USMLE

Description:	CV 6
Category:	USMLE
Created by:	Asclepius on 2008-10-19

Question	Answer
flow of blood through PDA?	aorta to left pulmonary artery
ACE inhibitors can cause what type of electrolyte disturbance?	hyperkalemia
small mass on mitral valve with finger-like projections; non-neoplastic	papillary fibroelastoma
calcium channel blocker associated with accelerated progression of CHF?	verapamil
drug to slow ventricular response in Wolff-Parkinson White?	ibutilide
hypersensitivity angiitis or microscopic polyarteritis nodosa (can be caused by penicilin)	leukocytoclastic angiitis
in which part of the systemic circulation does the greatest decrease in blood pressure occur?	arterioles
vasodilator with lupus-like syndrome as side effect?	hydralazine
mechanism of hydralazine?	increases cGMP - smooth muscle relaxation; vasodilates arterioles > veins; reduces afterload
what calcium channel blocker is most selective for peripheral vasculature?	nifedipine
mechanism of calcium channel blockers?	block voltage-dependent L-type calcium channels of cardiac and SM and thereby reduce contractility
which calcium channel blocker is not used to treat arrhythmias?	nifedipine
what is the goal of antianginal therapy?	reduce myocardial O2 consumption by decreasing 1 or more of the determinants of MVO2: EDV, BP, HR, contractility, ejection time
what do nitrates affect in antianginal therapy?	preload
what happens to contractility and HR in nitrate therapy?	increase - reflex response
what do beta blockers affect in antianginal therapy?	afterload
how do nitrates affect ejection time and MVO2?	decrease
how do beta blockers affect ejection time?	increase it
what do beta blockers do to EDV?	increase it
what do beta blockers do to BP, contractility, and HR?	decrease them
what is digitoxin used for?	CHF (increases contractility) and atrial fibrillation (decreases conduciton at the AV node)
toxicities of digitoxin are increased by what?	renal failure, hpokalemia, and quinidine
blurry yellow vision is side effect of what?	digitoxin
what is the antidote for digitoxin?	slowly normalize K+, lidocaine, cardiac pacer, anti-dig Fab fragments
lupus-like syndrome is associated with what class IA antiarrythmic?	procainamide
what are the class IA antiarrythmics?	Na+ channel blockers: quinidine, amiodarone, procainamide, disopyramide (queen amy proclaims disco pyramids)
this class IA antiarrhythmic can cause cinchonism (headache, tinnitus, thrombocytopenia), torsades de pointes (due to increased QT interval)	quinidine
what class of antiarrhythmics are contraindicated post-MI	class IC - proarrhythmic
what beta blocker is very short acting?	esmolol
what is the antiarrhythmic action of beta blockers?	decrease cAMP and calcium currents; suppress abnormal pacemaker by decreasing slope of phase 4 - AV node particularly sensitive - increased PR interval
toxicity of amiodarone?	pulmonary fibrosis, hepatotoxicity, hypo/hyperthroidism;corneal deposits, skin deposits resulting in photodermatitis, neuro effects, constipation, bradycardia, heart block, CHF
K+ channel blockers that can cause torsades de pointes	soltalol, ibutilide
K+ channel blocker that can cause new arrhythmias and hypotension?	bretylium
wha type of cells do Ca2+ channel blockers primarily affect?	AV nodal cells
what type of antiarrhythmics are used for prevention of nodal arrhythmias?	class IV - Ca2+ channel blockers
what class IV antiarrhythmic can cause torsades de pointes?	bepridil
what is the drug of choice for diagnosing/abolishing AV nodal arrhythmias?	adenosine
what depresses ectopic pacemakers, especially in digitoxin toxicity?	K+
Mg+ is effective for treating what?	torsades de pointes and digitoxin toxicity
drug for hypertension in patient with PKD?	ACE inhibitor
anti-hypertesive for pregnant woman?	methyldopa
in patients with wolff parkinson white and atrial fibrillation, what can digitoxin do?	enhance transmission through accessory pathways that can predispose to v-tach