LFT, Resp failure, Pul HTN Flashcards

1
Q

Eosinophilic Pneumonia

A

Diffuse pulmonary infiltrates on chest x-ray Bronchoalveolar lavage eosinophilia >25% Absence of parasitic, fungal, or other infection Absence of drugs known to cause pulmonary eosinophilia Quick clinical response to corticosteroids Failure to relapse after discontinuation of corticosteroids

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2
Q
A
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3
Q
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4
Q
A

Variable Intrathoracic

Causes - tumour, bronchial stenosis

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5
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6
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7
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8
Q
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9
Q

DLCO very low, normal/slightly decreased TLC

A
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10
Q

Indications for ECMO

Scoring

A

Resp - ARDS, Aspirtion, Pneumonia, Asthma, Post lung tx, Lung contusion

Cardia - Post AMI, Drug OD, PE, cardiogenic shock

RESP Score - prediction of survival on ECHMO. Factors - Age, Duration of lung injury

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11
Q

Mx of ARDS

A
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12
Q

NIV indications

A

Pul edema

COPD

Hypoxic resp failure

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13
Q

Resp Failures - Type 1–>4

A

Type 1 - hypoxia

Type 2 - hypoxia + hypercapnia

Type 3 - Perioperative Atelectasis

Type 4 - Shock

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14
Q

Elevated PAP - definition, factors

A

Pulmonary artery pressure >25 or >30 with exercise (but this is being debated to reduce it to 20)

Factors affecting - pulmonary artery pressure, pulmonary vascular resistance, left atrial pressure, cardiac output

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15
Q

Pul Htn Types 1–> 5

A
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16
Q

Sx of PAH

Ix for PAH

A
17
Q

Vasoreactivity Test

A

to check if its an issue with the endothelial wall itself

if vasoreactivity test positive, can use CCB, if not then need to use meds that act as vasodilators

Inhaled NO or IV Epoprostenol

18
Q

PAH - PDE5 inhibitors

MOA

Ex

C/I

A

Increases cGMP (which is broken down by PDE5)

Sildenafil, Tadelafil

Cant use with other cGMP stimulatns like Riociguat

19
Q

Prostacyclin agoniss

A

IV - Epoprostenol, iliprost

Oral - Selexipag

Only class with possible survival benefit

20
Q

Endothelin Receptor Antagonists

A

potent vasocontrictor

  • Non selective (A + B)
  • Bosenten, Macitentan

Selective

-ambrisentan

21
Q
A
22
Q

CTEPH

Dx - diagnostic feature

Mx

A

Dx - reduced DLCO out of proportion to spirometry

VQ scan - PROX pul HTN (unlike group 1 pul htn which is distal)

Mx - Warfarin, thromboendarterectomy, pul balloon angioplasty, meds if inoperable/persistent sx

23
Q

Normal A-a gradient

Formula

Causes of increased A-g gradient

A

5–10 mmHg

A-a gradient = (FiO2 - PCO2/0.8) - PaO2

24
Q

Causes raised DLCO

A

Alveolar haemorrage

Polycythaemia

Obesity

L –>R shunt

Exercise