Pulmonary Hypertension Flashcards
Chronic pulmonary HTN
histological findings
plexiform lesions
Presenting Sx of pulmonary HTN
exertional dyspnea
young adult female
1˚ pulmonary HTN
etiology
BMPR2 mutation
Causes of 2˚ pulmonary HTN
lung hypoxemia: clamping down
increased volume: congenital heart disease
recurrent PE: fibrosis of areas, blood shunted away from there
Recurrent PE
may cause
pulmonary HTN
dead areas of lung aren’t perfused so blood backs up away from there
*important because most PE are asymptomatic
*many can cause pulmonary HTN
ARDS
acute respiratory distress syndrome
pathology
diffuse damage to alveolar:capillary interface
formation of hyaline membranes
Hyaline membranes in ARDS
complications
diffusion barrier
alveolar collapse
CXR of ARDS
“white out” of entire lung fields
Damage in ARDS is mediated by…
neutrophils:
protease activation and free-radicals
Tx of ARDS
positive end-expiratory pressure ventilation
keeps alveoli from collapsing
Neonatal respiratory distress syndrome
pathology
decreased surfactant production from type II pneumocytes
Largest componenet of surfactant
phosphotidylcholine (lecithin)
Testing for maturity of lungs prenatally
lecithin (phosphotidylcholine):sphingmyelin ratio
2 indicates mature lungs
3 major risk factors for neonatal respiratory distress syndrome
- premature
- C-section: baby doesn’t make steroids via stress of going through birth canal
- maternal diabetes: sugar gets into baby, baby makes insulin to lower its sugar
insulin inhibits steroid production
decreased maturation of type II pneumocytes
CXR of neonatal respiratory distress syndrome
“ground glass”
