Causes
Pulmonary arterial hypertension associated with HIV falls under what category
Pathway in the endothelial cells of the pulmonary vascular system that ultimately leads to increased constriction and proliferation of smooth muscle cells
Endothelin pathway
Right heart failure/dysfunciton due to pulmonary causes
cor pulmonale
What is normal mPAP
10-14 mmhg
Occupational lung disease agent associated with pipefitter, shipyard workers, and boiler workers. Characterized by benign pleural plaques, exudative pleural effusion that is blood stained eosinophil and self resolving, and mesothelioma
Asbestos
Which category of Pulmonary hypertension is associated with chronic hypoxia at rest or with exercise and abnormal chest imaging
Category 3
What are the two relevant pathways that lead to relaxation and reduced proliferation of smooth muscle cells in the treatment of pulmonary hypertension
Prostacyclin and nitric oxide pathway,
Epoprostenol, troprostinil, iloprost and slexipag all act on the prostacylcin pathway through activation of IP
What do most cows drink
Water
X = (mPAP-PCWP)/CO, What is X
PVR
UTI causer (bacteria that is associated with lactose fermentation, mucoid/viscoid colonies, and currant jelly sputum when it is a respiratory infection
K Pneumoniae
Valvular heart disease falls under category 2 of pulmonary hypertension causes. What valve dysfunction would you expect to be the culprit in the case of
1. Early diastolic blowing murmur
2. Hyperdynamic circulation due to increased pulse pressure
3. LV dilation and eccentric hypertrophy
Aortic Regurgitation
PDE-5 inhibitor treatment of Pulmonary hypertension, leading to reduced production of cGMP breakdown product GMP (increases relaxation and reduced proliferation)
Sidenafil, Tadalafil
In pulmonary arterial hypertension associated with endothelin dysfunction, what molecules are often decreased (2 specific names)
vasodilators (prostacyclin, Nitric oxide)
Isolated reduction in _____________ on pulmonary function tests can be consistent with Idopathic Pulmonary arterial hypertension
Diffusion capacity
Molecule that breaks down Natiuretic peptides exacerbating heart failure
Neprilysin
What gene is highly associated with development of group 1 Pulmonary hypertension in young women
BMPR2 gene
Soluble Guanylate cyclase analog which increases production of cGMP leading to incrreased relaxation and reduced proliferation of smooth muscle cells
Ricigouat
Symptoms of heart failure with minimal exertion are what stage of heart failure on the NYHA classificaion (this isn't associated with pathology but theres only so many questions I could ask)
3
3 things associated with pulmonary hypertension likely to be found on ECG
Right axis deviation, right ventricular hypertrophy, right atrial enlargement
The two positive CD stains for Reed Sternberg cells
Cd15 and Cd30
Buildup of what molecule may lead to group 4 hypertension due to deficiency in folate or cobalamin
Homocysteine
What pulmonary hypertension medication blocks the ETA receptor in the endothelin pathway, leading to reduced constriction and proliferation of the pulmonary vasculature
Ambrisentan
Inflammatory causes of pulmonary artery hypertension like with COPD often occur due to inflammation of the ___________ of the pulmonary vessels
intima
To diagnose idiopathic pulmonary hypertension right heart catheterization would show PVR >3 wood units, in addition to mPAP and PCWP of what level (mmHG)
above 20, below 15 (normal)
Molecule found in pleur fluid highly associated with Esophageal rupture
Amylase