Question 1

Most pulmonary infarctions associated with thromboembolic obstruction occur in which part of the lung?

Accepted Answer

A)  Right lung 
B)  Lung bases 
C)  Lung apexes 
D)  Left lung 
A)  Right lung 
B)  Lung bases 
C)  Lung apexes 
D)  Left lung B

Question 2

Prophylactic deep venous thrombosis (DVT) therapy would be most important in which of the following patient groups?

Accepted Answer

A)  General surgery patients 
B)  General ward patients 
C)  ICU patients 
D)  Patients with hip replacements 
A)  General surgery patients 
B)  General ward patients 
C)  ICU patients 
D)  Patients with hip replacements D

Question 3

What is the most commonly used oral anticoagulant?

Accepted Answer

A)  Acetylcholine esterase 
B)  Heparin 
C)  Streptokinase 
D)  Warfarin 
A)  Acetylcholine esterase 
B)  Heparin 
C)  Streptokinase 
D)  Warfarin D

Question 4

Which of the following medications would be standard therapy to treat acute deep venous thrombi?

Accepted Answer

A)  Acetylcholine esterase 
B)  Heparin 
C)  Streptokinase 
D)  Warfarin 
A)  Acetylcholine esterase 
B)  Heparin 
C)  Streptokinase 
D)  Warfarin

Question 5

Which of the following arterial blood gas findings is seen in most patients with pulmonary embolism?

Accepted Answer

A)  Hypercapnia 
B)  Hypoxemia 
C)  Low pH 
D)  Normal SaO2 
A)  Hypercapnia 
B)  Hypoxemia 
C)  Low pH 
D)  Normal SaO2

Question 6

What is the fastest way to achieve therapeutic levels of heparin in the treatment of acute deep venous thrombi?

Accepted Answer

A)  Continuous drip system 
B)  Follow established nomogram 
C)  Large bolus at 10 µg/kg 
D)  IV injections while tracking blood levels 
A)  Continuous drip system 
B)  Follow established nomogram 
C)  Large bolus at 10 µg/kg 
D)  IV injections while tracking blood levels

Question 7

What drugs are classified as a prostanoid?
1) Epoprostenol
2) Iloprost
3) Treprostinil
4) Sildenafil

Accepted Answer

A) 1, 2, and 3 only 
B) 3 and 4 only 
C) 1 and 4 only 
D) 2 only 
A) 1, 2, and 3 only 
B) 3 and 4 only 
C) 1 and 4 only 
D) 2 only

Question 8

Why are calcium-channel blockers not used in all patients with idiopathic pulmonary artery hypertension?

Accepted Answer

A)  It causes severe side effects. 
B)  Many of these patients have systemic hypotension. 
C)  Only a small percentage of IPAH patients respond. 
D)  There is a high incidence of anaphylaxis. 
A)  It causes severe side effects. 
B)  Many of these patients have systemic hypotension. 
C)  Only a small percentage of IPAH patients respond. 
D)  There is a high incidence of anaphylaxis.

Question 9

Why is the use of oxygen to maintain oxygen saturations greater than 90% particularly important in the management of idiopathic pulmonary artery hypertension?

Accepted Answer

A)  These patients have a low cardiopulmonary reserve. 
B)  Low alveolar oxygen causes vasoconstriction. 
C)  Many patients have central cyanosis. 
D)  These patients are especially susceptible to tissue hypoxia. 
A)  These patients have a low cardiopulmonary reserve. 
B)  Low alveolar oxygen causes vasoconstriction. 
C)  Many patients have central cyanosis. 
D)  These patients are especially susceptible to tissue hypoxia.

Question 10

Which of the following is true regarding the use of CT with contrast for diagnosing pulmonary embolism (PE)?

Accepted Answer

A)  Limited due to availability of CT equipment 
B)  Most sensitive of the diagnostic techniques 
C)  Can only identify the medium to large PE 
D)  High risk of mortality limits its use 
A)  Limited due to availability of CT equipment 
B)  Most sensitive of the diagnostic techniques 
C)  Can only identify the medium to large PE 
D)  High risk of mortality limits its use

Question 11

On average, how long does the diagnosis of idiopathic pulmonary artery hypertension (IPAH) follow the onset of the disease?

Accepted Answer

A)  6 months 
B)  1 year 
C)  18 months 
D)  2 years 
A)  6 months 
B)  1 year 
C)  18 months 
D)  2 years

Question 12

What percentage of patients with pulmonary embolism have pulmonary infarction as a complication?

Accepted Answer

A)  Less than 10% 
B)  Approximately 25% 
C)  Approximately 40% 
D)  Approximately 65% 
A)  Less than 10% 
B)  Approximately 25% 
C)  Approximately 40% 
D)  Approximately 65%

Question 13

How does impedance plethysmography determine the presence or absence of deep vein thrombosis?

Accepted Answer

A)  Notes resistance to electrical current associated with blood flow. 
B)  Radioactive isotopes target clots and show "hot" on gamma cameras. 
C)  Uses ultrasonic waves to delineate the presence of clot or clots. 
D)  Uses radiographic technique to spot the clots. 
A)  Notes resistance to electrical current associated with blood flow. 
B)  Radioactive isotopes target clots and show "hot" on gamma cameras. 
C)  Uses ultrasonic waves to delineate the presence of clot or clots. 
D)  Uses radiographic technique to spot the clots.

Question 14

Which of the following physical examination findings are consistent with the diagnosis of pulmonary embolism?
1) Congestive heart failure
2) Inspiratory crackles on auscultation
3) Loud P2
4) Tachypnea

Accepted Answer

A) 2, 3, and 4 only 
B) 1 and 4 only 
C) 3 only 
D) 2 and 4 only 
A) 2, 3, and 4 only 
B) 1 and 4 only 
C) 3 only 
D) 2 and 4 only

Question 15

Which of the following are the main components of Virchow's triad?
1) Hypercoagulable states
2) Vessel wall abnormalities
3) Fibrinogen abnormalities
4) Venous stasis

Accepted Answer

A) 1, 3, and 4 only 
B) 1, 2, and 3 only 
C) 1, 2, and 4 only 
D) 2, 3, and 4 only 
A) 1, 3, and 4 only 
B) 1, 2, and 3 only 
C) 1, 2, and 4 only 
D) 2, 3, and 4 only

Question 16

Why is the D-dimer test not routinely performed on hospital inpatients suspected of having pulmonary emboli?

Accepted Answer

A)  A high D-dimer only suggests the presence of comorbidities. 
B)  A low D-dimer is associated with immunodepression. 
C)  It loses sensitivity if numerous blood tests have been performed. 
D)  The cost is prohibitive. 
A)  A high D-dimer only suggests the presence of comorbidities. 
B)  A low D-dimer is associated with immunodepression. 
C)  It loses sensitivity if numerous blood tests have been performed. 
D)  The cost is prohibitive.

Question 17

Which of the diagnostic tests for pulmonary embolism is likely the safest and the most consistently accurate?

Accepted Answer

A)  Impedance plethysmography 
B)  MRI 
C)  Pulmonary angiogram 
D)  Helical CTA 
A)  Impedance plethysmography 
B)  MRI 
C)  Pulmonary angiogram 
D)  Helical CTA

Question 18

What type of drug is Bosentan?

Accepted Answer

A)  Corticosteroid 
B)  Endothelin antagonists 
C)  Phosphodiesterase inhibitors 
D)  Prostanoids 
A)  Corticosteroid 
B)  Endothelin antagonists 
C)  Phosphodiesterase inhibitors 
D)  Prostanoids

Question 19

What ECG finding is most often associated with right-sided heart failure and pulmonary hypertension?

Accepted Answer

A)  Elevated ST segment 
B)  Inverted P wave in lead I 
C)  Prolonged PR interval 
D)  Right-axis deviation 
A)  Elevated ST segment 
B)  Inverted P wave in lead I 
C)  Prolonged PR interval 
D)  Right-axis deviation

Question 20

Unless there are contraindications, what treatment is given universally to all patients with idiopathic pulmonary artery hypertension (IPAH)?

Accepted Answer

A)  Oral anticoagulation 
B)  Oxygen 
C)  Steroids 
D)  Vasodilators 
A)  Oral anticoagulation 
B)  Oxygen 
C)  Steroids 
D)  Vasodilators

Exam 28: Pulmonary Vascular Disease

Most pulmonary infarctions associated with thromboembolic obstruction occur in which part of the lung?

Prophylactic deep venous thrombosis (DVT) therapy would be most important in which of the following patient groups?

What is the most commonly used oral anticoagulant?

Which of the following medications would be standard therapy to treat acute deep venous thrombi?

Which of the following arterial blood gas findings is seen in most patients with pulmonary embolism?

What is the fastest way to achieve therapeutic levels of heparin in the treatment of acute deep venous thrombi?

What drugs are classified as a prostanoid? 1) Epoprostenol 2) Iloprost 3) Treprostinil 4) Sildenafil

Why are calcium-channel blockers not used in all patients with idiopathic pulmonary artery hypertension?

Why is the use of oxygen to maintain oxygen saturations greater than 90% particularly important in the management of idiopathic pulmonary artery hypertension?

Which of the following is true regarding the use of CT with contrast for diagnosing pulmonary embolism (PE)?

On average, how long does the diagnosis of idiopathic pulmonary artery hypertension (IPAH) follow the onset of the disease?

What percentage of patients with pulmonary embolism have pulmonary infarction as a complication?

How does impedance plethysmography determine the presence or absence of deep vein thrombosis?

Which of the following physical examination findings are consistent with the diagnosis of pulmonary embolism? 1) Congestive heart failure 2) Inspiratory crackles on auscultation 3) Loud P2 4) Tachypnea

Which of the following are the main components of Virchow's triad? 1) Hypercoagulable states 2) Vessel wall abnormalities 3) Fibrinogen abnormalities 4) Venous stasis

Why is the D-dimer test not routinely performed on hospital inpatients suspected of having pulmonary emboli?

Which of the diagnostic tests for pulmonary embolism is likely the safest and the most consistently accurate?

What type of drug is Bosentan?

What ECG finding is most often associated with right-sided heart failure and pulmonary hypertension?

Unless there are contraindications, what treatment is given universally to all patients with idiopathic pulmonary artery hypertension (IPAH)?

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Filters

Which of the following physical examination findings are consistent with the diagnosis of pulmonary embolism? 1) Congestive heart failure 2) Inspiratory crackles on auscultation 3) Loud P₂ 4) Tachypnea