NURS 5220: PULM ACTUAL
QUESTIONS AND ANSWERS
What is the definition of pulmonary hypertension (PH)? - ANSWER-Mean
Pulmonary Artery Pressure (MPAP) > 25 mmHg.
What are common signs and symptoms of pulmonary hypertension? -
ANSWER-Progressive dyspnea, fatigue, syncope, chest pain, and palpitations.
What diagnostic tests are used for pulmonary hypertension? - ANSWER-
Elevated BNP, right ventricular strain on chest X-ray (CXR), and transthoracic
echocardiogram (TTE).
What is the impact of pulmonary hypertension on the right heart? - ANSWER-
The right heart becomes hypertrophied due to increased workload from
pumping against high pressures in the pulmonary vasculature.
What is the role of positive pressure ventilation in pulmonary hypertension? -
ANSWER-It can increase pressure in the right heart and lead to right
ventricular overload and potential myocardial infarction (MI) during the
perioperative period.
What is the significance of the BMPR2 gene in pulmonary hypertension? -
ANSWER-Mutations in the bone morphogenetic protein receptor type 2
(BMPR2) gene are the most common genetic cause of pulmonary
hypertension.
What are the effects of pulmonary hypertension? - ANSWER-Vasoconstriction,
vascular remodeling, thrombus formation, and stiffening of blood vessels.
What are endothelin receptor antagonists and their purpose in treating PH? -
ANSWER-They block the vasoconstrictive action of endothelin and help relax
smooth muscles. Examples include Ambrisentan, Bosentan, and Macitentan.
What are common side effects of endothelin receptor antagonists? -
ANSWER-Headache, edema, anemia, nasal congestion, and risk of infertility.
What are phosphodiesterase (PDE) inhibitors and their function? - ANSWER-
They enhance cAMP and cGMP leading to vasodilation and smooth muscle
relaxation. Examples include Sildenafil and Tadalafil.
, What are the side effects of phosphodiesterase inhibitors? - ANSWER-
Headache, flushing, transient blue-green tinting of vision, and hypotension
when combined with nitrates.
What is the role of soluble guanylate cyclase (sGC) stimulators in pulmonary
hypertension? - ANSWER-They increase signaling through the cGMP pathway
and enhance nitric oxide vasodilation. An example is Riociguat.
What are the adverse effects of sGC stimulators? - ANSWER-Severe
hypotension when combined with nitrates or PDE5 inhibitors, fetal toxicity,
and bleeding.
What are prostacyclin receptor agonists and their mechanism? - ANSWER-
They induce vasodilation and stimulate the release of nitric oxide, with
antiproliferative effects on vascular smooth muscle.
What are examples of prostacyclin receptor agonists? - ANSWER-
Epoprostenol, Treprostinil, Iloprost, and Selexipag.
What are common side effects of prostacyclin receptor agonists? - ANSWER-
Myalgias, jaw pain, nausea, headaches, dizziness, flushing, and hypotension.
What is the management approach for pulmonary hypertension? - ANSWER-
Focus on stopping vasoconstriction and using medications that promote
vasodilation.
What is the difference between COPD and asthma? - ANSWER-COPD involves
airflow obstruction that does not change over time, while asthma is a chronic
inflammatory disorder of the airways.
What cellular elements play a role in asthma? - ANSWER-Mast cells,
eosinophils, neutrophils, T-lymphocytes, macrophages, and epithelial cells.
What is the significance of right ventricular failure (RVF) in pulmonary
hypertension? - ANSWER-It occurs due to the right heart's inability to pump
blood effectively against elevated pulmonary pressures.
What is the relationship between pulmonary hypertension and myocardial
infarction (MI)? - ANSWER-Patients with pulmonary hypertension are at
increased risk of MI during the perioperative period due to right heart strain.
What is the role of reactive oxygen species in vascular health? - ANSWER-
They are involved in the complex healing process of endothelial injury and
modulate vascular responses.
QUESTIONS AND ANSWERS
What is the definition of pulmonary hypertension (PH)? - ANSWER-Mean
Pulmonary Artery Pressure (MPAP) > 25 mmHg.
What are common signs and symptoms of pulmonary hypertension? -
ANSWER-Progressive dyspnea, fatigue, syncope, chest pain, and palpitations.
What diagnostic tests are used for pulmonary hypertension? - ANSWER-
Elevated BNP, right ventricular strain on chest X-ray (CXR), and transthoracic
echocardiogram (TTE).
What is the impact of pulmonary hypertension on the right heart? - ANSWER-
The right heart becomes hypertrophied due to increased workload from
pumping against high pressures in the pulmonary vasculature.
What is the role of positive pressure ventilation in pulmonary hypertension? -
ANSWER-It can increase pressure in the right heart and lead to right
ventricular overload and potential myocardial infarction (MI) during the
perioperative period.
What is the significance of the BMPR2 gene in pulmonary hypertension? -
ANSWER-Mutations in the bone morphogenetic protein receptor type 2
(BMPR2) gene are the most common genetic cause of pulmonary
hypertension.
What are the effects of pulmonary hypertension? - ANSWER-Vasoconstriction,
vascular remodeling, thrombus formation, and stiffening of blood vessels.
What are endothelin receptor antagonists and their purpose in treating PH? -
ANSWER-They block the vasoconstrictive action of endothelin and help relax
smooth muscles. Examples include Ambrisentan, Bosentan, and Macitentan.
What are common side effects of endothelin receptor antagonists? -
ANSWER-Headache, edema, anemia, nasal congestion, and risk of infertility.
What are phosphodiesterase (PDE) inhibitors and their function? - ANSWER-
They enhance cAMP and cGMP leading to vasodilation and smooth muscle
relaxation. Examples include Sildenafil and Tadalafil.
, What are the side effects of phosphodiesterase inhibitors? - ANSWER-
Headache, flushing, transient blue-green tinting of vision, and hypotension
when combined with nitrates.
What is the role of soluble guanylate cyclase (sGC) stimulators in pulmonary
hypertension? - ANSWER-They increase signaling through the cGMP pathway
and enhance nitric oxide vasodilation. An example is Riociguat.
What are the adverse effects of sGC stimulators? - ANSWER-Severe
hypotension when combined with nitrates or PDE5 inhibitors, fetal toxicity,
and bleeding.
What are prostacyclin receptor agonists and their mechanism? - ANSWER-
They induce vasodilation and stimulate the release of nitric oxide, with
antiproliferative effects on vascular smooth muscle.
What are examples of prostacyclin receptor agonists? - ANSWER-
Epoprostenol, Treprostinil, Iloprost, and Selexipag.
What are common side effects of prostacyclin receptor agonists? - ANSWER-
Myalgias, jaw pain, nausea, headaches, dizziness, flushing, and hypotension.
What is the management approach for pulmonary hypertension? - ANSWER-
Focus on stopping vasoconstriction and using medications that promote
vasodilation.
What is the difference between COPD and asthma? - ANSWER-COPD involves
airflow obstruction that does not change over time, while asthma is a chronic
inflammatory disorder of the airways.
What cellular elements play a role in asthma? - ANSWER-Mast cells,
eosinophils, neutrophils, T-lymphocytes, macrophages, and epithelial cells.
What is the significance of right ventricular failure (RVF) in pulmonary
hypertension? - ANSWER-It occurs due to the right heart's inability to pump
blood effectively against elevated pulmonary pressures.
What is the relationship between pulmonary hypertension and myocardial
infarction (MI)? - ANSWER-Patients with pulmonary hypertension are at
increased risk of MI during the perioperative period due to right heart strain.
What is the role of reactive oxygen species in vascular health? - ANSWER-
They are involved in the complex healing process of endothelial injury and
modulate vascular responses.
