Pulmonary Circulation and other Pulmonary Pathologies

Question 1

Cardiogenic pulmonary edema

Answer 1

• CHF–> MCC
• Cardiomegaly on XR
• Responds to O2

Question 2

Noncardiogenic pulmonary edema

Answer 2

• Damage to the alveoli or capillary without elevation of the pulmonary capillary wedge pressure.
• Ex: ARDS and PE
• Does not respond to O2

Question 3

Neurogenic NCPE

Answer 3

Subarachnoid hemorrhage, head trauma

Question 4

Re-perfusion NCPE

Answer 4

Lung injury, occurs after surgery

Question 5

Re-expansion NCPE

Answer 5

S/p rapid expansion of collapsed lung in pneumothorax

Question 6

Opioid overdose NCPE

Answer 6

Heroin overdose, tx: Naloxone (Narcan)

Question 7

Salicylate NCPE

Answer 7

• Salicylate toxicity/poisoning, ASA OD

- Tx: Sodium bicarb

Question 8

Inhalants NCPE

Answer 8

• Cleaning products, chlorine gas, ammonia

Question 9

Virchows triad for PE

Answer 9

• Vascular intimal trauma: damage to inner lining of vessel
• Ex. HTN, smoking, ICDA, trauma, surgery
• Venous stasis: blood not in motion - stagnation thrombi
• Ex. Long flights, a.fib, pregnancy, obesity, varicose veins
• Hypercoagulable state: thick sludgy blood, sticks and forms clots
• Ex. BC pills, malignancy

Question 10

Manifestations for PE

Answer 10

dyspnea (MC sx), tachypnea (MC sign), tachycardia (MC ekg finding)

Question 11

MC diagnostic test for PE

Answer 11

CTA

Question 12

Gold standard diagnostic test for PE

Answer 12

Pulmonary angiography

Question 13

WHO classification for pulmonary HTN grade 1

Answer 13

• Pulmonary arterial hypertension (PAH)

- idiopathic, familial, HIV, women, poor prognosis

Question 14

WHO classification for pulmonary HTN grade 2

Answer 14

Left heart disease (MC)

Question 15

WHO classification for pulmonary HTN grade 3

Answer 15

Lung disease and or chronic hypoxemia

Question 16

WHO classification for pulmonary HTN grade 4

Answer 16

Chronic thromboembolic disease

ex. Recurrent PE

Question 17

WHO classification for pulmonary HTN grade 5

Answer 17

Miscellaneous

Question 18

Pathophysiology of pulmonary HTN

Answer 18

• Passive resistance in pulmonary venous system
• Hyperkinetic
• Obstruction
• Pulmonary vasoconstriction

Question 19

ARD pathology

Answer 19

• neutrophil activation in the systemic and pulmonary circulation.
• Occurs secondary to another inflammatory process.
• Massive intrapulmonary shunting of blood

Question 20

MCC of ARDS

Answer 20

Sepsis

Question 21

ABG testing in ARDS you’ll find

Answer 21

All ABGs are possible to see

Question 22

ARDS pa cath you’ll find

Answer 22

PCWP low <18

Question 23

ARD management you want to avoid

Answer 23

fluid overload and permanent damage ie honeycombing