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

Jugular vein distention

Peripheral edema

Ronchi bilaterally

Dyspnea on exertion

Systemic blood pressure greater than 130/90 mm HG

Answer and Explanation

Correct Answer : A,B,D

A. Jugular vein distention: Pulmonary hypertension increases right ventricular afterload, leading to right heart failure. As the right ventricle struggles to pump against elevated pulmonary pressures, blood backs up into the systemic circulation, causing jugular vein distention (JVD).

B. Peripheral edema: Right-sided heart failure due to pulmonary hypertension leads to venous congestion and fluid retention, resulting in peripheral edema. Swelling is commonly observed in the lower extremities due to increased venous hydrostatic pressure.

C. Ronchi bilaterally: Rhonchi are low-pitched breath sounds typically associated with airway obstruction due to secretions, commonly seen in conditions like chronic bronchitis or pneumonia. Pulmonary hypertension primarily affects the pulmonary vasculature rather than the airways, making rhonchi an unlikely manifestation.

D. Dyspnea on exertion: Pulmonary hypertension increases pressure in the pulmonary arteries, reducing oxygen exchange and causing exertional dyspnea. This symptom is often one of the earliest clinical manifestations as increased pulmonary vascular resistance impairs oxygen delivery.

E. Systemic blood pressure greater than 130/90 mm Hg: Pulmonary hypertension specifically affects the pulmonary circulation, not systemic arterial pressure. While pulmonary hypertension can eventually contribute to left heart dysfunction, it does not directly cause systemic hypertension.

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Correct Answer is A

Explanation

A. Prinzmetal or variant angina: Prinzmetal angina, also known as variant angina, is characterized by episodes of chest pain due to vasospasms of the coronary arteries. This type of angina can occur unpredictably, often at rest, and is associated with transient ischemia of the heart muscle.

B. Unstable angina: Unstable angina is characterized by sudden, unpredictable chest pain that occurs at rest or with minimal exertion and may last longer than stable angina. It indicates a significant risk of myocardial infarction but is not primarily caused by vasospasm.

C. Angina pectoris: Angina pectoris is a general term for chest pain due to ischemia, which can be stable or unstable. It does not specifically refer to the vasospasm that defines Prinzmetal angina.

D. Stable angina: Stable angina is characterized by predictable chest pain that occurs with exertion or stress and is relieved by rest or nitroglycerin. It is not associated with coronary artery vasospasms.

A. Myocardial ischemia B. Right ventricular failure C. Left ventricular hypertrophy D. Contractile dysfunction

Correct Answer is A

Explanation

A. Myocardial ischemia: Myocardial ischemia contributes to ventricular remodeling by causing damage to the heart muscle, leading to changes in the size, shape, and function of the ventricles. The process involves cellular and molecular alterations in response to ischemic injury, ultimately resulting in adverse remodeling that can exacerbate heart failure.

B. Right ventricular failure: Right ventricular failure may occur as a consequence of other cardiac conditions but is not a direct contributor to ventricular remodeling. Instead, it is often a result of left-sided heart failure or pulmonary hypertension, making it secondary to the primary pathologic changes.

C. Left ventricular hypertrophy: Left ventricular hypertrophy can occur as a response to chronic pressure overload (such as hypertension) but is a result of ventricular remodeling rather than a direct contributor to the remodeling process itself. It may indicate underlying issues rather than cause them.

D. Contractile dysfunction: Contractile dysfunction reflects impaired heart muscle contraction but does not directly cause ventricular remodeling. While it can be a consequence of remodeling due to conditions like ischemia or heart failure, it does not initiate the remodeling process itself.

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

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Naxlex Comprehensive Predictor Exams

What type of angina is characterized by vasospasms of coronary arteries and causes unpredictable chest pain?

Correct Answer is A

Explanation

What cardiac pathologic condition contributes to ventricular remodeling?

Correct Answer is A

Explanation

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