Question 1

A patient diagnosed with pulmonary arterial hypertension (PAH) has increased dyspnea with activity. Which medication may be prescribed to manage symptom on an outpatient basis?&#10;A) An inhaled prostanoid&#10;B) Bosentan&#10;C) Epoprostenol&#10;D) Trepostinil

Accepted Answer

Bosentan is an oral endothelin receptor antagonist used to manage PAH symptoms on an outpatient basis by reducing pulmonary vascular resistance and improving exercise capacity.

Question 2

A patient with increased left-sided heart pressure will have which type of pulmonary hypertension?&#10;A) Group 2&#10;B) Group 3&#10;C) Group 4&#10;D) Group 5

Accepted Answer

Group 2 pulmonary hypertension is caused by left-sided heart disease, including left ventricular dysfunction, mitral or aortic valve disease, and left atrial tumors or stenosis. Therefore, a patient with increased left-sided heart pressure would fall under this group.

Question 3

A patient who experienced mild pulmonary hypertension with a previously loud second heart sound on exam now demonstrates edema and jugular vein distension. This indicates which complication?&#10;A) Left ventricular dysfunction&#10;B) Right ventricular dysfunction&#10;C) Tricuspid valve involvement&#10;D) Mitral valve involvement

Accepted Answer

The edema and jugular vein distension are typical signs of right heart failure, which is caused by right ventricular dysfunction in patients with pulmonary hypertension. This is often due to increased pressure and volume overload on the right side of the heart. Left ventricular dysfunction may cause pulmonary edema, but it is less likely in patients with pulmonary hypertension who initially presented with mild symptoms. Tricuspid or mitral valve involvement may contribute to right ventricular dysfunction, but this would still be classified as right heart failure.

Deck 96: Pulmonary Hypertension