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Respiratory System > Pulmonary Vascular Disease > Flashcards

Pulmonary Vascular Disease Flashcards

1
Q

How does a pulmonary embolism form

A

Forms in the venous system usually in deep veins of the legs and breaks off and travels to the pulmonary arteries

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2
Q

Risk factors for PTE

A 
Major trauma
Recent surgery
Cancer
MI
Pregnancy
Inherited thrombophilia e.g. Factor V Leiden
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3
Q

Symptoms of PTE (6)

A 
Pleuritic chest pain
Cough
Hameoptysis
Acute dyspnoea
Syncope
Cardiac arrest
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4
Q

Signs

A 
Pyrexia
Pleural rub
Stony dullness at base (effusion)
Tachycardia
Hypotension
Tachypnoea
Hypoxia
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5
Q

Pre-test probability

A

Wells Score

Revised Geneva Score

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6
Q

Wells Score

A

Includes symptoms and signs of VTE, previous VTE and risk factors

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7
Q

Revised Geneva Score

A

Based on risk factors, symptoms and signs (heart rate)

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8
Q

Investigations

A 
FBC, biochemistry, blood gases
CXR
ECG
D-dimer
CT pulmonary Angiogram
V/Q scan
Echo
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9
Q

What is used to determine the prognosis

A

PESI score

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10
Q

Treatment

A 
Oxygen
Low molecular weight heparin
Warfarin
Direct oral anticoagulants- Rivaroxaban, apixaban
Thrombolysis: Ateplase
Pulmonary Embolectomy
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11
Q

What is Pulmonary Hypertension defined as?

A

Elavated blood pressure in the pulmonary arterial tree with a pressure greater than 25 mmHg

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12
Q

Causes

A 
Idiopathic
Secondary to chronic respiratory disease
Secondary to left heart disease
Collagen vascular disease
Portal hypertension
Congenital heart disease (L to R shunt)
HIV infection
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13
Q

Symptoms of pulmonary hypertension

A

Exertional dyspnoea
Chest tightness
Exertional presyncope or syncope

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14
Q

Signs of Pulmonary Hypertension

A 
Elevated JVP
Right ventricular heave
Loud pulmonary second heart sound
Hepatomegaly
Ankle Oedema
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15
Q

Investigations for Pulmonary Hypertension

A 
ECG
LFT
CXR
Echo
V/Q scan
CTPA (CT Pulmonary Angiogram)
Right Heart catherization
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16
Q

What is the purpose of right heart catherization (3)

A

Allows direct measurement of pulmonary artery pressure
Measurement of wedge pressure
Measurement of cardiac output

17
Q

General treatment of Pulmonary Hypertension

A

Treat underlying condition
Oxygen
Anticoagulation
Diuretics

18
Q

Specific treatment for pulmonary hypertension

A 
Calcium antagonists 
Prostacyclin
Endothelin receptor antagonists
Riociguat
Phosphodiesterase inhibitors
Thromboendarterectomy or lung/heart transplant
19
Q

What is the mechanism of calcium antagonists

A

Lowers blood pressure by blocking calcium channels

20
Q

What is the purpose of Prostacyclin

A

Inhibits platelet activation and promotes vasodilation

21
Q

What is the purpose of endothelin receptor antagonists

A

Inhibits production of endothelin in the blood

22
Q

What is the purpose of Riociguat

A

Stimulates the enzyme SGC which is a receptor for NO

Respiratory System (30 decks)

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