAH drugs

Answer 14

Prostacyclins
Epoprostenol
Treprostinil
Iloprost (inhaled)