pulmonary htn Flashcards

1
Q

PH or PAH?
More common

A

PH

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2
Q

PH or PAH?
progressive disease involving endothelial dysfunction -> elevated pulmonary arterial pressure and pulmonary vascular resistance

A

PAH duh

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3
Q

normal pulmonary arterial wedge pressure

A

4-12 mmHg

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4
Q

T or F: PAH is more common in men than women

A

false, more common in women

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5
Q

PAH leads to (left/right) ventricular failure

A

right

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6
Q

4 things with endothelial dysfunction in the slides:

A

-decrease in nitric oxide synthase
- decrease in prostacyclin production
- increase in thromboxane production
- increase in endothelin 1 production

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7
Q

Which class is defined by the following:
- symptom-free when physically active or resting
a. Class I
b. Class II
c. Class III
d. Class IV

A

a. Class I

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8
Q

Which class is defined by the following:
- slight limitation of physical activity-ordinary activity may cause symptoms
- comfortable at rest
a. Class I
b. Class II
c. Class III
d. Class IV

A

b. Class II

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9
Q

Which class is defined by the following:
- marked limitation in physical activity-less than ordinary activity causes symptoms
- comfortable at rest
a. Class I
b. Class II
c. Class III
d. Class IV

A

c. Class III

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10
Q

Which class is defined by the following:
- significant symptoms with activity
- symptoms at rest
a. Class I
b. Class II
c. Class III
d. Class IV

A

Class IV

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11
Q

first line therapy for pulmonary htn

A

CCBs

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12
Q

2nd line therapy for pulmonary htn

A

direct pulmonary vasodilator (inhaled nitric oxide)

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13
Q

3rd line treatment for pulmonary htn

A

PDE-5 inhibitors

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14
Q

4th line treatment for pulmonary htn

A

Endothelin receptor antagonists (ERAs)

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15
Q

5th line treatment for pulmonary htn

A

Prostacyclin (oral, inhaled, parenteral)

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16
Q

6th and last line for pulmonary htn

A

soluble guanylate cyclase (sGC) stimulator (riociguat)

17
Q

consider CCBs in _______ responders ______ right-sided failure or other contraindications to CCBs; do not use without positive ____

A

positive, without, AVT

18
Q

What are the 3 recommended CCBs in pulmonary htn?

A

long-acting nifedipine 120-240 mg daily
long acting diltiazem 240-720 mg daily
amlodipine 20 mg daily

19
Q

which CCB should be avoided due to negative inotropic effects

A

verapamil

20
Q

T or F: Pressure is higher on left side of the heart

A

truee

21
Q

what artery are we focused on for PAH

A

pulmonary artery lol

22
Q

a mean pulmonary artery pressure (mPAP) greater than what is elevated

A

> 20 mmHg

23
Q

what WHO group is PAH

A

WHO Group 1

24
Q

what is the gold standard for diagnosis of pulmonary htn

A

right heart catheterization

25
Q
A