pulmonary vascular

Question 1

mean PA pressure for dx with PH

Answer 1

equal or more than 25

Question 2

PCWP in PAH

Answer 2

less than 15

Question 3

PCWP in PVH

Answer 3

more than 15

Question 4

will pulmonary pressure rise with a reduction in vessel radius?

Answer 4

yep

Question 5

PH types

Answer 5

1. PAH
2. PH with lung disease or chronic hypoxia
3. PH with left heart disease PCW more than PCW
4. chronic thromboembolic PH
5. Miscellaneous; sarcoid

Question 6

PAH is associated with what heritable markers

Answer 6

BMPR2, ALK1 and endoglin

Question 7

what are the precapillary levels for PVR and PCWP in PAH

Answer 7

PVR is increases drastically

PCWP is less than 15

Question 8

PVH is associated with (3)

Answer 8

1. LV systolic dysfunction
2. LV diastolic dysfunction
3. valcular

Question 9

PVH post capillary values for PVR and PCWP

Answer 9

PVR is normal

PCWP is more than 15

Question 10

hypoxic/pulmonary parenchymal HP is associated with

Answer 10

• COPD
• restrictive
• hypoventilatory
• sleep apnea
• high altitude

Question 11

hypoxic/pulmonary parenchymal HP precapillary values for PVR and PCWP

Answer 11

PVR is mildly increased

PCWP is less than 15

Question 12

pulmonary embolic HP caused by

Answer 12

chronic thromboembolic PH

Question 13

pulmonary embolic HP pre capillary PVR and PCWP values

Answer 13

PVR is moderatly increased

PCWP is less than 15

Question 14

Miscellaneous PH pre capillary values for PVR nad PCWP values

Answer 14

PVR is moderatly increased

PCWP is less than 15

Question 15

Miscellaneous causes for PH

Answer 15

• sarcoid
• Gaucher
• hematologic

Question 16

treatment for CTEPH

Answer 16

anticoagulation and more common now is thromboendarterectomy

Question 17

CTEP follows acute PE in ___ %

Answer 17

3-4

Question 18

best screening test for PH

Answer 18

echo for estimation of PA pressures

Question 19

Gold standard in dx for PH

Answer 19

RHC

Question 20

most common PH gene associated

Answer 20

Bone morphogenic protein receptor that regulates vascular proliferation and when it is not workign there is dysregulation of proliferation and vascularization of smooth muscle cells

Question 21

what is important in the pathophysiology of PAH

Answer 21

• increased TBX and ET1 which promote vasiconstriction
• decreased in NO2 and PG12 that are vasodilators mediators
• endothelial injury

Question 22

only group that responds to pharmalogical treatment

Answer 22

PAH- group 1

Question 23

what is the treatment for PAH

Answer 23

vasodilators or vasoconstrictors antagonist

• PDE5 inhibitor
• endothelin receptor antagonist
• prostaglandins for vasodialtion

Question 24

how do we treat he other groups of PH?

Answer 24

treat underlying disease

Question 25

options for patient failing to respond to first line therapy

Answer 25

• lung transplantation

- atrial septostomy

Question 26

PE is often missed

Answer 26

true

Question 27

is there increased dead space in PE?

Answer 27

yep

Question 28

how is hypoxemia related to PE

Answer 28

V/Q mismatch and shunt

Question 29

in massive PE what are the signs

Answer 29

increase in JVD

increase in P2, right heart strain

Question 30

virchow’s triad

Answer 30

• stasis
• inflammation
• hypercoagulability

Question 31

westermark sign

Answer 31

sign of hypoperfusion and thus PE

Question 32

Hamptom’s hump

Answer 32

peripheral wedge-shaped infiltrate

Question 33

increased D-dimer helps in dx of PE?

Answer 33

nope, poor PPV

Question 34

wich pre-test proabability has high valifity

Answer 34

wells scoring system

Question 35

gold standard for PE dx

Answer 35

angiography

Question 36

systolic murmur that increases in intensity with inspiration

Answer 36

cavallo’s sign- tricuspid regurgitation

Question 37

clinical presentation ofr PAH

Answer 37

• increased P2
• carvallos
• RV heave/ right-sided S3
• JVD