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2. Respiratory Medicine (Lectures) > Pulmonary Vascular Disease > Flashcards

Pulmonary Vascular Disease Flashcards

1
Q

What is a pulmonary embolism?

A

Thrombus forms in the venous system, usually in deep vains of the legs and embolises to the pulmonary arteries

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2
Q

How many hospital admissions are due to pulmonary embolisms?

A

1%

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3
Q

What can be the consequences of a massive pulmonary embolism?

A

Can be fatal

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4
Q

What can minor pulmonary embolisms be treated with and how is the prognosis?

A

Anticoagulation and have a very good prognosis

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5
Q

Where do pulmonary embolisms usually originate?

A

Deep vains in the legs

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6
Q

What are major risk factors of venous thromboembolisms?

A

Recent major trauma

Recent surgery

Cancer

Significant cardiopulmonary disease

Pregnancy

Inherited thrombophilia

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7
Q

What are symptoms of pulmonary embolism?

A

Pleuritic chest pain, cough and haemoptysis

Isolated acute dyspnoea

Syncope or cardiac arrest

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8
Q

What is haemoptysis?

A

Coughing up blood

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9
Q

What is coughing up blood known as?

A

Haemoptysis

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10
Q

What is dyspnoea?

A

Shortness of breath

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11
Q

What is shortness of breath called?

A

Dyspnoea

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12
Q

What is a syncope?

A

Temporary loss of consciousness

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13
Q

What is a temporary loss of consciousness called?

A

Syncope

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14
Q

What are the signs of a pulmonary embolism?

A

Pyrexia, pleural rub, stony dullness to percussion at base

Tachycardia, tachypnoea, hypoxia

Tachycardia, hypotension, tachypnoea, hypoxia

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15
Q

What is tachypnoea?

A

Abnormally rapid breathing

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16
Q

What is abnormally rapid breathing called?

A

Tachypnoea

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17
Q

What does VTE stand for?

A

Venous thromboembolism

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18
Q

What is a venous thromboembolism?

A

Condition in which a blood clot forms most often in the deep veins of the legs, groin or arm

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19
Q

What is used pre-test to determine the probability of a pulmonary embolism?

A

Well score

Revised Geneva score

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20
Q

What does the well score include?

A

Includes symptoms and signs of venous thromboembolism, previous venous thromboembolism and risk factors

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21
Q

What does the revised Geneva score include?

A

Based on risk factors, symptoms and signs

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22
Q

What investigations can be done for pulmonary embolism?

A

Full blood count, biochemistry, blood gases

Chest X-ray

ECG

D-dimer

CT pulmonary angiogram

V/Q scan

Echocardiography

Consider CT abdomen and mammography

Consider thrombophilia testing

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23
Q

What is an angiogram?

A

Used to visualise the inside of the lumen or vessels of the body

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24
Q

What is used to visualise the inside of the lumen or vessels of the body?

A

Angiogram

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25
Q

What does the mortality at 30 days vary between?

A

0-25%

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26
Q

What is used to determine the mortality of patients with pulmonary embolism?

A

Pulmonary embolism severity index (PESI) score

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27
Q

What is the pulmonary embolism severity index (PESI) score based on?

A

Age

Sex

Comorbidity

Physiological parameters

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28
Q

What does the treatment of pulmonary embolism include?

A

Oxygen

Low molecular weight heparin (such as dalteparin)

Warfarin

Direct oral anticoagulants (DOAC)

Thrombolysis

Pulmonary embolectomy

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29
Q

What is an example of a low molecular weight heparin?

A

Dalteparin

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30
Q

What are examples of direct oral anticoagulants (DOAC)?

A

Rivaroxaban

Apixaban

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31
Q

What does DOAC stand up for?

A

Direct oral anticoagulants

32
Q

What is an example of a thrombolysis?

A

Alteplase

33
Q

What is thrombolysis?

A

Dissolution of a blood clot

34
Q

What is the dissolution of a blood clot called?

A

Thrombolysis

35
Q

What is pulmonary hypertension?

A

Elevated blood pressure in the pulmonary arterial tree (>25mmHg)

36
Q

What is elevated blood pressure in the pulmonary arterial tree called?

A

Pulmonary hypertension

37
Q

What pressure is considered pulmonary hypertension?

A

>25mmHg

38
Q

How common is pulmonary hypertension?

A

Rare with an incidence of 1-2 per million population

39
Q

What happens if pulmonary hypertension is left untreated?

A

Rapidly progressive condition that leads to premature death

40
Q

Is primary or secondary pulmonary hypertension more common?

A

Secondary which tends to occur in older age group

41
Q

Where does secondary pulmonary hypertension tend to occur?

A

Older age group

42
Q

What are some of the causes of pulmonary hypertension?

A

Idiopathic

Secondary to chronic respiratory disease

Secondary to left heart disease

Chronic thromboembolic pulmonary hypertension

Miscellaneous

43
Q

What are some miscellaneous causes of pulmonary hypertension?

A

Collagen vascular disease

Portal hypertension

Congenital heart disease (left to right shunt)

HIV infection

44
Q

What are symptoms of pulmonary hypertension?

A

Exertional dyspnoea

Chest tightness

Exertional presyncope or syncope

45
Q

What is exertional dyspnoea?

A

Shortness of breath on exertion

46
Q

What is shortness of breath on exertion called?

A

Exertional dyspnoea

47
Q

What are pulmonary hypertension signs?

A

Elevated jugular venous pressure

Right ventricular heave

Loud pulmonary second heart sound

Hepatomegaly

Ankle oedema

48
Q

What is hepatomegaly?

A

Abnormal enlargement of the liver

49
Q

What is abnormal enlargement of the liver called?

A

Hepatomegaly

50
Q

What investigations are done for pulmonary hypertension?

A

ECG

Lung function tests

Chest X-ray

Echocardiography

V/Q scan

CTPA (CT pulmonary angiography)

Right heart catheterisation

51
Q

What does right heart catheterisation allow?

A

Direct measurement of pulmonary artery pressure

Measurement of wedge pressure

Measurement of cardiac output

52
Q

What is the general treatment for pulmonary hypertension?

A

Treat underlying condition

Oxygen

Anticoagulants

Diuretics

53
Q

What are diuretics?

A

Also called water pills, medication designed to increase the amount of water and salt expelled from the body as urine

54
Q

What are specific treatments for pulmonary hypertension?

A

Calcium channel antagonist

Prostacyclin (inhibits platelet activation)

Endothelin receptor agonist

Riociguat

Phosphodiesterase inhibitors

55
Q

What is an example of a calcium channel antagonist?

A

Amlodipine

56
Q

Amlidopine is an example of what?

A

Calcium channel inhibitor

57
Q

What does prostacyclin do?

A

Inhibits platelet formation

58
Q

What are examples of endothelin receptor antagonist?

A

Bosentan

Ambrisentan

59
Q

Bosentan and ambrisentan are examples of what?

A

Endothelin receptor antagonist

60
Q

What are examples of phosphodiesterase inhibitors?

A

Sildenafil

Tedalafil

61
Q

Sildrenafil and tadalafil are examples of what?

A

Phosphodiesterase inhibitors

62
Q

What are some major pulmonary hypertension treatments?

A

Thromboendarterectomy

Lung or heart lung transplant

63
Q

What is thromboendarterectomy

A

Surgical procedure to remove blood clots (thrombus) from the pulmonary arteries

64
Q

What is the surgical procedure that removes thrombus from the pulmonary arteries called?

A

Thromboendarterectomy

65
Q

What is A?

A

Superior vena cava

66
Q

What is B?

A

Inferior vena cava

67
Q

What is C?

A

Right atrium

68
Q

What is D?

A

Tricuspid valve

69
Q

What is E?

A

Pulmonary valve

70
Q

What is F?

A

Right ventricle

71
Q

What is G?

A

Left ventricle

72
Q

What is H?

A

Aortic valve

73
Q

What is I?

A

Pulmonary artery

74
Q

What is J?

A

Left atrium

75
Q

What is K?

A

Mitral valve

76
Q

What is L?

A

Pulmonary vein

77
Q

What is M?

A

Aorta

2. Respiratory Medicine (Lectures) (50 decks)

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