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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
What does the mortality at 30 days vary between?
0-25%
26
What is used to determine the mortality of patients with pulmonary embolism?
Pulmonary embolism severity index (PESI) score
27
What is the pulmonary embolism severity index (PESI) score based on?
Age Sex Comorbidity Physiological parameters
28
What does the treatment of pulmonary embolism include?
Oxygen Low molecular weight heparin (such as dalteparin) Warfarin Direct oral anticoagulants (DOAC) Thrombolysis Pulmonary embolectomy
29
What is an example of a low molecular weight heparin?
Dalteparin
30
What are examples of direct oral anticoagulants (DOAC)?
Rivaroxaban Apixaban
31
What does DOAC stand up for?
Direct oral anticoagulants
32
What is an example of a thrombolysis?
Alteplase
33
What is thrombolysis?
Dissolution of a blood clot
34
What is the dissolution of a blood clot called?
Thrombolysis
35
What is pulmonary hypertension?
Elevated blood pressure in the pulmonary arterial tree (\>25mmHg)
36
What is elevated blood pressure in the pulmonary arterial tree called?
Pulmonary hypertension
37
What pressure is considered pulmonary hypertension?
\>25mmHg
38
How common is pulmonary hypertension?
Rare with an incidence of 1-2 per million population
39
What happens if pulmonary hypertension is left untreated?
Rapidly progressive condition that leads to premature death
40
Is primary or secondary pulmonary hypertension more common?
Secondary which tends to occur in older age group
41
Where does secondary pulmonary hypertension tend to occur?
Older age group
42
What are some of the causes of pulmonary hypertension?
Idiopathic Secondary to chronic respiratory disease Secondary to left heart disease Chronic thromboembolic pulmonary hypertension Miscellaneous
43
What are some miscellaneous causes of pulmonary hypertension?
Collagen vascular disease Portal hypertension Congenital heart disease (left to right shunt) HIV infection
44
What are symptoms of pulmonary hypertension?
Exertional dyspnoea Chest tightness Exertional presyncope or syncope
45
What is exertional dyspnoea?
Shortness of breath on exertion
46
What is shortness of breath on exertion called?
Exertional dyspnoea
47
What are pulmonary hypertension signs?
Elevated jugular venous pressure Right ventricular heave Loud pulmonary second heart sound Hepatomegaly Ankle oedema
48
What is hepatomegaly?
Abnormal enlargement of the liver
49
What is abnormal enlargement of the liver called?
Hepatomegaly
50
What investigations are done for pulmonary hypertension?
ECG Lung function tests Chest X-ray Echocardiography V/Q scan CTPA (CT pulmonary angiography) Right heart catheterisation
51
What does right heart catheterisation allow?
Direct measurement of pulmonary artery pressure Measurement of wedge pressure Measurement of cardiac output
52
What is the general treatment for pulmonary hypertension?
Treat underlying condition Oxygen Anticoagulants Diuretics
53
What are diuretics?
Also called water pills, medication designed to increase the amount of water and salt expelled from the body as urine
54
What are specific treatments for pulmonary hypertension?
Calcium channel antagonist Prostacyclin (inhibits platelet activation) Endothelin receptor agonist Riociguat Phosphodiesterase inhibitors
55
What is an example of a calcium channel antagonist?
Amlodipine
56
Amlidopine is an example of what?
Calcium channel inhibitor
57
What does prostacyclin do?
Inhibits platelet formation
58
What are examples of endothelin receptor antagonist?
Bosentan Ambrisentan
59
Bosentan and ambrisentan are examples of what?
Endothelin receptor antagonist
60
What are examples of phosphodiesterase inhibitors?
Sildenafil Tedalafil
61
Sildrenafil and tadalafil are examples of what?
Phosphodiesterase inhibitors
62
What are some major pulmonary hypertension treatments?
Thromboendarterectomy Lung or heart lung transplant
63
What is thromboendarterectomy
Surgical procedure to remove blood clots (thrombus) from the pulmonary arteries
64
What is the surgical procedure that removes thrombus from the pulmonary arteries called?
Thromboendarterectomy
65
What is A?
Superior vena cava
66
What is B?
Inferior vena cava
67
What is C?
Right atrium
68
What is D?
Tricuspid valve
69
What is E?
Pulmonary valve
70
What is F?
Right ventricle
71
What is G?
Left ventricle
72
What is H?
Aortic valve
73
What is I?
Pulmonary artery
74
What is J?
Left atrium
75
What is K?
Mitral valve
76
What is L?
Pulmonary vein
77
What is M?
Aorta

Respiratory System (37 decks)

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