Pulmonary embolism
What is the most common source of a pulmonary embolism?
Deep vein thrombosis (DVT) from the lower extremities.
What is the definition of pulmonary hypertension based on mean pulmonary arterial pressure (mPAP)?
A mean pulmonary arterial pressure (mPAP) > 20 mmHg at rest.
Define chronic respiratory failure based on arterial blood gas measurements.
A persistent decrease in the arterial oxygen tension (PaO2) below 60 mmHg and/or an increase in the arterial carbon dioxide tension (PaCO2) above 50 mmHg with normal blood Ph.
In patients at risk for hypercapnic respiratory failure, which parameter should be closely monitored when initiating oxygen therapy?
Arterial carbon dioxide (PaCO2) levels.
Name the classic clinical triad of pulmonary embolism symptoms.
Dyspnea, chest pain, and hemoptysis.
Name the investigation that is considered the gold standard for diagnosing pulmonary hypertension.
Right heart catheterization.
Which type of chronic respiratory failure is characterized by an elevated PaCO2 and a normal or elevated bicarbonate level?
Hypercapnic (Type II) respiratory failure.
For patients with COPD and chronic hypercapnic respiratory failure, what is the recommended target oxygen saturation range when using supplemental oxygen?
88-92%.
What is the name of the sign characterized by pain on deep inspiration or coughing, often seen in patients with pulmonary embolism?
Pleuritic chest pain.
Which group in the WHO PH classification includes pulmonary hypertension due to chronic thromboembolic pulmonary disease?
Group IV.
In patients with chronic hypercapnic respiratory failure, what compensatory mechanism leads to an elevated serum bicarbonate?
Renal compensation.
Name the phenomenon where oxygen therapy improves oxygen saturation but may lead to a worsening acid-base status due to increased PaCO2.
Oxygen-induced hypercapnia.
In patients with a contraindication to contrast or when CTPA is not available, which test can be used for the diagnosis of pulmonary embolism?
Ventilation-perfusion (V/Q) scan.
Which symptom is most commonly experienced by patients with pulmonary hypertension and is related to reduced cardiac output?
Dyspnea on exertion.
What is the primary drive to breathe in patients with chronic hypercapnic respiratory failure due to COPD?
Hypoxia.
Which type of mask is most suitable for delivering high concentrations of oxygen in emergencies, as it can deliver nearly 100% oxygen when the flow rate is set appropriately?
Mask with reservoir.
Name a potential complication of a pulmonary embolism that leads to chronic pulmonary hypertension.
Chronic thromboembolic pulmonary hypertension (CTEPH).
Name the condition characterized by the presence of pulmonary hypertension, increased pulmonary vascular resistance, but a normal wedge pressure (indicating no left heart disease).
Pre-capillary pulmonary hypertension.
In patients with chronic respiratory failure, what long-term therapy has been shown to improve survival in appropriately selected patients with chronic hypoxemia?
Long-term oxygen therapy.
For patients with a massive pulmonary embolism leading to acute RF, which intervention might rapidly improve oxygenation by reducing the clot burden?
Thrombolysis.