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Pulm 5 Vasc Diseases

Pulmonary Vascular Diseases

QuestionAnswer
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).
Created by: sarah3148