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Cardiology
Rx Review Round 3
| Question | Answer |
|---|---|
| What is the former name of Granulomatosis with Polyangiitis? | Wegener's Granulomatosis |
| What two organ systems are affected in Granulomatosis with Polyangiitis? | Pulmonary and Renal |
| What the associated renal pathology in Wegener's granulomatosis? | Necrotizing glomerulonephritis with damage occurring in a crescent-shaped pattern |
| Granulomatosis with polyangiitis is positive to which antibody? | c-ANCA |
| Which type of diuretic is first line of treatment to Pulmonary edema caused by congestive heart failure? | Loop diuretic (furosemide) |
| What is the mode of action that explains the effective of furosemide in treatment of CHF-induced pulmonary edema? | Rapidly and significantly RELAX smooth muscle in the pulmonary vessels |
| Diltiazem is a Class_____ antiarrhythmic, that causes --> | Class IV; Slows down action potential conduction |
| Negative chronotropy is defined as: | Slowing down the action potential conduction |
| Calcium channel blockers produce ________________ chronotropy. | Negative |
| In which type of cells are Calcium channel blockers the most effective? | AV nodal cells |
| What is the mode of action of Diltiazem? | Inhibition of Calcium ion influx into the cell (AV nodal cell) |
| What EKG change is seen/produced by Calcium channel blockers? | PR-interval prolongation. |
| What organism is the MCC of subacute bacterial endocarditis in patients with damaged cardiac valves? | Strep sanguinis (strep viridans) |
| What is the mnemonic used to summarize the MC symptoms of Bacterial endocarditis? | FROM JANE |
| What does the "E" in FROM JANE, stands for? | Emboli |
| Plasmodium falciparum is often treated with which antiarrhythmic? | Quinide |
| What fatal arrhythmia may be produced by Quinidine? | Torsade de Pointes |
| What is the time frame seen in Left Ventricular Free wall rupture after an MI? | 5-10 days after MI |
| What is a common post-MI complication after 5-10 days? | Left ventricular free wall rupture |
| Ventricular free wall rupture pathogenesis? | Blood is spill into the Pericardium ---> TAMPONADE |
| What are the common symptoms seen with Cardiac tamponade? | Chest pain, sudden onset of severe hypotension, and unresponsiveness. |
| What is the time frame for Papillary muscle rupture after an MI? | 4-7 days |
| Which part of the heart is the papillary muscle rupture after an MI located? | Near the Mitral valve |
| What murmur is acutely developed in Papillary muscle rupture? | Mitral Regurgitation |
| What are the common symptoms seen in Papillary muscle rupture? | Tachycardia, tachypnea, severe hypotension, and diffuse pulmonary rales and respiratory distress. |
| What is the most common treatment for PCP? | Sulfonamides (TMP-SMX) |
| Sulfonamides are CYP450 __________________, which caused: | Inhibitors; lead to the increase concentration of other drugs used concurrently. |
| What Prolonged QT interval condition is associated with sensorineural hearing loss? | Jervell and Lange-Nielsen Syndrome |
| Which condition is caused by mutated voltage-gated K+ channels and hearing loss? | Jervell and Lange-Nielsen Syndrome |
| What key features are to be seen in a patient with Jervell and Lange-Nielsen syndrome? | Sensorineural hearing loss, Family Hx of sudden death, and Prolonged QT interval on ECG. |
| What ion channels are defective in Romano Ward Syndrome? | K+ and Na+ channels |
| Romano-Ward syndrome is NOT associated with? | Hearing loss |
| What are the 2 most common types of Long QT-interval syndromes? | 1. Jervell and Lange-Nielsen syndrome 2. Romano-Ward Syndrome |
| What is the cause or pathogenesis of Long QT-interval syndrome? | Inherited disorder of Myocardial repolarization due mainly to mutated or defective voltage-gated K+ channels |
| What arrhythmia is potential fatal in Long QT-interval syndrome? | Torsade de Pointes |
| What is the most common cause of Acute Bowel ischemia? | Thrombotic arterial occlusion; presented with Rebound tenderness |
| What symptoms are seen with Complete bowel Obstruction? | Constipation, nausea, vomit and anorexia |
| Non-occlusive ischemia is often the result of? | Hypovolemia and/or hypoperfusion |
| What electrolyte abnormality is seen to develop in Digoxin toxicity? | Hyperkalemia |
| What anatomical characteristic is seen with higher changes of developing atherosclerotic plaque formation? | The narrower the vessel |
| What kind of heart condition is associated with Lyme disease? | 3 degree AV block |
| What activity is often associated with Lyme disease development? | Hiking |
| What gene is mutated in Romano-Ward syndrome? | ANK-2 gene |
| Which Long QT-interval syndrome is purely with cardiac phenotype? | Romano-Ward Syndrome |
| What is commonly seen in ECG of a Brugada syndrome patient? | Pseudo Right BBB and ST-elevation of V1-V3. |
| What population is at higher risk of developing Brugada syndrome? | Asian males |
| What are the 3 main mode of action seen with Digoxin? | 1. Increase in Cardiac contractility --> Increase Cardiac Output, which relieves the symptoms of fluid overload 2. Increase Ejection fraction 3. Decreases Heart Rate by increasing stimulation of vagal tone, which allows for more cardiac filling time. |
| What is the overall change in the Cardiac curve (Cardiac output vs RA pressure) with the use of Digoxin? | Increase in Maximal Height and slope, and small decrease in RA pressure. |
| What is the main reason for the dysfunction seen in Acute Aortic regurgitation? | Rise in LVED volume occurs too rapidly for Left Ventricular compensation to occur. |
| What is seen in Aortic Regurgitation Pressures? | EQUALIZATION of the End-diastolic aortic and Left ventricular Pressures. |
| Chronic AR --> | LV dilation due to volume overload |
| Aortic stenosis --> | High systolic pressure gradient across the aortic valve |
| What conditions are seen with Equalization of the Left and Right ventricular diastolic pressures? | Severe VSD, cardiac tamponade, or severe Pericarditis |
| What is the main symptom caused by Coronary atherosclerosis? | Stable angina |
| Chest pain that is relieved by rest or nitroglycerin? | Stable angina |
| What is result of coronary atherosclerosis? | Plaque formation that causes downstream myocardial ischemia. |
| What is the main vessel histopathology of PAN? | Transmural inflammation and fibrinoid necrosis |
| What virus is highly associated with PAN? | Hepatitis B virus |
| PAN is characterized by: | Exhibiting different stages of inflammation in the same vessel and leading to renal microaneurysms. |
| Wegener's granulomatosis vascular histopathology description. | Necrotizing granulomas |
| What are the symptoms and EKG changes seen in Pericarditis? | Precordial chest pain, friction rub, diffuse ST-segment elevation, pulsus paradoxus, and distant heart sounds. |
| What common Picornavirus is associated in the development of Pericarditis? | Coxsackievirus |
| small, naked, ss-RNA virus family? | Picornaviridae |
| What are the changes in PCWP, PVR, and CO during a SEPTIC shock? | Decreased: PCWP and PVR Increased: Cardiac Output (CO) |
| Patient with hypotension goes into ER and saline infusion fails to reestablish normal blood pressure. Dx? | Septic Shock |
| Phase 4 of the SA nodal cells is controlled by which ion current? | I-funny current (Na+ and K+) |
| What drug is used to produce a positive chronotropic effect on Phase 4 of the SA node? | Norepinephrine |
| Norepinephrine causes (on atrial tissue): | Increase Na+ conductance, which leads to an increase in slope of phase 4 and increase heart rate. |
| Blood flow down the vertebral artery to the DISTAL Subclavian Artery. Dx? | Subclavian Steal Syndrome |
| What mechanical action (movement) of the neck can cause Subclavian steal syndrome? | Tilting head/neck backwards |
| What is the cause of Subclavian Steal syndrome? | Narrowing or blockage of Subclavian artery PROXIMAL to the Vertebral artery. |
| What artery is blocked or occluded in Subclavian Steal syndrome? | Subclavian artery PROXIMAL to the Vertebral artery. |
| What drugs are known to cause/induce Drug-induced SLE? | 1. Procainamide 2. Hydralazine 3. Phenytoin 4. Isoniazid 5. Sulfa drugs 6. Etarnecept 7. Methyldopa |
| What is an agent used in emergency hypertension in pregnant women? | Hydralazine |
| ASD's key S2: | Fixed and wide S2 split |
| What is a common complication of an ASD? | It allows a venous embolism to enter the Left-side of the harte and then the systemic circulation |
| What is dangerous complication of an Left Atrial embolus? | Stroke |
| Granulomatosis with polyangiitis is positive for? | c-ANCA |
| c-ANCA (+); Necrotizing granulomas in the lungs and upper airway. Dx? | Granulomatosis with Polyangiitis |
| What vasculitis is associated with Necrotizing glomerulonephritis? | Granulomatosis with Polyangiitis |
| What are common clinical manifestations of Granulomatosis with polyangiitis? | Malaise, hemoptysis, mucosal ulcers in nares, and elevated Creatine (urine) |
| What part of the alphabet contain the Selective B-blockers? | A-- M (MC metoprolol) |
| Which receptor is blocked by Selective B-blockers? | B-1 |
| Which kind of beta-blockers may be used in a COPD patient? | Selective (B-1) blockers |
| Which beta-blocker action causes smooth muscle bronchial constriction? | B-2 receptor blockers |
| Which kind of beta blockers are contraindicated in COPD patients? | Non-selective beta blockers |
| What are the main two uses for Beta-blockers? | 1. SVT 2. Ventricular control of AFIB and A-FLUTTER |
| What are the two man MOA of Beta-blockers? | 1. Decreased AV and SA node activity by decreasing cAMP, and decreasing Ca2+ currents. 2. Suppress abnormal pacemakers by decreasing the slope of phase 4. |
| What enzyme is inhibited by Statins? | HMG-CoA reductase |
| Which antihyperlipidemic drug decreases the de-novo cholesterol production in the liver? | Statins |
| What is the secondary function of Statins? | Upregulate LDL receptors on the liver's surface by increasing the LDL clearance from the bloodstream. |
| Competitive inhibitors cause what kind of change in the Michaelis-Menten graph? | Increase the Km |
| The higher greater the affinity to a drug ---> | The lower the Km |
| What is the effect on potency by competitive inhibitors? | Decrease in potency |
| Which kind of inhibitors may be overcomed by increase in Substrate? | Competitive inhibitors |
| Non-competitive inhibitors: | 1. Decrease Vmax = decrease in Efficacy 2. Km remains unchanged 3. Not overcomed by increase in [S] |
| Class III antiarrhythmics MoA --> | Block voltage-gated K+ channels ---> Longer Effective refractory period |
| What are the common clinical findings of Aortic Dissection? | 1. Tearing chest pain radiating to the back 2. Asymmetric pulses 3. CXR -----> Mediastinal widening |
| What is a common and dangerous complication of Aortic dissection? | Cardiac tamponade |
| What is the triad of symptoms seen in Cardiac tamponade? | 1. Hypotension 2. Distended neck veins 3. Distant heart sounds |
| Along with Beck's triad, what other symptoms are seen in Cardiac tamponade? | Tachycardia and Pulsus paradoxus |
| What is the compression of heart by fluid, which can lead to a decrease cardiac output? | Cardiac tamponade |
| What is seen in Cardiac tamponade with respect the pressure in the heart chambers? | Equalization of diastolic pressures in all 4 chambers |
| Dilated Cardiomyopathy is seen with: Ventricular Wall size ----> Ventricular Cavity size ---> Contractile dysfunction ----> | Decreased Increased Systolic dysfunction |
| Hypertrophic Cardiomyopathy is seen with: Ventricular Wall size ----> Ventricular Cavity size ---> Contractile dysfunction ----> | Increased Decreased Diastolic dysfunction |
| Dilated Cardiomyopathy is seen with: Ventricular Wall size ----> Ventricular Cavity size ---> Contractile dysfunction ----> | Unchanged Unchanged Diastolic dysfunction |
| What kind of cardiomyopathies have a diastolic dysfunction? | Hypertrophic and Restrictive |
| Which cardiomyopathy has a systolic dysfunction? | Dilated |
| What is the simple definition of diastolic function? | Filling of the heart |
| What is Diastolic dysfunction? | Impaired Left ventricular RELAXATION with increased stiffness of the LV and ELEVATED FILLING PRESSURES. |
| What is systolic dysfunction? | It reflects loss of myocardial CONTRACTILITY resulting form loss of muscle fibers (prior to infarction) and/or increased intracellular connective tissue (increase resistance to contraction) |
| What happens in with valvular incompetence? | Backs up blood flow within the heart, enlarging the PREVIOUS CHAMBER. |
| What the order of MC affected heart valves in Rheumatic fever? | Mitral > Aortic > Tricuspid |
| Which heart chamber is mostly enlarged in Mitral Regurgitation (MR)? | Left Atrium |
| Enlargement of the LA causes an _________________ PCWP. | Increase PCWP |
| What is the MCC of MI? | Rupture of Coronary artery of atherosclerotic plaque ---> acute thrombosis |
| What are the cardiac biomarkers used to dx MI? | CK-MB and Troponin |
| NSTEMI: | - Subendocardial infarcts -Subendocardium (inner 1/3) most susceptible area to ischemia. - ST depression |
| STEMI: | - Transmural infract - Full thickness of myocardial wall involved - ST elevation, Q waves |
| What ST-segment changes are seen with Stable angina? | ST depression |
| Transient ST-elevation are seen in: | Transient (Prinzmetal) angina |
| Unstable angina is seen with: | +/- ST-depression + +/- T wave inversion |
| What are the effects of Beta blockers in cardiovascular tissue? | 1. Negative inotropic / chronotropic 2. Inhibits vasodilation |
| What Pulmonary effects can be seen with beta blockers? | Constricts bronchial smooth muscle (B-2 receptors) |
| What are effects on endocrine system of beta blockers? | 1. Inhibition of GLUCAGON release by Pancreas 2. Inhibition of RENIN release by JXG cells 3. Decreased lipolysis in Adipose tissue |
| What is the clinical presentation of B-blocker toxicity? | Cardiogenic shock, including: - Pale and cool extremities - Bradycardia - Hypotension |
| What is the treatment of choice for B-blocker overdose? | Glucagon |
| Why is Glucagon used in Beta blocker intoxication? | Increases intracellular cAMP in cardiac myocytes via activation of GPCR. |
| Extracellular deposition of misfolded low molecular weight subunits known as amyloid fibrils. Dx? | Amyloidosis |
| What are the two most affected organs in Amyloidosis? | Kidney and Heart |
| How are the kidneys affected in Amyloidosis? | Nephrotic syndrome with kidney insufficiency and failure |
| How is the heart affected in Amyloidosis? | Restrictive filling pattern (diastolic dysfunction) and Heart Failure (HF). |
| What are some EKG changes seen in a patient with Amyloidosis? | -AV block, sinus node dysfunction and conduction abnormalities, - Low voltage ECG despite thick myocardium |
| What is a ocular distinctive feature of Amyloidosis? | Bleeding under the skin around the eyes, without trauma. |
| What are the uses for Niacin in anti- lipid therapy? | Reduced hepatic triglyceride and VLDL synthesis |
| What are the associated side effects of Niacin therapy? | 1. Hyperuricemia -------> Gout 2. Flushing 3. Hyperglycemia |
| What drug inhibits Hormone-sensitive lipase? | Niacin |
| What are common viral etiologies for DCM? | Coxsackie B viral myocarditis and Chagas Disease |
| What are common etiologies or causes of Dilated cardiomyopathy? | Chronic Alcohol abuse, Wet Beriberi, chronic Cocaine use, Doxorubicin toxicity, Hemochromatosis, Peripartum cardiomyopathy, Coxsackie B virus, and Chagas disease. |
| What kind of hypertrophy is seen with Dilated CM? | Eccentric ; sarcomeres added in SERIES |
| HF, S3, systolic regurgitation murmur, and dilated heart. DX? | Dilated Cardiomyopathy |
| What are some key characteristics of Hypertrophic Cardiomyopathy? | S4 gallop, systolic ejection murmur at left sternal border. |
| What is the treatment of choice for HCM? | 1. B-blockers 2. Non-dihydropyridine Ca2+ channel blockers |
| What are the Non-dihydropyridine Calcium channel blockers? | Verapamil and Diltiazem |
| What condition is associated with Aschoff bodies? | Rheumatic fever |
| What are Aschoff bodies? | Cell aggregates that contain multinucleated giant cells and Anitschkow cells. |
| What is the auculation description of Mitral stenosis? | Late diastolic murmur with a diminished S1 sound. |
| Which post-MI complication is associated with Free Wall rupture? | Cardiac tamponade |
| What is common 3-5 day post-MI complication? | Left Ventricular Wall rupture |
| Hypotension + distant heart sounds + increased JVD. DX? | Cardiac Tamponade |
| What is a common post -MI complication after 2-7 days after the event? | Papillary muscle rupture |
| Why does Papillary muscle rupture after an MI, causes acute onset of Mitral regurgitation? | The Papillary muscle is near anatomical proximity to the Mitral valve |
| The incorrect use or abuse of Nitroprusside therapy, may induce _____________________________. | Cyanide toxicity |
| What is the mode of action of Cyanide? | Inhibition of Mitochondrial Cytochrome C oxidase in the ETC (complex IV) |
| Congestive heart failure causes a change in which Starling force? | Increase in Capillary hydrostatic pressure (Pc) |
| What kind of alteration is seen in Liver failure or Nephrotic syndrome, with relation to the Starling forces causing edema? | Decrease blood Oncotic pressure (pi C) |
| Increase in blood oncotic hydrostatic pressure is seen in ? | Lymphatic obstruction |
| How is acute onset of L-sided HF presented clinically? | Hypoxemic respiratory failure and the subjective sensation of SOB. |
| What is the pathology of Transudation of pulmonary fluid in HF? | Elevated LV diastolic filling pressures |
| What is the equation Cardiac Output (CO)? | = Stroke volume (SV) x Heart Rate (HR) |
| CO= | Mean arterial pressure (MAP) = ------------------------------------------------------ Total Peripheral Resistance (TPR) |
| (Rate of Oxygen consumption) ---------------------------------------------- = (Arterial Oxygen - Venous Oxygen) | CO |
| SV = | = EDV - ESV |
| If R---R is 0.8. What is the patient's heart Rate? | 1 x 60 secs = ------ (R -- R) |
| Which type of drug competition has a higher Km? | Competitive inhibition |
| The PCWP, PVR, and CO profile changes of Septic Shock are also shared by what other type of shock? | Anaphylactic |
| What are proven actions that reduce Cardiac events in Hyperlipidemic patient? | 1. High - intensity Statin therapy 2. Aerobic exercise 3. Weight loss |
| What is the MC organism causing Subacute Bacterial endocarditis in previous damaged heart valves? | Strep sanguinis (a subclass of a Strep viridans) |
| What are the 3 most common organisms causing Tricuspid endocarditis? | S. aureus, > Pseudomonas and Candida |
| A patient with Colon cancer is more likely to develop Subacute bacterial endocarditis by with organism? | S. bovis |
| A patient with prosthetic valves, often will develop Subacute bacterial endocarditis by which organism? | Staph epidermidis |
| What is the MC organism and description causing ACUTE bacterial endocarditis? | S. aureus; Large vegetations on previously normal valves; Rapid onset. |
| Which bacterial endocarditis is describe with a GRADUAL onset? | Subacute Bacterial Endocarditis |
| What is the preferred treatment for black population with Essential hypertension? | 1. Low-dose Thiazide (HCTZ) diuretics 2. Long-acting Calcium channel blockers |
| What is main function of Fibrates? | Decrease triglyceride levels |
| What is the MoA of Fibrates? | Upregulatin LIPOPROTEIN LIPASE through increase PPAR-a activity. |
| What are SE seen with Fibrates? | Formation of gallstones, by inhibition of 7-a- hydrolase |
| What is the pathology of NRDS? | Disorder in which lung fails to produce a sufficient amount of SURFACTANT resultrin gin increased surface tension and collapse of small alveoli |
| NRDS eventually lead to the development of: | Diffuse atelectasis |
| Why is there signs and symptoms of hypoxemia developed in NRDS? | Occurs as blood bypasses the atelectatic air spaces |
| What is the treatment of Septic Shock? | Norepinephrine |
| Why is NE used in Septic Shock treatment? | 1. Activation of alpha-1 receptors 2. Causes smooth muscle contraction ---> quick rebound of blood pressure. |
| What is the common Calcium channel blocker used in treating Variant Angina? | Amlodipine |
| Is amlodipine safe to used in a pregnant person? | Yes |
| What drug is used in pregnant women to treat Essential HTN? | HCTZ |
| What is used to treat gestational Hypertension? | Alpha-methyldopa |
| Holosystolic murmur best heard at apex of the heart. | Mitral Regurgitation |
| How are pressures affected in Mitral regurgitation? | - Increase in Left Atrial pressure during systolic due to the regurgitation of blood from the LV into the LA though an insufficient mitral valve. |
| Anatomically the Inferior Jugular vein is located? | Lateral to the Common Carotid artery, and Posterolateral to the Vagus nerve, within the Carotid sheath |
| Which are the MC used veins for Central line application? | Internal jugular vein (neck), Femoral and Subclavian vessels |
| Central lines are inserted into ____________. | Veins |
| Aortic regurgitation is most commonly due to a setting of: | Aortic dissection, endocarditis, or trauma |
| Which Class III antiarrhythmic is part of the ACLS treatment for managing Ventricular fibrillation after an MI? | Amiodarone |
| What are the associated side effects of Amiodarone? | 1. Abnormal LFTs, PFTs (restrictive pattern), and Hyper/Hypothyroidism, and Corneal deposits |
| What is the MC congenital cardiac abnormality? | VSD |
| Which cardiac abnormality is described with a HARSH or BLOWING Holosystolic murmur? | VSD |
| Loud S1 and wide, fixed split S2. | ASD |
| S2 sound has no changes during inspiration or expiration. | ASD |
| Aortic regurgitation is described by auscultation as: | Decrescendo Diastolic murmur |
| What kind of murmur is associated with a Marfan syndrome patient? | Aortic Regurgitation |
| Head bobbing and pistol-shot pulses, are characteristics of? | Aortic Regurgitation |
| What pathology is characterized by LV dilation due to volume overload? | Chronic Aortic regurgitation |
| High systolic pressure gradient across the aortic valve is seen in? | Aortic Stenosis |
| Which conditions present with equalization of the Left and Right Ventricular diastolic pressures? | Severe VSD, cardiac tamponade, and/or severe Pericarditis |
| Coronary atherosclerosis symptology is due to? | Stable angina episodes |
| Which systemic vasculitis is characterized by Transmural inflammation and fibrinoid necrosis? | PAN |
| PAN (vasculitis) is highly associated to which viral infection? | Hepatitis B Viral infection |
| Renal microaneurysms are characteristic of which medium sise vessel vasculitis? | PAN |
| What is the main treatment of PAN? | Cyclophosphamide |
| PAN is seen characterized by: | Transmural inflammation and Fibrinoid necrosis |
| Which vasculitis is seen with Necrotizing granulomas? | Wegener's granulomatosis |
| Wegener granulomatosis is seen with _________________ ___________. | Necrotizing granulomas |
| What the most the featured symptoms seen with Pericarditis? | - Precordial chest pain - Friction rub - Diffuse ST-segment elevations on EKG - Pulsus paradoxus - Distant heart sounds |
| Which virus is often associated with the development of Pericarditis? | Coxsackie B virus |
| Coxsackievirus is part of which viral family? | Picornaviridae family |
| Picornaviruses are described as: | Small, naked, single-stranded-RNA virus |
| What kind of "shock" is characterized by the failure to reestablish blood pressure by Hydration? | Septic Shock |
| What are the changes seen in PCWP, PVR, and cardiac output in a patient with Septic shock? | - DECREASED PCWP and PVR - INCREASED Cardiac Output |
| Which phase in the atrial tissue is controlled by the Funny currents? | Phase 4 |
| What ions participate in the If current of pacemaker cardiac tissue? | Na+ (main) and K+ |
| What is the effect on atrial AP upon administration of NE? | + chronotropic effect ---> Increase Sodium conductance, which lead to an increase slope of phase 4 and heart rate. |
| What pathogenesis of Subclavian Steal Syndrome? | Blood flow down the Vertebral artery to the distal Subclavian Artery |
| Subclavian Steal syndrome occurs most often (location)? | Due to narrowing or blockade of the Subclavian artery PROXIMAL to the Vertebral artery. |
| What head/neck motion can trigger Subclavian Steal syndrome symptoms? | Tilting head backwards |
| What common arterial vasodilator is associated with Drug-induced SLE? | Hydralazine |
| What is the MoA of Hydralazine? | Direct dilation of arterioles by means of vascular smooth muscle relaxation |
| Which drugs are associated with the development of Drug-induced SLE? | Procainamide, Hydralazine, Phenytoin, Isoniazid, sulfa drugs (TMP-SMX), Etanercept, and Methyldopa |
| Wide and Fixed S2 split | ASD |
| What is a potentially dangerous complication of a severe ASD? | Allowance of a venous emboli to enter the Left-side of the heart, and enter the systemic circulation |
| What is the most common complication of an Left atrial embolus? | Stroke |
| What renal complication is associated with Granulomatosis with Polyangiitis? | Necrotizing glomerulonephritis |
| Granulomatosis with polyangiitis is often positive for: | C-ANCA |
| What are some common clinical features in a Granulomatosis with polyangiitis patient? | Malaise, hemoptysis, mucosal ulcers in nasal mucosa, and increased Cr. |
| Necrotizing granulomas in the lungs and upper airways, if characteristic of? | Granulomatosis with polyangiitis |
| Which is the most commonly mentioned or used Selective Beta-blocker? | Metoprolol |
| Most of the selective beta-blockers are summarized by which letter in the alphabet? | A---M |
| Selective beta blockers are specific for with receptor? | B-1 receptors |
| Which type of beta-blocker is SAFE to use with COPD patients? | Selective Beta receptors |
| WHich receptor of Non-selective beta blockers is the cause of contraindication in COPD patients? | B-2 receptor |
| What is the most commonly used or mentioned Non-selective Beta blocker? | Propranolol |
| Which a common medication that can cause bronchial smooth muscle contraction? | Propranolol |
| What is the MoA of Beta blockers? | 1. Decrease SA and AV nodal activity by decreasing cAMP, and Ca2+ currents 2. Suppress abnormal pacemakers by decrease slope of phase 4 |
| Beta blockers work on which phase of the SA node AP? | Phase 4 |
| What are the most common uses for Beta blockers? | 1. SVT 2. Ventricular control in AFIB and AFLUTTER |
| Competitive inhibitors of HMG-CoA reductase | Statins |
| What is the secondary function of Statins? | Upregulate LDL receptors on the liver's surface by increasing LDL clearance from the bloodstream |
| Competitive inhibitors increase ________. | Km |
| What is the Km of a drug? | Michaelis-Menten constant |
| Which kind of inhibitors decrease Potency and may be overcomed by increase in substrate concentration? | Competitive inhibitors |
| Non-competitive inhibitors decrease __________, which means? | Decrease Vmax, which means a decrease in Efficacy |
| Decrease in Efficacy is seen with? | Non-Competitive Inhibitors |
| A decrease in Potency is characterized by: | Competitive inhibitors |
| What kind of inhibitors are not overcome by increasing the concentration of the substrate? | Non-Competitive Inhibitors |
| What is the mechanism of action of Class III antiarrhythmics? | Block voltage-K+ channels ----> Longer Effective Refractory period |
| Longer Effective refractory period is seen with the use of? | Class III antiarrhythmics |
| What is a common and dangerous complication of Aortic Dissection? | Cardiac Tamponade |
| What are featured symptoms of Aortic Dissection? | 1. Tearing chest pain radiating to the back 2. Asymmetric pulses 3. CXR ---> Mediastinal widening |
| What is the name given to the common triad of symptoms seen in Cardiac Tamponade? | Beck's triad |
| What are the components of Beck's Triad? | Hypotension, distended neck veins, and muffled (distant) heart sounds. |
| In Cardiac Tamponade, what are the other two associated clinical symptoms seen besides Beck's triad? | Tachycardia and Pulsus Paradoxus. |
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rakomi
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