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Cardiology Flashcards

1
Q

BP equals

A

heart rate x SV x PVR

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2
Q

cardiac output equals

A

heart rate x stroke volume

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3
Q

as one ages what is a risk with blood pressure

A

systolic hypertension

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4
Q

What is hypertension?

A

a complex disease with core defet of vascular dysfx that leads to select target organ damage

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5
Q

What does Tx of HTN do?

A

minimizes risk for target organ damage

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6
Q

Organs affected by HTN

A

brain
cardiovascular system
kidney
eye (optic disk)

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7
Q

Affect of HTN on brain

A

stroke

vascular dementia

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8
Q

Affect of HTN on cardiovascular system

A

atherosclerosis
MI
left ventricular hypertrophy
heart failure

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9
Q

Affect of HTN on kidney

A

hypertensive nephropathy

renal failure

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10
Q

Affect of HTN on eyes

A

hypertensive retinopathy

risk of blindness

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11
Q

How is hypertensive retinopathy graded

A

1-4

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12
Q

grade 1 retinopathy

A

narrowing of terminal branches

no visual changes

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13
Q

grade 2 retinopathy

A

local constriction of vessels

no vision changes

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14
Q

grade 3 retinopathy

A

striate hemorrhages and soft yellow exudate

visual changes

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15
Q

grade 4 retinopathy

A

papilledema

visual changes

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16
Q

What are the lifestyle changes to encourage for HTN

A 
weight reduction
DASH diet
Na restriction
exercise
limit alcohol consumption
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17
Q

Diuretics for HTN

A

HCTZ
chlorthalidone
it is used to lower sodium depletion that leads to PVR reduction

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18
Q

Caution of diuretics

A

can have a neg impact on dyslipidemia and glucose control if dose is over 25mg

monitor for Na, K and Mg depletion

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19
Q

Beta- adrenergic antagonists for HTN

A

“lol” medications: atenolol

works to block andrenergic beta receptor sites, blunt catecholamine response and are non cardioseletive

you have B2 in your 2 lungs and periphery

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20
Q

Caution of Beta adrenergic antagonists

A

in heart block
lower dose for COPD, asthma
taper to discontinue

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21
Q

Alpha adrenergic antagonists for HTN

A

carvedilol
labetalol

works on all BP componets (alpha and beta)

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22
Q

when is it good to use alpha adrenergic

A

less insulin resistance

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23
Q

ACE inhibitors for HTN

A

“prils”

take time to work no instant

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24
Q

ARBS for HTN

A

“sartan”

25
Q

direct renin inhibitor for HTN

A

aliskiren

26
Q

Caution with ACE ARBS and DRI’s

A

not in bilateral renal artery stenosis
risk for hyperkalemia
angioedema risk
Cate D in pregnancy

27
Q

Calcium channel blockers for HTN

A

amlodipine
diltiazem
verapamil

cause vasodilation and decrease HR
work quicker

28
Q

Caution with calcium channel blockers

A

ankle edema

heart failure, renal or hepatic impairment

29
Q

Aldosterone antagonists for HTN

A

spironolactone
eplerenone

blocks effects of aldosterone
better regulator of Na and water homeotostasis

30
Q

Caution with aldosterone antagonists

A

hyperkalemia risk esp with ACE and ARB

used in heart failure tx
gynecomastia risk

31
Q

Centrally acting agents for HTN

A

clonidine
methyldopa

works on brain BP control center

32
Q

Caution with centrally acting agents

A

sedation

can have rebound htn if you stop

33
Q

BP goal age 60 and >

A

<150/90

34
Q

BP goal age <60

A

<140/90

35
Q

BP goal in someone with DM

A

<140/90

36
Q

BP goal in someone with kidney disease

A

< 140/90

37
Q

beginning med tx for non black person with htn

A

diuretic
ACE
ARB
CCB if needed

38
Q

beginning med tx for black person with htn

A

diuretic
CCB
need higher doses of ACES

39
Q

When starting someone on spironolactone have them back to check

A

Potassium

40
Q

What can be a herbal remedy for HTN

A

cumin and coriander

41
Q

What does a person need to do before having lipid panel drawn

A

fast for 12 hours

42
Q

Lifestyle changes for dislipidemia

A

reduce sat fats
increase omega 3s
weight management
physical activity

43
Q

HMG CoA reductase inhibitors for tx of dislipidemia are

A

“the statins”

44
Q

Use of statins for dislipidemia

A

power house medication
lowers LDL by 18-55%
hepatic enzymes prior to start
caution with grapefruit juice

rhabdomyolysis and myositis are adverse effects so don’t use in dose over 80mg

45
Q

Bile acid resins in dislipidemia

A

cholestyramine
colestipol

could increase TG
no hepatic monitoring required
take 2 hours apart from other meds
can have GI s/e

46
Q

use of cholesterol absorption inhibitor with dislipidemia

A

ezetimibe

most often used in combo with a statin for LDL lowering

no need to adjust with decreased hepatic fx

47
Q

use of niacin with dislipidemia

A

vasodilator

used to decrease TG
minimal effect on LDL

can cause flushing, hyperglycemia, hyperuricemia
not in liver disease, gout or ulcers

48
Q

Use of fibric acid derivatives in dislipidemia

A

fenofibrate
gemfibrozil

for lowering TG and increasing HDL
LDLs can increase

if takin with a statin can increase risk of dyspepsia, gallstones and myopathy

49
Q

Fish oil with dislipidemia

A

omega 3
decrease TG by 20-30%

increased risk of bleeding
GI upset

50
Q

How often should you do ASCVD risk factor for someone 40-75 with no co morbidities

A

every 4-6 years

51
Q

low intensity statin therapy examples

A

LDL reduction < 30%

pravastatin 10-20mg
lovastatin 20mg

52
Q

moderate intensity statin therapy

A

LDL reduction 30-49%

lovastatin 40mg
pravastatin 40-80mg

53
Q

High intensity statin therapy

A

LDL reduction >50%

atorvastatin 40-80mg
rosuvastatin 20-40mg

54
Q

LDL goal in someone with very high risk

A

someone with early MI and genetic lipid disorder

<70

55
Q

LDL goal in someone with CHD, or DM

A

< 100***

56
Q

LDL goal with someone with > 2 risk factors

A

<130

57
Q

LDL goal with someone with 0-1 risk factors

A

<160

58
Q

What is the lipid goal for a man with DM and HTN

A

HDL >45

LDL<150

59
Q

What are 3 potential causes of hypertriglyceridemia

A

untreated hypothyroid
poorly controlled DM
excess alcohol use

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