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DIT cardiopathpharm

pt 1: HTN, anto-HTN drugs, atherosclerosis, chest pain, angina

QuestionAnswer
HTN + paroxysms of increased sympathetic tone: anxiety, palpitations, diaphoresis pheochromocytoma
HTN + age of onset between 20 and 50 primary/essential HTN
HTN + elevated serum creatinine and abnormal urinalysis renal disease
HTN + abdominal bruit renal a stenosis
HTN + BP in arms > legs coarctation of the aorta
family history of HTN primary/essential HTN
HTN + tachycardia, heat intolerance, diarrhea hyperthyroidism
HTN + hyperkalemia renal failure
HTN + episodic sweating and tachycardia pheochromocytoma
HTN + abrupt onset in a pt <20 or >50, and depressed serum K+ levels hyperaldosteronism
HTN + central obesity, moon-shaped face, hirsutism Cushings
HTN + nL urinalysis and nL serum K+ levels primary/essential
HTN in young individual w/ acute onset tachycardia stimulant abuse
HTN + hypokalemia hyperaldosteronism or renal artery stenosis
HTN + proteinuria renal disease
SE: first dose orthostatic hypotension alpha 1 blockers (-zosins)
SE: ototoxic (esp. with aminoglcosides) Loops (furosemide)
SE: Hypertrichosis minoxidil
SE: cyanide toxicity nitroprusside
SE: dry mouth, sedation, severe rebound HN clonidine
SE: bradycardia, impotence, asthmas exacerbation beta blockers
SE: reflex tachycardia Hydralazine, Nitros, minoxidil, CCBs
Cough Ace inhibitors
Avoid in pts with a sulfa allergy loops and thiazides (furosemide and HCTZ)
possible angioedema Ace inhibitors
possible development of drug induced lupus hydralazine
hypercalcemia, hypokalemia HCTZ
hyperkalemia Ace inhibitors, Arbs, potassium sparing diuretics
What antihypertensives are safe to use in pregnancy Hydralazine, Nifedipine, Labetalol, Nifedipine, Methyldopa
While on a ACE, a pt get's a cough. What should you replace it with and why? ARBS because they don't release bradykinin
SE: facial flushing niacin
SE: elevated LFTs, myositis statins and fibrates
SE: GI discomfort, bad taste Bile acid resins
Best effect on HDL niacin
Best effect on triglycerides/VLDL fibrates, followed by omega 3s
Best effect on LDL/cholesterol statins
Binds C diff toxin cholestyramine
50 y o man starts on lipid lowering medication. On first dose he gets rash, pruritis and diarrhea? name that drug Niacin
How can the flushing reaction of niacin be prevented ASA, take it before bed, it gets better with longterm use
What is the mechanism of cardiac glycosides (digoxin, digitoxin) block the Na+/K+ ATPase which causes decreased extracellular sodium, which increases Calcium into cells and increases contractility.
An abdominal aortic aneurysm is most like a consequence of what process? atherosclerosis
5 deadly causes of acute chest pain aortic dissection, unstable angina, MI, tension pneumothorax, pulmonary embolus
pt with HTN has acute, sharp, substernal pain that radiates to the back and progresses over a few hours. He dies. dx? aortic dissection
0-4 hrs post MI nothin'
4-24 hrs post MI contraction bands, early coag necrosis, release of enzymes, dark mottling
2-4 days post MI acute inflammation, dilated vessels, NPs, extensive coag necrosis, hyperemic
5-10 days post MI outer zone granulation, yellow, MP
10 days post MI scar tissue/ grey white
St segment elevation only during brief episodes of chest pain printzmetal's angina
patient is able to point to localize the chest pain using one finger musculoskeletal
chest wall tenderness on palpation musculoskeletal
rapid onset sharp chest pain that radiates to the scapula aortic dissection
rapid onset sharp pain in a 20 yo a/w dyspnea spontaneous pneumothorax
occurs after heavy meals and improved by antacids GERD or esophageal spasm
Sharp pain lasting hours/days that is somewhat relieved by sitting forward Pericarditis
Pain made worse by deep breating and/or motion musculoskeletal
Chest pain in a dermatomal distribution VZV - shingles
most common cause of non cardia chest pain Indigestion/GERD/musculoskeletal
acute onset dyspnea, tachycardia, and confusion ina hospitalized pt pulmonary embolus
pain began the day following an intensive new exercise program muscular
HS football game, young athlete collapses and dies immediately. Que paso? Hypertrophic cardiomyopathi
Most common cause of myocarditis in the US coxsackie virus. Also echovirus and influenza virus
Diffuse interstitial infiltrate of lymphocyte cells with myocyte necrosis myocarditis
opens K+ channels and hyperpolarizes smooth muscle resulting in relaxation of vascular sm muscle Minoxidil
non dihydropyridine CCB verapamil, diltiazem
block ca channels at pacemaker cells non dihydropyridine CCBs (verapamil, diltiazem)
dihydropyridine CCB nifedipine, amlodipine, felodipine, nicardipine, nisoldipine
act on vascular smooth muscle to cause venous dilation and decrease preload dihydropyridine CCBs (nifedipine, amlodipine)
ST segment elevation , T wave inversion, new Q waves, new LBBB EKG changes with MI
wall perfused with LAD anterior wall
wall perfused w LCX lateral wall
wall perfused w RCA inferior wall, posterior wall
EKG leads w LAD V1-V4, V5
EKG leads w LCX aVL, V5, V6
EKG leads with RCA (inf wall) II, III, aVF
Created by: kayjames
 

 



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