IM Pulm

Question 1

Step down/step Up therapy for mild asthma

Answer 1

1. B-2 agonist prn
2. low dose CS
3. Inhaled CS (low dose) + LABA or Inhaled CS
4. Inhaled CS (med dose) + LABA and/or Theophylline, Leukotriene receptor antagonist

Refer to PULM at this point.

Question 2

Pulm HTN Cpx

Answer 2

fatigue, exertional dyspnea, and, occasionally, chest discomfort and syncope.

Question 3

Pulm HTN dx

Answer 3

echo determines elevated pulm artery pressure

confirmed by Right heart cath **GOLD STANDARD**

Question 4

mean pulm arterial pressure must be what in order to be considered pulm HTN?

Answer 4

>25mm/Hg @ rest

Question 5

MCC of pulm HTN

Answer 5

mitral stenosis

The mitral valve is so tight blood can’t pass into the left ventricle which backs pressure up into the lungs.

Question 6

Pulm HTN tx

Answer 6

tx underlying cause

Question 7

heart sounds of pulm HTN

Answer 7

splittin gof S2 with loud pulmonic component

Question 8

PE of pulm HTN

Answer 8

fingernail clubbing & cyanosis

right atrial enlargement

tricuspid regurgitation

increased jugular pulsation in neck

Question 9

signs of right heart failure

Answer 9

JVD

hepatomegaly

peripheral edema