Which clinical manifestations would you assess for in a painter with pulmonary hypertension?
(Select All that Apply.)

A. Carotid wall thinness: Carotid wall thinness is not considered a nontraditional risk factor for coronary artery disease (CAD). Traditional risk factors for CAD include age, gender, hypertension, hyperlipidemia, and smoking, while carotid wall thickness (rather than thinness) is often used as a marker for atherosclerosis and cardiovascular risk.

B. Chronic kidney disease: Chronic kidney disease (CKD) is recognized as a nontraditional risk factor for coronary artery disease. It is associated with increased cardiovascular risk due to factors like inflammation, mineral metabolism disorders, and increased vascular stiffness.

C. Coronary artery calcification: Coronary artery calcification is considered a nontraditional risk factor for CAD. It reflects the presence of atherosclerosis and is associated with an increased risk of cardiovascular events.

D. Markers of inflammation, ischemia, and thrombosis: Markers of inflammation (such as C-reactive protein), ischemia, and thrombosis (such as fibrinogen and D-dimer) are nontraditional risk factors for coronary artery disease. Elevated levels of these markers indicate increased cardiovascular risk and are used in risk stratification.

A. Hypoventilation causes hypocapnia: Hypoventilation leads to inadequate removal of carbon dioxide (CO₂), resulting in hypercapnia rather than hypocapnia. This occurs because decreased ventilation reduces gas exchange efficiency, allowing CO₂ to accumulate in the blood, which can cause respiratory acidosis.

B. Hypoventilation causes alkalosis: Hypoventilation leads to respiratory acidosis rather than alkalosis. When ventilation is insufficient, CO₂ builds up in the bloodstream, leading to an increase in hydrogen ion concentration and a subsequent drop in blood pH. This is commonly seen in conditions like chronic obstructive pulmonary disease (COPD), neuromuscular disorders, and opioid overdose.

C. Hyperventilation causes acidosis: Hyperventilation results in excessive elimination of CO₂, leading to a decrease in hydrogen ion concentration and an increase in blood pH, causing respiratory alkalosis rather than acidosis. Acidosis occurs when CO₂ retention leads to an increase in hydrogen ion concentration, which is the opposite of what happens with hyperventilation.

D. Hyperventilation causes hypocapnia: Hyperventilation leads to an excessive exhalation of CO₂, causing a reduction in blood CO₂ levels (hypocapnia). This can result in respiratory alkalosis, leading to symptoms such as dizziness, lightheadedness, tingling sensations, and even syncope. It is often seen in conditions like anxiety, panic attacks, fever, or high-altitude exposure.