Pulmonary Hypertension (SS)

Question 1

Agents used for pulmonary vasoreactivity

Answer 1

1) Oxygen
2) Nitric oxide
3) Adenosine
4) Epoprostenol

Question 2

Positive test
Negative test

Answer 2

If positive then treat with CCBs
If negative then treat with ERA, PDE-5 inhibitors, Prostacyclins

Question 3

X ray Features

Answer 3

Large central pulmonary artery
RV hypertrophy
Vascular pruning
Clear lungs

Question 4

ECG features

Answer 4

RVH
RAE
RAD

Question 5

Echo

Answer 5

Bubble study- screening
RV Dilatation

Question 6

PFT

Answer 6

Increased A-a
Near Normal FVC
Increased FEV1
Reduced DLCO

Question 7

Gold standard

Answer 7

Right heart catheterization

Question 8

WHO Classification of Pulmonary Hypertension

Answer 8

I- Pulmonary arterial hypertension (Idiopathic)
II- Left heart disease
III- Lung disease
IV- Thromboembolic
V- Others

Question 9

Clinical Picture

Answer 9

Exertional chest pain
Raised JVP
Edema
Ascites
Loud P2, S3, S4

Question 10

Pulmonary arterial hypertension indices

Answer 10

PAP >20
PCWP <15
PVR >3 wood units

Question 10

Definition

Answer 10

Mean Pulmonary artery pressure more than 20 mm Hg

Question 11

Murmurs

Answer 11

TR (pansystolic)
PS (ejection systolic)
PR (end diastolic) GRAHAM STEEL

Question 12

Gene Mutation

Answer 12

Bone Morphogenic Protein receptor 2

Question 13

High Risk Factors

Answer 13

Signs of HF
Rapid Progression
Syncope
Class IV
6MWT <169 min
Nt Pro BNP >1400
RA Dilated
RAP Increased