Lecture 6 Pulmonary Vascular Disease Flashcards
A swan catheter measures what?
LA pressure aka pulmonary capillary wedge pressure
Pulmonary arterial hypertension:
elevation of pulm arterial pressure to more than ____ at rest and with a pulmonary capillary wedge pressure less than ____ mm hg
25, 15
what generally causes pulmonary arterial hypertension? Who is the classic patient? (according to pathoma)
generally idiopathic (IPAH); young women
IPAH is heritable, due to a inactivating mutation in ____ gene, which normally inhibits ____ proliferation. Other gene mentioned in notes is ____
BMPR2;
vascular smooth muscle;
ALK1
what connective tissue disease is associated with PAH?
systemic sclerosis (Associated with poor prognosis)
_____ may be the most prevalent cause of PAH worldwide
shistosomiasis
clinical findings in PAH: increased \_\_\_ (heart sound). \_\_\_\_ lift. \_\_\_\_ regurg. late \_\_\_\_.
P2 (closing of pulmonic);
parasternal; tricuspid, cyanosis
2 drugs associated with pulm HTN (mentioned in notes/FA)
cocaine, anorexigens (also meth)
Give one particularly common example of Pulm HTN due to left heart disease
mitral stenosis (or regurg);
ie LV dysfunction, Aortic stenosis
Pulm HTN due to hypoxemia:
disease such as ____ cause hypoxemic _____ of blood vessels, leading to general vaso____ of pulmonary vessels
COPD (or sleep apnea, high altitdue);
vasoconstriction, constriction
Recurrent pulmonary _____ can cause pulm HTN due to ____ and decreased cross sectional area of the vascular bed
emboli; reorganization (of emboli)
Pulm Aterial HTN pathological changes:
medial ____ due to increased ___ ____;
____ fibrosis;
_____ arteriopathy (High Yield as per pathoma)
hypertrophy, smooth muscle;
intimal;
plexiform
what does scleroderma look like on CT (mentioned a few times in class)
honeycomb
Path of HTN:
name 2 vasodilators that are decreased;
name a vasoconstrictor that is increased
prostacyclin, NO;
endothelin
What should be given first to a patient with PAH?
Oxygen
