Tracheal & Vascular disorders

Question 1

Granulomatosis with polyangitis tracheal findings

Answer 1

Nodular or smooth thickening, posterior membrane not spared

Question 2

Tracheal inflammatory disorders

Answer 2

Tracheobronchopathia osteochondroplastica (TPO)
Relapsing polychondritis
Tracheobronchial amyloidosis
Granulomatosis with polyangitis

Question 3

Tracheobronchial amyloidosis characteristic findings

Answer 3

Diffuse plaques of amyloid (calcified) along airway wall, posterior membrane not spared

Question 4

Relapsing polychondritis characteristic findings

Answer 4

Multisystem

Progressive inflammation and destruction of cartilaginous structures, diffuse but posterior membrane spared

Question 5

Tracheobronchopathia Osteochondroplastica characteristic findings

Answer 5

Calcified nodules from cartilage (anterior and lateral aspects of the inner tracheal and proximal bronchial wall)

Question 6

Idarucizumab

Answer 6

Reversal for dabigatran

Question 7

Ciraparantag

Answer 7

Universal reversal for DOACs

Question 8

Contraindications to tPA for PE

Answer 8

Intracranial neoplasm
Intracranial or spinal surgery or trauma
Hx or hemorrhagic stroke
Active bleeding
Nonhemorrhagic stroke within past 3 months

Question 9

Anticoagulation for confirmed HIT how long

Answer 9

4 weeks

Question 10

Idiopathic pulmonary arterial hypertension meds OK in pregnancy

Answer 10

Iloprost
Treprostinil
Tadalafil

Question 11

Complication after pulmonary thromboendarterectomy for CTEPH

Answer 11

Reperfusion lung injury within 48hr after surgery in ~ 30% of patients

Question 12

Risk for reperfusion lung injury after thromboendarterectomy

Answer 12

RAP >12 mm Hg and PVR >1000 dynes

Question 13

Rivaroxaban and Apixaban

Answer 13

Can be initiated without a 5 to 10 day period of parenteral anticoagulation

Question 14

Warfarin MOA

Answer 14

Competitively inhibits the vitamin K epoxide reductase complex 1, which is essential for activating vitamin K to synthesize factors II, VII, IX and X

Question 15

BMPR2 gene

Answer 15

In PAH

Question 16

Identification of intrapulmonary vascular dilutions

Answer 16

ECHO with bubble - micro bubbles in the LA within 3-6 cycles
Abnormal brain uptake on radionuclide scanning (less frequently used)

Question 17

Cause of intrapulmonary shunt in hepatopulmonary syndrome

Answer 17

Dysregulated mediators including nitric oxide lead to vascular vasodilation and AVM formation

Question 18

Hepatopulmonary syndrome triad

Answer 18

Liver disease
Increased alveolar-oxygen difference breathing room air
Intrapulmonary vascular dilutions (IPVDs)

Question 19

Chinking

Answer 19

Incomplete abduction of posterior vocal cords in VCD during inspiration