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Adaptation to Hypoxia > Chronic Hypoxic Lung diseases > Flashcards

Chronic Hypoxic Lung diseases Flashcards

1
Q

What happens to mean pulmonary artery pressure in high altitude hypoxia?

A

Increases due to increased pulmonary vascular resistance which is asymptomatic & well tolerated in most individuals

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2
Q

How is COPD charcterised?

A

Airway obstruction that is not completely reversible

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3
Q

What are 2 components of COPD?

A

Emphysema
Small airways disease

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4
Q

Define Emphysema.

A

Irreversible destruction of airways distal to terminal bronchioles

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5
Q

What are 2 major causes of COPD worldwide?

A

Cigarette smoking
Indoor exposure to biomass combustion

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6
Q

What is respiratory failure?

A

Failure to maintain normal PaO2 and PaCO2 under normal environmental conditions

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7
Q

What is type 1 respiratory failure?

A

Hypoxaemia with normal or reduced PaCO2

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8
Q

What is type 2 respiratory failure?

A

Hypoxaemia with hypercapnia

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9
Q

What are 3 causes of abnormal blood gases in lung disease?

A

Increased V-Q mismatch
Generalized alveolar hypoventilation
Diffusion block

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10
Q

How do lung diseases affect V-Q?

A

Alter regional compliance & resistance in a non-homogenous way
Cause intrapulmonary shunt

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11
Q

What does V-Q mismatch produce?

A

Large regions of alveolar hypoxia in COPd & most of the cardiac output passes through hypoxic alveoli

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12
Q

What does hypoventilation cause?

A

Widespread alveolar hypoxia throughout lungs in COPD

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13
Q

What 4 respiratory diseases does pulmonary hypertension occur in?

A

Idiopathic pulmonary fibrosis
Cystic fibrosis
Kyphoscoliosis
Obesity hypoventilation syndrome

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14
Q

What is the upper limit of normal PA pressure?

A

< 20mmHg

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15
Q

How is pulmonary vascular resistance calculated?

A

PVR = PAP - LAP(mmHg)/CO (l/min)

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16
Q

What are 2 structural changes that are directly caused by COPD?

A

Destruction & loss of vascular bed
Obstruction of vascular lumen caused by inflammation

17
Q

What are 2 possible mechanisms of pulmonary hypertension in COPD?

A

structural changes
hypoxic pulmonary hypertension

18
Q

What are 4 characteristics of PAH without alveolar hypoxia?

A

Progressive increase in mPAP
Progressive reduction in exercise tolerance with dyspnoea
right ventricular failure
50% mortality after 2 yrs

19
Q

What are the effects of arterial septostomy in PAH?

A

Reduction of flow through RV & lungs - reduced mPAP
Entry of desaturated blood into LA
mixing of venous & pulmonary venous blood in LA
Reduced SaO2
increased survival & exercise capacity

20
Q

What is brisket disease?

A

Susceptible cattle migrate to high altitude and develop pulmonary hypertension resulting in right heart failure, oedema (brisket) & death

21
Q

What are charcteristics of subacute mountain sickness?

A

Excessive Pulmonary hypertensiom
CO falls
Normal Hb abd SaO2

22
Q

What is the enlarged heart due to?

A

Right ventricular failure

23
Q

Is aortic pressure elevated in SMS?

A

No

24
Q

What is right ventricular failure due to?

A

Increased pulmonary hy[ertension

25
Q

When does chronic mountain sickness occur?

A

Long term residents at high altitude (middle age)

26
Q

What are 2 characteristics of chronic mountain sickness?

A

Progressive increase in PVR leading to RVF
Increase in Hct

27
Q

What happens in sensitive individuals at high altitude?

A

Hypoxia alone without lung disease can cause fatal pulmonary hypertension

28
Q

What lung disease could be at risk of PVF?

A

COPD

29
Q

What is the MoA of long-term oxygen therapy?

A

Supplemental oxygen for ~18hrs
Increases inhaled oxygen to get PaO2 above 90%

30
Q

When is long term oxygen therapy given?

A

Patients with COPD

31
Q

Which group was PVR substantially lower, NOT or COT?

A

COT - indicates that in COPD correcting oxygen brings down hypertension

32
Q

Is hypoxic pulmonary hypertension part of the story in pulmonary hypertension in COPD?

A

Yes

33
Q

Does long term oxygen therapy increase survival rate?

A

Yes

Adaptation to Hypoxia (11 decks)

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