pulmonary vascular/circulatory disorders

Question 1

what determines vasoconstriction and vasodilation

Answer 1

humoral and autonomic system

Question 2

what does hypoxia trigger

Answer 2

vasoconstriction allowing for shunting of blood to the more aerated areas within the lungs

Question 3

what does entire lung vasoconstriction lead to

Answer 3

pulmonary HTN

Question 4

what is the supportive blood supply to the parenchyma and supportive structures

Answer 4

bronchial vessels

Question 5

what is the purpose of the pulmonary lymphatics

Answer 5

removed both infectious material as well as excess fluid
moves toward the hilum

Question 6

where does the pulmonary lymphatics drain into

Answer 6

the right thoracic lymphatic duct

Question 7

what is a pulmonary embolism

Answer 7

blood clot within the pulmonary vasculature

Question 8

what causes PE

Answer 8

DVT
fat embolism
air embolism
amniotic embolism

Question 9

what is virchows triad

Answer 9

stasis
hypercoagulability
vessel wall injury

Question 10

how long do we treat provoked clots

Answer 10

3 months

Question 11

how long do we treat unprovoked clots

Answer 11

forever

Question 12

where do DVTs form

Answer 12

on the valves and will disrupt valvular function and venous blood will pool more

Question 13

what can occur with injury to long bone

Answer 13

fat embolism

Question 14

what is the most common association with septic emboli

Answer 14

associated with IVDU as this will affect the right side of the heart
S. aureus

Question 15

what are the causes of air embolism

Answer 15

iatrogenic
scuba diving - ‘the bends’, AKA decompression illness, N2 bubbles

Question 16

what is an amniotic embolism

Answer 16

amniotic fluid is able to get into moms circulation
m/c occurs during labor or immediately postpartum

Question 17

what increases your risk of amniotic embolism

Answer 17

premature delivery
advanced maternal age
abnormal attachment site of placenta
preeclampsia
c-section
polyhydramnios

Question 18

what is the presentation of PE

Answer 18

pleuritic chest pain
SOB, hypoxia
syncope
shock (right sided HF)
findings of DVT
cough
emoptysis
tachycardia

Question 19

what are the classifications of PEs

Answer 19

Massive
submassive PE with right heart strain
submassive PE without right heart strain
subsegmental

Question 20

what is a massive PE

Answer 20

hemodynamic instability with hypotension
mortality rate 25-52%
causes hypotension with WBP <90 for 15+ min or constant drop of >40mmHg

Question 21

what are the complications of PE

Answer 21

Right heart failure
decreased gas exchange

Question 22

what does an elevated pulmonary vascular pressure lead to

Answer 22

increase in RV pressure

Question 23

what is pulmonary arterial HTN

Answer 23

occlusion/constriction of the capillary arterioles within the pulmonary vasculature
- vasoconstriction associated with endothelial dysfunction
-remodeling of smooth muscles
-thrombosis

Question 24

what are the common causes of pulmonary arterial HTN

Answer 24

PE
ARDS
COPD
interstitial lung disease

Question 25

what is pulmonary venous HTN associated with

Answer 25

left sided heart disease

Question 26

what is primary pulmonary HTN

Answer 26

pulmonary vasculature is only area affected
genetic predisposition
vascular wall remodeling
pulmonary vasoconstriction
increased risk of thrombi

Question 27

what is primary pulmonary HTN associated with

Answer 27

HIV
dietary medications (amphetamines)
cocaine
chemo
smoking
collagen disorders
congenital shunting of blood

Question 28

what is secondary pulmonary HTN

Answer 28

results when there is a known cause and something else is involved in disease process
LV dysfunction- pulmonary venous HTN
COPD, interstitial lung disease - that cause primary lung disease that then leads to pulmonary HTN

Question 29

what are the classifications of Pulmonary HTN

Answer 29

Groups 1-5

Question 30

what is cor pulmonale

Answer 30

or right-sided HF
an enlargement of RV due to high BP in lungs usually caused by chronic lung disease