13 April wk6-C

Question 1

Enalapril

Answer 1

ACE Inhibitor (-pril’s)
ACEI’s are first line treatments for HTN in DM, renal failure, LVH (congestive heart failure)
SE: cough, angioedema, hyperkalemia
More effective in young caucasians

Question 2

Why does administration of ACEI’s in patients with bilateral renal artery stenosis cause acute renal failure?

Answer 2

Stenosis causes decreased perfusion to the kidneys. ANG II constricts efferent arteriole to maintain GFR and perfusion. Blocking ANG II rapidly reduces GFR and the kidney will fail.

Question 3

Amlodipine

Answer 3

Ca channel blocker (-pine’s)
Others are Nifedipine, Nicardapine, Felodipine, Isradipine, Diltiazem, Verapamil
Prevents contraction of smooth muscle causing vasodilation

Question 4

What are Ca channel blockers used for and what are the drugs in this class?

Answer 4

HTN, angina, arrhythmia
Drugs that end in -pine: Amlodipine, Nifedipine, Nicardapine, Felodipine, Isradipine, Diltiazem, Verapamil
SE: edema, gingival hyperplasia, dizziness, HA, flushing, palpitations
Use caution in CHF patients

Question 5

Patient has DM and HTN and is treated with a drug for HTN that results in a chronic cough. What drug class was used and what are the common drugs?

Answer 5

ACEI’s
Drugs end in -pril
Enalapril, Captopril, etc.

Question 6

Patient being treated for HTN found to have gingival hyperplasia, dizziness, flushing, and headache. What drug class? Caution use in what patients?

Answer 6

Ca channel blockers
Drugs end in -pine and also include Diltiazem, Verapamil
Caution in CHF patients

Question 7

When are beta blockers used?

Answer 7

Acute MI, CHF, HTN, arrhythmia, angina

Question 8

Adverse effects of beta blockers

Answer 8

Bradycardia, dizziness, HA, fatigue, hypotension, fainting, sexual dysfunction, bronchospasm

Question 9

Contraindications for beta blockers

Answer 9

Sinus bradycardia, heart block greater than first degree, sick sinus syndrome, cardiogenic shock, decompensated heart failure, asthma, COPD

Question 10

Clonidine

Answer 10

Centrally acting alpha-2 agonist reduces sympathetic outflow and causes vasodilation and decreased CO for lower BP

Question 11

Chlorthalidone

Answer 11

Thiazide diuretic

Prevents Na reabsoprtion in early distal tubule

Question 12

What can cause flash pulmonary edema?

Answer 12

Patients with bilateral pulmonary artery stenosis depend on ANG II to maintain GFR. If given an ACEI GFR drops causing renal damage, renal vasculature HTN, acute renal failure, and sudden pulmonary edema presenting with SOB

Question 13

Inheritance pattern for dwarfism achondroplasia

Answer 13

AD
Most common cause of dwarfism
Mutation in FGFR3, most often spontaneous, assoc. with increasing paternal age
Homozygous for the mutated gene is lethal

Question 14

What disease is caused by the parvovirus B19? What are the classic Sx and what are other significant conditions that it can cause?

Answer 14

Erythema infectiosum or 5th disease
Classically presents with a slapped cheek rash that becomes a lacy rash on extremities and body and has a fever
Can also cause symmetrical arthritis in adults, chronic anemia in immune compromised, aplastic crisis in sickle cell, and hydrops fetalis

Question 15

What is hydrops fetalis?

Answer 15

Accumulation of fluid in at least two compartments in a fetus including: subQ/scalp, pleura, pericardium, abdomen
Type of fetal CHF
Often from anemia in the fetus
Rh disease is a type of immune cause of anemia leading to this

Question 16

Describe exanthem subitum

Answer 16

Also called Roseola Infantum
Being an exanthem it exhibits a rash that is macular, pink, non-puritic, also have high fevers
Caused by HHV-6
Often in young kids around 2y