Pulmonary Vascular Disease

Question 1

pathogenesis of pulmonary embolism

Answer 1

thrombus forms in venous system usually in deep veins of legs and embolisms to the pulmonary arteries. can be fatal if massive

Question 2

principles of management of pulmonary vascular diseases.

Answer 2

anticoagulation

Question 3

pathogenesis of pulmonary infarction

Answer 3

some of the lung tissue does not receive enough oxygen from blood flow due to clot

Question 4

pulmonary hypertension

Answer 4

elevated blood pressure in the pulmonary arterial tree. mean pulmonary artery pressure of more than 25mmHg

Question 5

the major causes of pulmonary hypertension (GROUPS)

Answer 5

idiopathic 1, secondary to left heart disease2, secondary to chronic respiratory disease 3, chronic thromboembolic pulmonary hypertension 4, miscellaneous 5

Question 6

diagnostic investigative procedures used in pulmonary vascular disease.

Answer 6

wells score, revised Geneva score, full blood count, blood gases, chest X ray, ECG, V/Q scan, CTPA, D dimer test, echocardiography, CT abdomen/ mammography/test for thrombophilia??

Question 7

principles of management of pulmonary vascular diseases.

Answer 7

heparin, Direct Oral anticoagulants eg rivaroxaban, apixaban, oxygen, warfarin, pulmonary embolectomy

Question 8

prognosis of PE

Answer 8

PESI score, can be up to 25% mortality rate

Question 9

vessel that is affected most by hypertension

Answer 9

pulmonary artery and branches of pulmonary artery

Question 10

symptoms of hypertension

Answer 10

exertion dyspnoea, chest tightness, exertion pre syncope or syncope, haemoptysis

Question 11

signs of hypertension

Answer 11

elevated JVP, right ventricular heave, loud pulmonary second heart sound, hepatomegaly, ankle oedema

Question 12

investigations of hypertension

Answer 12

ECG, lung function tests, chest Xray, echocardiography, V/Q scan, CTPA, right heart catheterisation

Question 13

right heart catheterisation why

Answer 13

allows direct measure of pulmonary artery pressure, measurement of wedge pressure, measurement of cardiac output, vasodilator trial

Question 14

treatment of hypertension

Answer 14

treat underlying condition, oxygen, anticoagulation, diuretics

Question 15

specific treatment of hypertension

Answer 15

calcium channel antagonist, prostaglandins, thromboendarterectomy, lung or heart transplant if severe.