Immediately from the ACCP Pulmonary drugs Board assessment 2009 path, this article covers each subject in a concise, easy-to-use structure. Use as a self-study source to arrange for the pulmonary drugs subspecialty board exam.
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In addition, the following supportive treatments are available: 1. Anticoagulation: Patients with PAH should receive long-term anticoagulation therapy. Patients with this condition are prone to thromboembolism, in part caused by reduced PA blood flow, right ventricular dilation, venous ACCP Pulmonary Medicine Board Review: 25th Edition insufficiency, and inactivity. 5. 2. Oxygen: All patients with PAH and documented hypoxemia should receive supplemental oxygen to maintain an oxygen saturation of Ͼ 90%.
Budhiraja R, Hassoun PM. Portopulmonary hypertension: a tale of two circulations. Chest 2003; 123:562−576 Pulmonary involvement is common in patients with portal hypertension and can manifest in diverse ways. Changes in pulmonary arterial resistance, manifesting either as the hepatopulmonary syndrome or portopulmonary hypertension, have been increasingly recognized. Portopulmonary hypertension is defined as an elevated PAP in the setting of increased pulmonary vascular resistance and normal wedge pressure in a patient with portal hypertension.
Patients who experience a major central thromboembolic event, or have significant hemodynamic compromise on presentation, a documented thrombophilia, or persistent abnormalities seen on lung perfusion studies on follow-up may need to be monitored more closely. Ventilation/perfusion . (V/Q ) scanning is the screening investigation of choice because many chest radiologists are not familiar with the distinguishing features of CTEPH seen on CT angiography. Patients who are surgical candidates should be referred to a specialty center for the consideration of pulmonary endarterectomy.