Download ACCP pulmonary medicine board review by American College of Chest Physicians PDF

By American College of Chest Physicians

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The major changes noted in these revisions were as follows: (1) abandonment of the term secondary PH and (2) the replacement of the term primary PH with idiopathic pulmonary arterial hypertension (IPAH) or, when supported by genetic testing, familial pulmonary arterial hypertension (FPAH). PAH is a subset of PH that is defined as a mean PAP of Ͼ 25 mm Hg at rest or Ͼ 30 mm Hg during exercise with a normal pulmonary capillary wedge pressure (Ͻ 15 mm Hg) and a lesion localized to the pulmonary arteriole.

Bosentan has also been shown to improve hemodynamics. Two studies have shown improved survival with bosentan therapy compared with historical control subjects. Although many of the trials that use these classes of medications were not powered to detect an improvement in survival, a recent metaanalysis suggests that the rate of mortality is lower in patients treated with targeted therapies. The approach to the use of these agents in PAH is typically based on their functional class, as defined by the WHO classification system, which is a modification of the NYHA functional class system for heart failure (Table 6).

8th ed. Chest 2008; 133:381S−453S Evidence-based recommendations on prevention of VTE in all surgical and medical populations. Excellent review of the literature on risk, risk stratification, and preventive strategies. Goldhaber SZ, Grodstein F, Stampfer MJ, et al. A prospective study of risk factors for pulmonary embolism in women. JAMA 1997; 277:642−645 Obesity, cigarette smoking, and hypertension were associated with an increased risk of PE in women. Control of these risk factors could decrease the risk of PE among women.

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