Chapter28-Pulmonary Vascular Disease Flashcards

1
Q

What is a pulmonary embolism

A

When a fragment of thrombus in the venous system travels to the lungs

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

What are risk factors for PE

A
Advanced age
Post op 
Trauma
Prolonged bed rest 
Long period of travel
Dvt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pe pathophysiology

A

Sudden obstruction of pulmonary artery causes a decrease in blood flow to the lung
This increases dead space
Causes bronchoconstriction
And decreases production of surfactant

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

What does the body to to compensate for pe

A

Increases rr which worsens dyspnea

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

Hypocapnia causes bronchial vaso?

A

Vasoconstriction

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

A-a gradient will _____ with pe

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When does pulmonary hypertension occur with pe ?

A

When 50% or more of the pulmonary vascular bed is occluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When mean pulmonary artery pressure exceeds __ hemodynamic compromise and death occur

A

40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If hypotension is present with an increased cvp what should be suspected?

A

Pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Symptoms with pe

A
Dyspnea
Pleuritic chest pain
Cough
Hemoptysis
Tachypnea
Tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do ABGs with pe typically present with

A

Hypoxemia and hypocapnia

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

What can be used to exclude pe diagnosis

A

D-dimer test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What non invasive tests can be used to diagnose pe

A

V/q scan

Ct

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

Treatment for patients at moderate risk of dvt

A

Prophylaxis with heparin, enoxaparin or dalteparin

Mechanical prophylaxis

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

Prevention of dvt in patients at high risk for developing

A
Apixaban
Rivaroxaban
Heparin
Warfarin
Mechanical prophylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What patients are Moderate risk for dvt

A

Abdominal or pelvic surgery
Bed rest
High Bleeding risk

17
Q

What patients are at high risk for dvt

A

Hip or knee surgery
Major trauma
Hip fracture
Spinal cord injury

18
Q

Mechanical measures to prevent dvt include

A

Early ambulation
Compression socks
Electrical stimulation of calf muscles

19
Q

What is pulmonary hypertension

A

Mpap greater than 25 at rest

20
Q

What is the target Inr with anti coagulation for pulmonary hypertension

A

2-3

21
Q

Why is it important to maintain SpO2 above 90 in ph

A

Because hypoxemia causes pulmonary vasoconstriction

22
Q

What are current treatment options for ph

A

Ccb
Prostanoids
Endothelin receptor antagonists
Pde-5 inhibitors

23
Q

When are diuretics indicated

A

For right ventricular volume overload

24
Q

When may digoxin be used

A

For patients with refractory right ventricle failure or for a fib or flutter

25
Q

When may calcium channel blockers be used for ph

A

When patients have significant response to nitric oxide

26
Q

What class of meds are sildinafil and tadalafil

A

Pde5 inhibitors