Pulm - pHTN, OSA & ARDS

Question 0

Physical exam findings in pHTN?

CXR?

EKG?

Answer 0

Wide splitting of S2

Dilation of proximal pulmonary arteries with narrowing of distal vessels

Right axis deviation, right atrial and ventricular hypertrophy

Question 1

pHTN?

Answer 1

Wedge pressure > 25

Question 2

Treatment for pHTN?

Answer 2

#Prostacyclin analogues/pulmonary artery vasodilators – epoprostenol , iloprost, beraprost
#endothelin antagonists – Bosentan
#Phosphodiesterase inhibitors – sildenafil

Question 3

Sleep apnea versus obesity hypoventilation syndrome?

Answer 3

Normal bicarb versus increased bicarb

Question 4

Treatment of OSA?

Answer 4

#Weight-loss 
#avoid alcohol
#CPAP
#surgery

Question 5

ARDS?

Answer 5

pO2/FIO2 < 300

Question 6

Management of ARDS?

Answer 6

#Low tidal volume (6 mL per kilogram)
#Increase PEEP
#Decrease FIO2
#Plateau pressure < 30 cm