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A2. Respiratory System > Pulmonary Vascular Disease > Flashcards

Pulmonary Vascular Disease Flashcards

1
Q

Where does thrombus normally form?

A

In the deep veins of the legs

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2
Q

What % of hospital admissions are due to pulmonary embolisms?

A

1%

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3
Q

Where do thrombus form in pulmonary embolism and where do they travel to?

A

Form in the venous system (usually in the legS) and embolises to the pulmonary arteries

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4
Q

What is an embolism?

A

A thrombus (clot) that is travelling in the blood

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5
Q

Does some or all of the thrombus break off and become an embolism?

A

Either can occur

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6
Q

What is the normal path of apulmonary embolism?

A

Travels up via the inferior vena cava
Enters the right atrium into the right ventricle
Then is pumped into the pulmonary artery where it lodges

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7
Q

Why does recent trauma and major surgery create a higher risk for pulmonary embolism?

A

As the clotting system will be more activated, therefore the blood has a higher risk of clotting

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8
Q

What are the major risk factors of pulmonary embolism?

A 
Recent major trauma 
Recent surgery 
Cancer 
Pregnancy 
Sig. cardiopulmonary disease
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9
Q

What are some of the signs and symptoms of a pulmonary embolism?

A 
Breathlessness (acute and isolate dyspnoea)
Pleuritic chest pain 
Cough 
Haemoptysis 
Cardiac arrest (massive PE)
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10
Q

What scales can be used to calculate the risk of PE?

A

Wells score

Geneva score

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11
Q

What classes can PE be classified into?

A

Small-medium
Multiple
Massive

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12
Q

What investigations are done to diagnose pulmonary embolism?

A 
Full blood count 
Chest X-ray 
ECG
D-dimer 
CT Pulmonary Angiogram 
V/Q san 
Echocardiography 
consider CT abdomen and mammography
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13
Q

What does the mortality at 30 days vary form in pulmonary embolism?

A

0-25%

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14
Q

What is a PESI score based on?

A

Age
Sex
Cormobidity
Physiological parameters

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15
Q

What is the treatment for Pulmonary embolism?

A 
Oxygen 
Warfarin (to thin blood) 
Direct Oral Anticoagulants 
Thrombolysis 
Pulmonary Embolectomy
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16
Q

What does warfarin do and why would it be used in the treatment of PE?

A

It thins the blood

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17
Q

What do thrombolysis do?

A

Break down clots

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18
Q

What is pulmonary hypertension?

A

Elevated blood pressure in the pulmonary arterial or tree

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19
Q

What is the pressure in pulmonary hypertension?

A

> 25mmHg

20
Q

Is primary or secondary pulmonary hypertension more common?

A

Secondary

21
Q

Who does secondary pulmonary hypertension tend to occur in?

A

Older age group

22
Q

What are the symptoms of pulmonary hypertension?

A 
Exertional dyspnoea 
Chest tightness 
Exertional presyncope or syncope
Racing heartbeat 
Leg and ankle swelling
23
Q

What is syncope?

A

Loss of consciousness

24
Q

What investigations are done to diagnose pulmonary hypertension?

A 
ECG
Lung function tests 
Chest X-ray
Echocariopgraphy 
V/Q scan 
CTPA 
Right heart catheterisation
25
Q

What can pulmonary hypertension lead to?

A

Heart failure

26
Q

Which part of the heart has to work harder with pulmonary hypertension?

A

Right hand side

27
Q

What are the signs of pulmonary hypertension?

A 
Elevated JVP
Right ventricular heave 
Loud pulmonary second heart sound 
Hepatomegaly 
Ankle oedema
28
Q

What is hepatomegaly?

A

Abnormal enlargement of the liver

29
Q

What is the general treatment for pulmonary hypertension?

A

Treat underlying condition
Oxygen
Anticoagulation
Diuretics

30
Q

What are the very extreme treatments for pulmonary hypertension?

A

Thromoendarterectomy

Lung or heart lung transplant

31
Q

What does thromoendarecteromy do?

A

Removes the part of the vessel that is causing the obstruction

32
Q

What is pulmonary hypertension?

A

Abnormally elevated pressure in the pulmonary circulation

33
Q

What are the potential causes of pulmonary hypertension?

A 
Certain drugs 
Infections 
COPD
Heart failure 
Blood clots in lungs 
Certain diseases
34
Q

What are the symptoms of deep venous thrombosis - if there are any symptoms?

A

Leg swelling
Redness
Oedema

35
Q

What is normal pressure in the pulmonary arterial circulation?

A

25mmHg

36
Q

What is the pressure in mild pulmonary hypertension?

A

25-45mmHg

37
Q

What is the pressure in moderate pulmonary hypertension?

A

46-65mmHg

38
Q

What is the pressure in severe pulmonary hypertension?

A

> 65mmHg

39
Q

Why is trauma and recent surgery a major risk factor for pulmonary embolism?

A

Because the clotting system becomes more activated and this makes the blood more likely to clot

40
Q

For which trimester is there the highest risk for pulmonary embolism?

A

The risk is the same for all 3 trimesters

41
Q

What is pulmonary hypertension?

A

Elevated blood pressure in the pulmonary arterial or tree

42
Q

What is potential sign on a CXR for pulmonary hypertension?

A

Enlargement of the pulmonary arteries

43
Q

What are some of the specific treatment options for pulmonary hypertension?

A

Calcium channel antagonist
Prostacyclin
Endothelin receptor antagonist
Phosphodiesterase inhibitors

44
Q

What endothelin receptor antagonists can be used to treat pulmonary hypertension?

A

Bosentan

Ambrisentan

45
Q

What phosphodiesterase inhibitors can be used to treat pulmonary hypertension?

A

Sildenafil

Tadalafil

46
Q

What is the last resort treatments for serious pulmonary hypertension?

A

Lung or heart/lung transplant

A2. Respiratory System (15 decks)

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