Cardiolo1 Flashcards
What 2 mechanism leads to volume overload?
Systolic dysfunction (CM, MI, IHD...) Volume overload (MR, AR..)
What 2(early and late) mechanisms make the patient asymptomatic in case of volume overload?
1) Early–Frank starling force–increase contractility
2) late–Eccentric hyperthrophy–increase compliance and contractility
How do they help?
Increase cardiac output
When become symptomatic?
Eccentric .H–Maladaptive(increase wall stress)–myocardial dysfunction—HF symptom
How is MI related to arterial embolism?
Large MI–Aneurysm–ballooning during contraction and formation of thrombus.
Risk factor?
Delay in tx of MI (>8 hr)
How we diagnose?
Transthoracic echocardiography.
HIT?
Commonly occur in 5-10 days of treatment.
venous thrombosis is more common
How is the warfarin(coumarin) effect altered?
Diet,Antibiotic,acetaminphen and cyp450 afecting drug.
Diet how?
Green vegetables–increase substrate for Vit K dependent clotting factor–decrease its effect
Antibiotics how?
Decrease GI bacteria synthesize VIT K–increase toxicity.
Acetaminophen how?
Alter recycling of Vit K in liver–increase warfarin toxicity risk.
CYP450 affecting drug?
two class
Make increase CYP450 activity?
Carbamazepin phenitoin Phenobarb Rifampin st.jhon swart
Make Decrease CYP450 activity?
Antibiotics(Macrolide and metrindazole) Azoles Amiodarone cimetidine grapefruit juice