Question 1

Venous thromboembolism is a major national health issue in the United States.

Accepted Answer

A) True 
 B)False  True

Question 2

What therapy has been proven to improve survival in patients with COPD and pulmonary hypertension?

Accepted Answer

A)  Bronchodilators
B)  Oral vasodilators
C)  Oxygen
D)  Prostanoids C

Question 3

What is the critical value for mean pulmonary arterial pressure, above which the right ventricle fails and death may ensue?

Accepted Answer

A)  30 mm Hg
B)  40 mm Hg
C)  50 mm Hg
D)  60 mm Hg B

Question 4

What ECG findings are typically seen in patients with idiopathic pulmonary artery hypertension?
I.frequent premature ventricular complexes
II.right-axis deviation
III.right ventricular hypertrophy
IV.left bundle-branch block

Accepted Answer

A)  I, II, and IV
B)  II and III
C)  IV only
D)  I, II, III, and IV

Question 5

Which of the following conditions contribute to the development of hypoxemia in a patient with pulmonary emboli?
I.cardiogenic shock
II.destruction of lung parenchyma
III.intrapulmonary shunt
IV. $\dot { V } / \dot { Q }$ mismatch

Accepted Answer

A)  I, II, and III
B)  I and IV
C)  II only
D)  I, III, and IV

Question 6

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

Question 7

What is the initial event in the pathogenesis of idiopathic pulmonary artery hypertension (IPAH)?

Accepted Answer

A)  insult to the pulmonary endothelium
B)  elevated level of serotonin
C)  monoclonal proliferation of endothelial cells
D)  vascular remodeling

Question 8

Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.

Accepted Answer

A) True 
 B)False

Question 9

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.

Question 10

What is the main hemodynamic consequence of pulmonary emboli?

Accepted Answer

A)  increased pulmonary vascular resistance
B)  increased systemic vascular resistance
C)  pulmonary instability
D)  pulmonary vasodilation

Question 11

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.

Question 12

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

Question 13

What is the most common pulmonary function abnormality found in patients with idiopathic pulmonary artery hypertension (IPAH)?

Accepted Answer

A)  reduced diffusing capacity of the lungs (DLCO) 
B)  reduced forced vital capacity (FV
C)  
C)  reduced forced expiratory flow (FEF25%-75%) 
D)  reduced lung compliance (CL)

Question 14

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

Question 15

Idiopathic pulmonary artery hypertension (IPAH) is often a fatal disease.

Accepted Answer

A) True 
 B)False

Question 16

What are the two most common findings on the electrocardiogram (ECG) in the patient with pulmonary embolism?

Accepted Answer

A)  bradycardia and elevated ST segment
B)  inverted T waves and depressed ST segment
C)  large P waves and inverted T waves
D)  tachycardia and depressed ST segment

Question 17

What type of drug is Bosentan?

Accepted Answer

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

Question 18

Which of the following radiographic findings is NOT typical for patients with primary pulmonary hypertension?

Accepted Answer

A)  enlargement of the pulmonary artery
B)  enlargement of the right ventricle
C)  narrowing of the peripheral arteries
D)  pleural effusion

Question 19

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

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

Question 20

In what type of IPAH patient is lung transplantation indicated?

Accepted Answer

A)  All pulmonary artery hypertension patients with clinically significant disease
B)  Patients not responding to vasodilators with significant cardiac dysfunction
C)  Patients with class II, class III, or class IV disease
D)  Patients with refractory hypoxemia

Exam 26: Pulmonary Vascular Disease

Venous thromboembolism is a major national health issue in the United States.

What therapy has been proven to improve survival in patients with COPD and pulmonary hypertension?

What is the critical value for mean pulmonary arterial pressure, above which the right ventricle fails and death may ensue?

What ECG findings are typically seen in patients with idiopathic pulmonary artery hypertension? I.frequent premature ventricular complexes II.right-axis deviation III.right ventricular hypertrophy IV.left bundle-branch block

Which of the following conditions contribute to the development of hypoxemia in a patient with pulmonary emboli? I.cardiogenic shock II.destruction of lung parenchyma III.intrapulmonary shunt IV. $\dot { V } / \dot { Q }$ mismatch

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

What is the initial event in the pathogenesis of idiopathic pulmonary artery hypertension (IPAH) ?

Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.

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

What is the main hemodynamic consequence of pulmonary emboli?

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

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

What is the most common pulmonary function abnormality found in patients with idiopathic pulmonary artery hypertension (IPAH) ?

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

Idiopathic pulmonary artery hypertension (IPAH) is often a fatal disease.

What are the two most common findings on the electrocardiogram (ECG) in the patient with pulmonary embolism?

What type of drug is Bosentan?

Which of the following radiographic findings is NOT typical for patients with primary pulmonary hypertension?

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

In what type of IPAH patient is lung transplantation indicated?

Exam 26: Pulmonary Vascular Disease

Venous thromboembolism is a major national health issue in the United States.

What therapy has been proven to improve survival in patients with COPD and pulmonary hypertension?

What is the critical value for mean pulmonary arterial pressure, above which the right ventricle fails and death may ensue?

What ECG findings are typically seen in patients with idiopathic pulmonary artery hypertension? I.frequent premature ventricular complexes II.right-axis deviation III.right ventricular hypertrophy IV.left bundle-branch block

Which of the following conditions contribute to the development of hypoxemia in a patient with pulmonary emboli? I.cardiogenic shock II.destruction of lung parenchyma III.intrapulmonary shunt IV. V˙/Q˙\dot { V } / \dot { Q }V˙/Q˙​ mismatch

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

What is the initial event in the pathogenesis of idiopathic pulmonary artery hypertension (IPAH) ?

Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.

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

What is the main hemodynamic consequence of pulmonary emboli?

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

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

What is the most common pulmonary function abnormality found in patients with idiopathic pulmonary artery hypertension (IPAH) ?

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

Idiopathic pulmonary artery hypertension (IPAH) is often a fatal disease.

What are the two most common findings on the electrocardiogram (ECG) in the patient with pulmonary embolism?

What type of drug is Bosentan?

Which of the following radiographic findings is NOT typical for patients with primary pulmonary hypertension?

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

In what type of IPAH patient is lung transplantation indicated?

Which of the following conditions contribute to the development of hypoxemia in a patient with pulmonary emboli? I.cardiogenic shock II.destruction of lung parenchyma III.intrapulmonary shunt IV. $\dot { V } / \dot { Q }$ mismatch