Save
Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't know
Remaining cards (0)
Know
0:00
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

ADHF

Acute decompensated heart failure

QuestionAnswer
What stage are patients with persistent/refractory symptoms despite oral therapy based on ACC/AHA staging system? Stage D
What class are patients that experience symptoms with mild or moderate exercise based on NYHA functional class? III(mild)-IV(moderate)
What are possible causes for ADHF? -Lifestyle/Medication non-adherence -Acute insult(AFib, acute coronary syndrome) -Disease progression
What is the body response to ADHF? Activation of RASS(increase in sodium & water retention -> preload) and SNS(incrase in SVR->afterload); arginine vasopressin secretion -> free water retention -> hyponatremia
How is ADHF diagnosed? -Dyspnea -BNP > 100 pg/mL
Reasons for false BNP elevation(2) -Pneumonia -Pulmonary embolism
Use of pulmonary artery catheter/swan ganz catheter help improveoutcomes) T/F) False
What are indications for PAC(3)? -Patients not responding to initial therapy -Pts whose volume status cannot be determine by hx of physical examination -Pts experiencing hemodynamical instability during tx
How are pts with CI < 2.2 L/min/m2 classified? Cold
How are pts with CI> 2.2 L/min/m2 classified? Warm
How are pts with PCWP of > 18 mmHg classified? Wet
How are pts with PCWP of 15 - 18 mmHg classified? Dry/Euvolimic
What is a normal PCWP? 6-12
What is a normal value for SVR measured using PAC? 800-1200 dyne*sec*cm5
What values of SVR are considered a vasoconstricted state? >1200 dyne*sec*cm5
What values of SVR are considered a vasodylated state? <800 dyne*sec*cm5
Clinical presentation of pulmonary edema? Crackles, hypoxemia, dyspnea, orthopnea, elevated PCWP
Clinical presentation of peripheral edema? Ascites, hepatomegaly/hepatojugular reflux
Goal of treatmet of ADHF? Restoration of hemodynamical stability and correction of fluid overload
When should beta blockers be d/c in the setting of ADHF? Cardiogenic shock or clinically significant hypotension
If a pt presents with ADHF and acute kideny injury which medications should be discontinued? RAAS, digoxin(renally excreted --> acumulation)
Why might ACE/ARBs and MRA be stopped? Decreased urine output might mean higher risk for hyperkalemia if already hyperkalemic upon admission.
What are three common vasodilators? Nitroglycerin, nitroprusside, nesiritide
What is the place in therapy of IV vasodilators? Persistent ADHF despite aggressive treatment with diuretics in the absence of hypotension(SBP < 90 mmHg)
Nitroglyerin effect at high vs low dose? Low dose: Venous dilation --> decreased preload High dose: Arterial dilation --> decreased SVR --> increased CI MOA: Nitric oxide donor
When should we expect tolerance development from Nitroglycerin? After 12 hours(might need to increase dose)
What is Nesiritide MOA? Recombinant BNP which promotes natriuresis, venous and arterial vasodilation.
What is Nitroglycerin MOA? Nitric oxide donor
Place in therapy of IV ionotropes Diuretic refractory patients with low CO or symptoms of hypo perfusion.
Mechanism of action of Dobutamine? Non-selective beta agonist with alpha 1 adrenergic agonist effects.
Mechanism of action of Milrinone? PDE3 inhibitor
What are major cardiovascular concerns with ionotropes? Arrhythmias: Sinus tachycardia, ventricular tachycardia, Afib
Created by: olimac
 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards