Pathology Notes

Practice questions answers, Pulmonary hypertension © Jun Wang, MD, PhD   1. B. The presentations of exertional dyspnea and dry cough are suggestive of disorders involving heart and/or lung. In a patient with long history of cigarette smoking, with the presence of perioral cyanosis, diminished breath sound and bilateral crackles, it is likely to be a form of chronic obstructive pulmonary disease. The findings of jugular vein distention and lower extremity edema are suggestive of elevated right atrial pressure that may be associated with tricuspid stenosis or pulmonary hypertension . The presence of loud second, in this background, is likely caused by P2, suggestive of pulmonary hypertension . Based on these information, this patient might have group 3 pulmonary hypertension , pulmonary hypertension due to lung diseases and/or hypoxia . In these patient, diagnoses of pulmonary hypertension and underlying lung disorder are needed. Therefore, chest X-ray would be a convenient init

Practice questions, Pulmonary hypertension © Jun Wang, MD, PhD   1. Use this case for next 7 questions . A 62-year-old man presents with dyspnea after activity and dry coughing for 3 months. He does have progressive dyspnea for 6 years. He has a history of type 2 diabetes for 15 years. He has been smoking 2 packs of cigarette per day for the last 40 years. His family history is unremarkable. His vital signs are within normal range. Physical examination reveals perioral cyanosis. Dilated jugular veins are noted. Chest auscultation reveals diminished breath sounds with wheezing crackles bilaterally. He has a rhythmical heart rate with a loud second sound. No significant abnormalities are noted in his abdomen. His lower extremities have edema below the knee. What initial exam should be performed? A. Arterial blood gas test B. Chest X-ray C. Complete blood count D. Liver function tests E. Troponin levels 2. A 62-year-old man presents with dyspnea after activity and dry coughing for