Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CPR Exam 2 > Clinical Med Part 3 (Pence) > Flashcards

Clinical Med Part 3 (Pence) Flashcards

1
Q

What is pulmonary hypertension?

A
  • Mean pulmonary artery pressure >20 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the importance of pulmonary hypertension?

A
  • Associated with increased mortality if left untreated

- Onset is insidious and can be overlooked due to vague symptoms or co-morbid conditions

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

What are some symptoms of pulmonary hypertension?

A
  • Dyspnea on exertion
  • Fatigue
  • Chest pain
  • Presyncope
  • Signs of right sided heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is pulmonary hypertension diagnosed?

A
  • ECG (showing right ventricular hypertrophy)
  • Labs (increased BNP)
  • TTE
  • Cardiac catheterization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the Swanz-Ganz catheter?

A
  • A catheter that is threaded through the venous system and and eventually into the pulmonary artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the treatment for pulmonary hypertension?

A
  • Treat underlying cause

- Symptoms based treatment (graded exercise, supplemental oxygen, diuretics)

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

What are some medications that are used to treat pulmonary hypertension?

A
  • Prostacyclin agonist (promote vasodilation)
  • Phosphodiesterase inhibitor (reduce breakdown of NO)
  • Endothelium antagonist (inhibit endothelium-1)
  • CCBs (inhibits calcium channels in vascular smooth muscle)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a pulmonary embolism?

A
  • Venous thromboembolism located in pulmonary vasculature

- Usually arises from a DVT

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

What is the importance of a pulmonary embolism?

A
  • Common diagnosis
  • Wide range of risk factors
  • Affects large portion of the population, increased incidence with age
  • High mortality if left untreated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Virchow’s triad?

A
  • Hypercoagulability
  • Venous stasis
  • Endothelial injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do protein C and S do?

A
  • Block sites at VIII and V to inhibit clotting cascade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does antithrombin III do?

A
  • Block sites at II and X
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens in a protein C and S deficiency?

A
  • Ineffective regulation of factor VIIIa and Va
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens in an antithrombin III deficiency?

A
  • Ineffective regulation of Xa and IIa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens in a Factor V leiden mutation?

A
  • Mutation of factor V prevents binding of protein C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some symptoms of a pulmonary embolism?

A
  • Chest pain
  • Palpitations
  • Dyspnea
  • Syncope
  • +/- LE edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is a pulmonary embolism diagnosed?

A
  • Requires an index of suspicion
  • Wells criteria
  • Elevated D-dimer (good for ruling out PE if D-dimer is normal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does an EKG look like in a PE?

A
  • Sinus Tach
  • RV strain
  • Incomplete or complete RBBB
  • S1Q3T3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does the imaging look like in a PE?

A
  • CT chest with contrast: primary test for diagnosis of PE

- V/Q scan: second line nuclear study (use technegas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the treatment for unstable PE?

A
  • Resuscitation
  • Thrombolytic therapy
  • Attempt catheter directed thrombolysis
  • Proceed to surgery for thromboectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment for stable PE?

A
  • Heparin (binds antithrombin and inhibits factors IIa and Xa)
  • Low molecular weight heparin
  • Vitamin K antagonist
  • Direct oral anticoagulants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the reversal agent for LMWH?

A
  • Protamine sulfate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the reversal agent for warfarin?

A
  • Vitamin K, PCC, FFP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the reversal agent for DOACs?

A
  • Xa inhibitors inhibitors: andexanet alfa

- Dabigatran: idarucizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the duration of treatment for PE?
- Minimum of 3 months for all patients | - Extended treatment for those who have traveled, had surgery, or on hormone therapy
26
When would you give indefinite anticoagulation?
- Those with underlying disease with high risk like malignancy and genetic mutations
27
What is obstructive sleep apnea?
- Disruption in breathing pattern while sleeping that results in excessive daytime somnolence despite adequate sleep periods and not explained by other causes
28
What is apnea?
- Reduction in breathing for at least 10 seconds with a noted drop in SpO2 by >3%
29
What are the two issues that are related to breathing disorders?
- Obstruction (soft tissue or anatomical abnormalities) | - Ventilatory drive (body sensitivity to CO2)
30
Why is obstructive sleep apnea important?
- OSA is associated with: - HTN - A fib/flutter - CAD - Insulin resistance (T2DM) - Occupational hazard
31
What are some OSA risk factors?
- Obesity - Large tongue - Craniofacial abnormalities - Enlarged tonsils - Enlarged lymph nodes - Male sex
32
How could micrognathia affect OSA?
- Reduces that amount of airway that is available
33
What are some symptoms of OSA?
- Excessive daytime somnolence - Partner witness apnea episodes or voices concern of gasping episodes - STOPBANG questionairre
34
How is OSA diagnosed?
- Polysomnogram (gold standard) | - Occurs in a sleep lab or at home
35
What are some treatment options for OSA?
- CPAP | - Oral appliances (work by thrusting the mandible forward and result in opening airway)
36
What is interstitial lung disease?
- Heterogeneous group of pulmonary disorders with a variety of different causes that present with the same characteristics.
37
What are some characteristics in interstitial lung disease?
- Restrictive pattern on PFT - Decreased DLCO - Dyspnea on exertion - Absence of primary infection or malignancy
38
What are the symptoms of interstitial pulmonary fibrosis?
- Progressive dyspnea - Dry cough - Fatigue - Inability to perform activities of daily living
39
What is a key characteristic of interstitial pulmonary fibrosis?
- Prominent inspiratory crackles sounding like velcro
40
What does CT show of interstitial pulmonary fibrosis?
- Significant fibrosis bilaterally "honeycombing" with traction bronchiectasis
41
What do PFTs show of interstitial pulmonary fibrosis?
- Progressive restrictive pattern | - Decreased DLCO
42
What is the treatment for idiopathic pulmonary fibrosis?
- Supportive care (O2, physical rehab) - Steroids - Immunomodulators - Anti-fibrotic therapy
43
What is sarcoidosis?
- Disease of multisystem involvement of unknown cause, characterized by the presence of non-caseating granulomas
44
Who is more likely to have sarcoidosis?
- African americans have a 3:1 chance compared to caucasians - Females are more likely than male - Older people
45
What is the clinical presentation of someone with sarcoidosis?
- Asymptomatic - Cough, dyspnea - Cutaneous involvement - Ocular symptoms - Lofgren's syndrome - Heerfordt's syndrome
46
What does radiology find in sarcoidosis?
- Most common finding is hilar lymphadenopathy | - Can range from minimal disease finding to diffuse fibrosis
47
What do the PFTs look like in sarcoidosis?
- Normal, restrictive, or obstructive pattern | - +/- reduced DLCO
48
What is the treatment of sarcoidosis?
- Supportive care (O2, rehab, nutritional counseling, social services) - Immunosuppression (steroid, methotrexate)
49
What is the cause of granulomatosis with polyangiitis?
- Systemic small vessel vasculitis most often affecting the sinuses, kidneys, and lungs
50
What is the clinical presentation for granulomatosis with polyangiitis?
- Dyspnea - Cough - Hemoptysis - Fevers - Saddle nose - Chronic sinusitis/rhinitis - Recurrent otitis media
51
What do the labs and imaging show in granulomatosis with polyangiitis?
- +C-ANCA | - Lung nodules, patchy ground glass opacities, hilar LAD
52
What is the treatment for granulomatosis with polyangiits?
- Steroids + cyclophosphamide
53
What is goodpasture's syndrome?
- Autoimmune condition with antibodies against basement membrane of alveolar and glomerular parenchyma
54
What is the clinical presentation of goodpasture's syndrome?
- Weight loss - Fevers - Proteinuria - Hematuria - Dyspnea - Cough - Hemoptysis - Hypoxemia
55
What do the labs and radiology show in goodpasture's syndrome?
- +anti-GBM | - Bilateral ground glass opacities indicative of diffuse alveolar hemorrhage
56
What is the treatment of goodpasture's syndrome?
- Plasmapheresis + steroids + cyclophosphamide
57
What are some ILD associated connective tissue diseases?
- Systemic sclerosis - Rheumatoid arthritis - Dermatomyositis/polymyositis
58
What is hypersensitivity pneumonitis?
- Extrinsic allergic alveolitis
59
What causes hypersensitivity pneumonitis?
- Caused by repeated exposure to specific antigen of environmental or occupation nature in a sensitized individual
60
What are some common names of hypersensitivity pneumonitis?
- Farmer's lung - Bird fancier's lung - Woodworker's lung - Baker's lung
61
What is the clinical presentation for hypersensitivity pneumonitis?
- Cough - Dyspnea - +/- fevers
62
What do PFTs show in hypersensitivity pneumonitis?
- Restrictive pattern | - +/- reduced DLCO
63
What is the treatment for hypersensitivity pneumonitis?
- Remove patient from antigen
64
What is pneumoconiosis?
- ILD caused by the inhalation of inorganic dust that results in tissue inflammatory response causing fibrosis
65
What do PFTs show in pneumoconiosis?
- Restrictive pattern | - +/- reduction in DLCO
66
What is the treatment of pneumoconiosis?
- Removal from occupational exposure - Smoking cessation - Immunizations - Oxygen therapy
67
What causes silicosis?
- Inhalation of silica "crystalline quartz"
68
What occupations typically have silicosis?
- Miners - Stonecutters - Sand blasting - Quarry workers
69
What is asbestosis?
- Fibrosis due to inhalation of asbestos
70
What occupations typically have asbestosis?
- Construction - Insulation - Demolition - Automobile workers
71
What does radiology show in asbestosis?
- Multiple nodular opacities - Pleural effusions - Pleural fibrosis - May see blurring of diaphragm/cardiac sihouette
72
What may be at in increased risk in asbestosis?
- Malignant mesothelioma | - Lung cancer
73
What is coal workers pneumoconiosis?
- FIbrosis caused by inhalation of coal dust
74
What is simple CWP?
- Asymptomatic | - Radiology has small nodules at apex
75
What is complicated CWP?
- Symptomatic (cough, dyspnea, sputum production) - PFTs: restrictive pattern - Radiology shows large nodules and patchy infiltrates
76
What is berylliosis?
- Fibrosis due to beryllium exposure | - Have increased chance of lung cancer
77
Who is most like to have berylliosis?
- Manufacturing of alloys and electronic devices
78
What does the acute version of berylliosis look like?
- Similar reaction to hypersensitivity pneumonconiosis
79
What does chronic berylliosis look like?
- Insidious onset | - Thought to be from cumulative exposure of beryllium
80
What do PFTs and radiology show in berylliosis?
- Hilar LAD, diffuse infiltrates | - Restrictive pattern
81
What is the treatment of berylliosis?
- Steroids | - Removal from beryllium environment

CPR Exam 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions