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DIT cardiopathpharm
pt 1: HTN, anto-HTN drugs, atherosclerosis, chest pain, angina
| Question | Answer |
|---|---|
| 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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