Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory Anatomy & Disease Mechanisms > Clinical Aspects of Pulmonary Hypertension (DISEASE MECHANISMS) > Flashcards

Clinical Aspects of Pulmonary Hypertension (DISEASE MECHANISMS) Flashcards

1
Q

What is included in thromboembolic disease?

A

DVT

PE

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

What is a PE?

A

Blockage of a pulmonary artery by a blood clot, fat tumour or air

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

If blood flow ad oxygen to a lung tissue is compromise the lung tissue may die. What is this process called?

A

Pulmonary infarction

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

Which DVTs are most likely to embolism and lead to chronic venous insufficiency and venous leg ulcers?

A

Proximal (ileo-femoral DVT)

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

Which DVTs are least likely to embolism?

A

Distal (Popliteal DVT)

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

What is the clinical presentation of DVT?

A

Swollen, hot, red, tender

Whole leg or calf

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

Which investigations can be used to diagnose DVT?

A

US-Doppler scan to exclude Baker’s cyst and pelvic mass

CT scan of oleo-femoral vein, IVC, and pelvis

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

What should be in the differential for DVT?

A

Popliteal synovial (Baker’s) cyst
Superficial thrombophlebitis
Calf cellulitis

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

What is the clinical presentation of a large PE?

A

Cardiovascular shock
Low BP
Central cyanosis
Sudden death

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

What is the clinical presentation of a medium PE?

A

Pleuritic pain
Haemoptysis
Breathless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the clinical presentation of small recurrent PEs?

A

Progressive dyspnoea
Pulmonary hypertension
Right heart failure

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

What can happen the to RV if under long term strain?

A

Can dilate causing ventricular dysfunction leading to hypertension

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

What are the risk factors for DVT and PE?

A 
Thrombophilia
Contraceptive pill
Hormone replacement therapy (HRT)
Pregnancy
Pelvic obstruction
Trauma 
Surgery (esp. hip, pelvis, knee)
Immobility
Malignancy
Pulmonary hypertension/vasculitis
Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would be expected in the history of presenting complaint for a patient with a PE?

A 
Shortness of breath (often acute onset)
Pleuritic chest pain
Haemoptysis
Leg pain / swelling
Collapse / sudden death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the clinical features of PE?

A 
Tachycardia
Tachypnoea
Cyanosis
Low BP
Crackles 
Pleural rub
Pleural effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why would ABGs show low PaO2, low SaO2 and normal or low PaCO2 for a PE?

A

Because PE is a perfusion not ventilation issue

17
Q

What would be seen an a CXR for a patient with a PE`

A

Normal early on before infarction
Basal atelectasis, consolidation
Pleural effusion

18
Q

What are the different methods to diagnose and investigate a PE?

A 
ECG
D-dimer
V/Q scan
CT pulmonary angiogram (CTPA)
Leg and pelvic US 
Echocardiogram
19
Q

What D-dimer reading would you expect for a PE?

A

Raised D-dimer

20
Q

What would you expect on the ECG for a PE patient?

A

Acute right heart strain pattern

S1Q3T3; T inversion in V1-3)

21
Q

Why is a V/Q scan useful in PE Ix?

A

Sensitive for small peripheral emboli
Perfusion defect before infarction
V/Q match defect after infarction

22
Q

What is a CTPA used for?

A

Image pulmonary arter filling defect and pick up larger clots in larger vessels

23
Q

What does a leg and pelvic US deter?

A

Silent DVT

24
Q

What can an echocardiogram measure and detect for PEs?

A

Pulmonary arter pressure and RV size

Acute dilation of RV in keeping with acute PE

25
Q

If there is no obvious cause of PE which factors should be investigated?

A

Cancer
SLE
Thrombophilia

26
Q

How can cancer causing PEs be detected?

A 
Clinical exam
CXR
PSA (Prostate specific antigen)
CA125 (cancer antigen - protein)
CEA  (carcinoembryonic antigen)
Pelvic USS
CT abdo/pelvis
27
Q

How SLE as the underlying cause of PEs be detected?

A

Antinuclear antibodies

Anti-Cardiolipin antibodies

28
Q

What is tested for in a thrombophilia screen?

A

Anti-thrombin-III deficiency
Protein C or S deficiency
Factor V Leiden
Increased VIII

29
Q

How can DVT be prevented?

A

Early post-op mobilisation
TED compression stockings
Calf muscle exercises
Subcutaneous low dose low mol wt heparin preoperatively (Dalteparin - Fragmin)
Novel Oral anticoagulant (NOAC) medication
- Dabigatran - direct thrombin inhibitor
- Rivaroxaban / apixaban - direct inhibitor of activation factor Xa

Respiratory Anatomy & Disease Mechanisms (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions