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Cardiology
Rx Review 4.1
| Question | Answer |
|---|---|
| Steroid hormones are _______________ or _________________. | Hydrophobic; Lipophilic |
| What are the kind of receptors that steroid hormones are binded to? | Intracellular receptor |
| What are the two main clinical manifestations of Acute-onset Left-sided Heart Failure? | 1. Hypoxemic respiratory failure 2. Subjective sensation of SOB |
| What is the pathogenesis of Acute-onset L-sided HF? | Elevated ventricular diastolic filling pressures lead to the TRANSUDATION of fluid into the Pulmonary interstitium |
| The transudation of of fluid into interstitium in HF, is represented respiratory as: | Areas of V/Q mismatch and Shunt leading to an overall decrease in Lung Compliance |
| Beta blockers block what enzyme in the kidneys leading to changes in RAAS? | Renin |
| What is the result in ATI, AT II, aldosterone, and sodium tubular reabsorption, when the patient is placed on Propranolol? | Decreased levels |
| What are the effects on Preload and Afterload in cases of AV fistulas? | - Increase in Preload -Decrease in Afterload |
| The increase of preload caused by an AV fistula causes: | Shunting of blood from Artery ---> Vein |
| AV fistulas cause a decrease in Afterload which is manifested by: | Reduce systemic vascular resistance |
| What are the changes in the Cardiac Volume-Pressure loop seen in a patient with an AV fistula? | Rightward expansion + Downward contraction |
| Milrinone inhibits which specific enzyme? | PDE-3 |
| What is the main effect of Milrinone? | Increase levels of intracellular cAMP in cardiac muscle and vascular smooth muscle |
| Increase of cAMP in cardiac muscle is seen with? | Milrinone |
| What is the result of increased intracellular cAMP levels in cardiac muscle? | Increase Cardiac contractility |
| Which medication causes an intracellular cAMP level increase? | Milrinone |
| What is the effect of elevated levels of intracellular cAMP in vascular smooth muscle, most commonly due to Milrinone therapy? | Decreased Peripheral Vascular resistance |
| What agent can be used to increase cardiac contractility and decrease Peripheral vascular resistance? | Milrinone |
| What is the key physical characteristic of Acute Bowel ischemia in physical examination? | Abdominal pain out of proportion to findings in Physical Exam |
| What is the MCC of Acute Bowel Ischemia? | Thrombotic Arterial Occlusion |
| What is the most commonly occluded artery in Acute Bowel ischemia? | Superior Mesenteric Artery (SMA) |
| What are some clinical manifestations of bowel ischemia? | 1. Small bowel necrosis 2. +/- Red "Currant jelly" stools 3. Abdominal pain out of proportion to findings in PE |
| Bowel necrosis and abdominal rebound tenderness. Dx? | Acute Bowel Ischemia |
| What are the clinical features of Pericarditis? | Precordial chest pain, friction rub, diffuse ST-segment elevation on ECG, pulsus paradoxus, and distant heart sounds |
| What is a common viral organism that causes Pericarditis? | Coxsackie B virus |
| To which family does Coxsackie B virus belong to? | Picornaviridae family |
| What is the genetic description of Picornaviridae viruses? | Small, naked, ss (+) linear RNA virus |
| Blood vessel radius is: | - Directly proportional to Blood Flow - Indirectly proportional to Resistance |
| What is the complication of "Monday Disease"? | Non-atherosclerotic-related cardiac ischemia |
| What are the best treatment of essential hypertension in African-Americans? | 1. Low-dose Thiazide diuretics, 2. Long-acting Calcium channel blokcers |
| PAN is a type ____ hypersensitivity reaction | 3 |
| What is the hypersensitivity reaction of PAN? | Type 3 hypersensitivity reaction |
| What kind of hepatitis infection is associated of PAN? | Hepatitis B |
| What is a common complication of untreated Rheumatic Heart Disease? | Mitral valve stenosis |
| The increase contractility seen with Digoxin causes: | Increased Cardiac Output (CO) = relieve CHF symptoms of fluid overload |
| Besides increased contractility, what other actions are performed by Digoxin? | 1. Increase ejection fraction 2. Decreases heart rate |
| What is the effect on Ejection fraction caused by Digoxin? | Increased |
| Tilting head/neck backwards causes fainting. Dx? | Subclavian Steal syndrome |
| What is Subclavian Steal syndrome? | Narrowing or blockage occurs in the SUBCLAVIAN artery PROXIMAL to the vertebral artery, vascular demand from the ipsilateral upper extremity can cause blood flow in a retrograde fashion. |
| When blood is shunted from vertebral artery back to the distal part of the Subclavian artery. Dx? | Subclavian Steal syndrome |
| What is a common type of emboli seen in a patient with endocarditis? | Septic emboli |
| What is a possible ocular complication of an endocarditis-induced septic emboli? | Central retinal artery occlusion |
| How is Central Retinal artery occlusion often described? | Painless, acute macular vision loss |
| What are the common fundoscopic findings of Central retinal artery occlusion? | Retna cloudy with attenuated vessels and "cherry-red" spot of fovea (center of macular). |
| In Aortic Stenosis, which chamber pressure is the most affected? | Left VENTRICULAR pressure is greatly elevated due to stft aortic valve leaflets |
| Wheres is the main chamber pressure elevation seen in Mitral regurgitation? | Left atrium (LAP) |
| What are the cardiac effects of alpha-1 adrenoceptor stimulation? | 1. Increase Vasoconstriction 2. Increase in Blood Pressure 3. Decrease mucosal edema |
| Blockage of alpha-1 adrenoreceptors will cause: | Vasodilation and a decrease in BP |
| B-1 adrenoreceptor stimulation causes: | 1. Increase cardiac contraction force 2. Tachycardia |
| What are the effects of B-1 receptor inhibition? | Decrease cardiac contraction force and bradycardia |
| B-2 adrenoreceptor agonist causes: | Bronchodilation |
| Why is a B-2 blocker contraindicated in asthmatic or COPD patients? | It will cause bronchonstiction |
Created by:
rakomi
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