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Pulm 5 Vasc Diseases
Pulmonary Vascular Diseases
Question | Answer |
---|---|
What are the indications for surgical repair of a triple A? | >5.5cm, >0.5cm change in 6mos, or symptomatic/ruptured |
What is the next step in the mgmt of a child with severe asthma exacerbation and persistently low oxygen saturation despite medication? | Intubation |
WHat is the next step once a brain tumor has been ID'd on CT or MRI head? | CT of chest/abd/pelvis and bone scan to look for primary tumor (most likely a met) |
What is Hampton's hump? | A wedge-shaped opacification at the distal lung fields on CXR indicative of PE |
What EKG finding can sometimes be seen in PE? | S1Q3T3 (wide S in lead 1, large Q in lead 3, and inverted T in lead 3) |
What happens to the A-a gradient in PE? | Increased |
A hospitalized pt suddenly develops tachypnea, tachycardia, and delirium. Dx? | PE |
What is the MC EKG finding in pulmonary embolism? | Sinus tach |
Name 4 classes of vasodilators used to treat pulmonary HTN. | Prostanoids (epoprostenol, treprostinil, iloprost), Endothelin receptor antagonists (bosentan, ambrisentan), cyclic GMP phosphodiesterase inhibitors (sildenafil), and CCB (nifedipine) |
EKG finding on pulmonary HTN? | RV hypertrophy (sign of cor pulmonale) |
What study can be used to monitor LMWH? | anti-factor Xa levels |
Name the 4 parts of treatment for pulmonary HTN. | Oxygen, vasodilators, diuretics, and anticoagulants |
What is the next step in the mgmt of a pt that you suspect has pulmonary HTN because of his sx of JVD, loud S2, dyspnea, and fatiuge? | Echo |
A former smoker with chronic COPD and chronic CHF presents with acute shortness of breath and hypoxemia. What CXR findings might suggest pulmonary edema as the cause of his dyspnea? | Diffuse interstitial fluid, cephalization of vessels, and Kerley B lines |
What imaging studies are helpful in diagnosing a PE? | Spiral CT with IV contrast (CT angio), V/Q perfusion scan, pulm angio |
What is the primary drug category used to treat pulmonary HTN? | Vasodilators (prostanoids, endothelin receptor antagonists, cyclic GMP phosphodiesterase inhibitors, and dihydropyridine CCBs) |
Name 5 causes of pulmonary edema. | L sided heart failure, MI, valvular disease, arrhythmias, and ARDS. |
Name 2 lab findings in pulmonary edema. | Elevated BNP and abnorm cardiac enzymes--> points towards cardiac cause. |
Tx for pulmonary edema? | LMNOP: Loop diuretics, morphine, nitrates, oxygen, and positioning/pressors (dobutamine). |