which of the following is the most potent stimulus for the devlopment of cor pulmonale in patients with chronic obstructive pulmonary disease?
Correct Answer: hypoxia
Description: Definitions # Cor pulmonale is a latin word means "pulmonary hea" . # The world Health Organizaton in 1963 adopted this definition of cor pulmonale :" hyperophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs, except when these pulmonary alterations are the result of diseases that primarily affect the left side of the hea , as congenital hea diseases" # Cor pulmonale is a disease of the right ventricle characterized by hyperophy and dilation that results from diseases directly affecting the lung parenchyma or lung vasculature. Of note ,right hea failure need not be present in cor pulmonale . Pathophysiology * Under normal phsyologic conditions. the right ventricle pumps against a low-resistance circuit. * Normal pulmonary vascular resistance is approximately one-tenth the resistance of the systemic aeries. * The right ventricle is thin walled and able to accommodate considerable changes in volume without large changes in pressure. * Increased cardiac output leads to recruitment of underperfused pulmonary vessels and distention of other pulmonary vessels. * The initial pathophysiologic event in the production of co r pulmonale is elevation of the pulmonary vascular resistance. * As the resistance increases. the pulmonary aerial pressure rises. right ventricular work increases. right ventricular hyperophy (i.e.,thickening. dilation. or both ). * Right ventricular failure occurs when compensation through dilation and hyperophy are exhausted. Management * Treat underlying cause -- e.g. COPD and pulmonary infections * Treat respiratory failure -- in the acute situation give 24% oxygen if pa02 <8k Pa . Monitor ABG and gradually increase oxygen concentration if P,C0_ is stable. In COPD patients, long-term oxygen therapy (LTOT) for 15h/d increases survival. Patients with chronic hypoxia when clinically stable should be assessed for LTOT. ref : harrisons 21st ed
Category:
Medicine
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now