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Perfusion: patho

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QuestionAnswer
Identified cause for coagulation deficit? Thrombocytopenia Vitamin K deficiency Liver disease inherited disorders/Hemophilia Von Willebrand [Factor (vWF)] Disease (many variants)
What cause Vitamin K deficiency ? Lack of coagulation factor (II, VII, IX, X) & prothrombin
The drug of choice for Von Willebrand [Factor (vWF)] insufficiency?What is its mechanism of action? Drug: Desmopressin (vasopressin, ADH) Action: stimulates vWF endothelial cell synthesis & secretion
Please discuss about hemophilia A disorder and how it causes bleeding ? X-linked recessive disorder Factor VIII insufficiency => bleeding Tx: synthetic Factor VIII; plasma
Describe risk factors for thrombus formation with rational Venous stasis tissue injury smoking DIC high estrogen others.......
Discuss the pathophysiology of atrial fibrillation Disorganized atrial contractility => inadequate ventricular filling => low CO Atrial rate >300 bpm; Ventricular rate 80-180 bpm(please read text book for detials) Tx plan: Ablation procedure
What are the common feature of atrial fibrillation & how you mange it? Features : dizziness, irregular pulse, pulse deficit treatment ER: cardioversion ASA; slow nodal conduction (beta blockers, Cardiac selective Calcium channel blockers); interrupt the impulse re-entry pathway: Ablation
What is the most common cause of hypercoagulation (eg. pulmonary embolism)? Deep vein thrombosis; usually in the legs
What is the pharmacology treatment of DVT? Tx: Heparin or LMWH
Pharmacology treatment for pulmonary embolism? Tx ER: thrombolytics Tx: Heparin or LMWH, Coumadin (Warfarin) NB:cuation with using Warfarin anticoagulation pre/during/post sx (Heparin, LMWH)
What preventive measure should nurse provide to prevent pulmonary embolism? Early mobilization post sx; compression stockings anticoagulation pre/during/post sx (Heparin, LMWH)
Factor v leiden mutation is an autosomal dominant disorder.Discuss the probability of affecting child See your ppt
How factor v leiden mutation cause hypercoagulation and what is its treatment ? Mutation present in Factor V Factor V – endogenous coagulation activator mutated Factor V = cannot be deactivated => hypercoagulation Tx: monitor; LMWH (Apixaban)
List at list three risk factor for pulmonary HTN Chronic small pulmonary embolisms; COPD; idiopathic; heart failure
Pulmonary HTN can be treated with ? Tx ER: Nipride (nitroprusside) Tx: decrease preload (diuretics); prevention of cor pulmonale (RHF)
Discuss about hypercholesterolemia See your text book
Discuss acute and chronic coronary artery disease (CAD) See your ppt
What is the treatment of acute coronary syndrome? Vasodilation: organic nitrates, morphine 02 Tx obstruction: PTCA, CABG Tx clotting: ASA, Reopro Thrombolytics: < 6hrs from onset for best efficacy Optimize CO: beta blockers, ACE, ARBs Tx arrhythmias – Ventricular fibrillation
Discuss the Vtach/Vfib - algorithm clearly See your ppt and book
Compare the different between right and left heart failure? Right side receives blood from the venous system & pumps into the lungs, if does not pump: back up into Systemic circulation Capillary pressure builds => interstitial fluid shift Left side receives blood from the lungs & pumps into the body; if it can
What do you think the most common cause of heart failure? Low output failure
The treatment goal of heart failure is ? Decrease preload,afterload & improve contractility
Which drug group used to improve contractility Cardiac Glycosides like Digoxin (Lanoxin), Digitoxin P Inhibitors like Milrinone; Amrinone; Viagra (sildenafil) Adrenergic Agonists like Dobutamine; Dopamine HCL NB:see its MOA and implications
What is the drug of choice to reduce preload and afterload in acute heart failure preload: Loop Diuretics like Lasix afterload:Direct acting vasodilators like Nipride
What is the drug of choice to improve contractility in acute heart failure B1 agonists: Dobutamine Read also Perfuse coronaries Organic Nitrates: Nitro
What about drugs for chronic HF ? longer acting/less potent drugs: Combination diuretics Cardiac glycosides instead of B1 agonists ACE/ARBs instead of Direct acting Vasodilator ...
Created by: aynalem
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