Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NPLEX II TIA > Cardiovascular & Intro to Blood Chemistry > Flashcards

Cardiovascular & Intro to Blood Chemistry Flashcards

1
Q

Which marker is more likely to rise during early MI; ALT or AST?

A

AST; “A sick heart can beat f-AST”

L is for Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CPK elevation indicates what?

A
  • often done to document acute MI; after 12 hours but before 24 hours
  • CPK-MB can also be elevated with PE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is LDH released by cells?

A

Increased amounts of hypoxic metabolism; reduces lactate back to pyruvate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is your first step after an elevated LDH?

A

Fractionate the LDH; multiple conditions with tissue damage cause elevated LDH and you need to differentiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What LDL isoenzyme ratio is seen in MI?

A

LDH-1 > LDH 2
(in normal states, LDH-1 is lower)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to differentiate liver dz from cardio pathology utilizing LDH isoenzymes?

A

in liver dz LDH < AST & ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

LDH may be up to 50x normal in what pathology?

A

pernicious anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What LDH isoenzyme is increased in muscle disease?

A

LDH-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Increased levels of homocysteine may indicate what?

A

increased myocardial risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most common cause of elevated ammonia (NH3) levels?

A

severe liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what would be markers consistent with methylation defects?

A

elevated MCV
low reticulocyte
hyper segmented neutrophils (5+)
high MMA
<200pg/mL B12 (can aso be low in pernicious anemia and alcoholism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

normal folate levels

A

200-640 ng/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

folate is decreased in which conditions

A

megaloblastic anemia and alcoholism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

folate is increased in which conditions

A

acute renal failure
liver dz
non fasting status (plasma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Apoprotein A1 vs B vs lipoprotein a

A

A1: >140, associated with HDL, higher = better
B: 70-110, associated with LDL; higher = more myocardial risk
a: indicateds CAD risk; <30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hyperlipidemia Genotypes (2 most common)

A

IV: most common
- chol 200+
- HDL = low, LDL = high
- TG > chol

II: second most common
- chol > 200
- TG normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does a higher level of LDL associate with inflammation?

A

LDL carry oxidants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Higher triglycerides carry an association with what other type of pathology

A

insulin - sugar biochemistry disorders (can’t burn fats and sugars at same time; if sugars are blocking transporter after carb ingestion, TG get released into blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

HMG-coA reductase inhibitors are what commonly used drug? how does blocking HMG-coA reductase cause a clinical effect?

A

statins; blocking the mevalonic to cholesterol pathway (also blocks coQ10 so need to replenish)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adverse effects of statins

A

GI distress
headache
dizziness
abdominal cramps
rash
liver toxicity
rhabdomyaloysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pre-prescribing and monitoring considerations for statins

A

check AST and ALT prior to rx and at 6 weeks post rx

monitor liver function

rx with 75-100 mg coq10 minimum

discontinue if pt has muscle pain concomitant to RX - EVEN if LFTs are normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

simvastatin MOA

A

HMG CoA reductase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

atorvastatin MOA

A

HMG CoA reductase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Lipitor/Atorvastatin typical and max dose

A

10-20 mg qd (in severe cases 40mg)

max dose 80 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Questran is what type of drug? What other name is it known by?

A

Cholestyramine; bile sequesterant used for hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cholestyramine/questran MOA

A

combines with bile acid to form an insoluble compound that is excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Cholestyramine/questran adverse effects

A

constipation
fecal impaction
abominal pain
nausea
def of fat soluble vitamins (reduces absorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What vitamin can be used as a lipid lowering agent? What is the MOA?

A

niacin; stimulates hepatic lipid metabolism; lowers TC/LDL/TG, raises HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

niacin adverse effects

A

niacin flush
rash
GI distress
liver toxicity (give with vit C to avoid hepatic effect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

which form of niacin is more hepatotoxic?

A

slow release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

dosing of niacin for hyperlipidemia

A

alone or with low dose statin
1500-2000mg daily
rx with vit c and high potency B complex (gram per gram)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

drugs that end in -fibrate are what type of drug? how are they dosed?

A

fibrates; TG lowering drugs
48-145 mg qd, max dose 145 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is lovaza?

A

high dose estherized omega 3 - 4 grams daily

TG lowering; alone or with statins in high/very high TG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Classifications of BP/HTN

A
  • normal: <120 AND <80
  • preHTN: 120-139 OR 80-89
  • stage 1: 140-159 OR 90-99
  • stage 2: 160+ OR 100+

systolic goes by 20 mmHg jumps, diastolic by 10 mmHg jumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

top causes of secondary HTN

A

renal artery stenosis
chronic renal dz
primary hyperaldosteronism
thyroid dz
pheochromocytoma
preeclampsia
aortic coarctation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

basic tests for HTN evaluation

A
  • urine for protein, blood, glucose, and microscopic exam
  • hemoglobin or hematocrit; leukocyte ct
  • serum potassium
  • serum calcium, phosphate
  • serum creatinine or BUN
  • fasting glucose
  • total, HDL, and LDL cholesterol; TGss
  • ECG
  • TSH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what are first line pharmaceuticals for HTN?

A

diuretics and beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

diuretics MOA

A

loop diuretics: affects the thick asc loop of henle (inhibits Na re-absorption)

thiazide diuretics: affects dital tubule/CD (Na reabsorption/excretion, Na-Cl cotrasnporter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

where do carbonic anhydrase inibibitors act?

A

proximal tubule of nephron and blocks HCO3 reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what diuretics are potassium wasting?

A

chlorothiazide (HCTZ)
furosemide (lasix)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

chlorothiazide MOA

A

inhibits sodium and chloride re-absorption in distal tubule = decrease GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

furosemide MOA

A

loop diuretic; inhibits sodium and chloride reabsorption in the loop of henle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

diuretic uses

A

HTN, edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what adverse effects do thiazide and loop diuretics have in common?

A

hypokalemia (potassium wasting)
hyperglycemia
oliguria
anuria
GI disturbance
hypercalcemia
hyperuricemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

adverse effects unique to thiazide diuretics

A

renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

adverse effects unique to loop diuretics/furosemide

A

ototoxicity
hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

CI thiazide diuretics

A

hypersensitivity to thiazide or sulfonamide drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what two diuretics/anti-hypertensives are potassium sparing?

A

triamterene and spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

triamterene MOA and uses

A

potassium sparing diuretic acting on distal tubules

HTN/edema (often used with HCTZ to balance k levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

spironolactone MOA and uses

A

aldosterone antagonist

HTN, edema, endocrine uses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

triamterene adverse effects

A

hyperkalemia
nausea/vomiting
diarrhea
may turn urine blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

spironolactone adverse effects

A

hyperkalemia
breast deformity/tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

list the antihypertensive drugs

A
  • beta blockers (-OLOL)
  • ACE inhibitors (-PRIL)
  • ARBS (-SARTAN)
  • Alpha2 central agonist (clonidine)
  • catecholamine agent (reserpine)
  • CCBs (all the rest)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what antihypertensive drug class ends in -OLOL

A

beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what antihypertensive drug class ends in -PRIL

A

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what antihypertensive drug class ends in -SARTAN

A

ARBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what antihypertensive drug is an alpha2 central agonist

A

clonidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what antihypertensive drug is a catecholamine agent

A

reserpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what are the two types/MOA of Beta blockers?

A

Specific, newer B1 adrenergic receptor blockers

Nonspecific, older B1 + B2 adrenergic receptor blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what are the specific B1 blockers?

A

atenolol
metoprolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what are the nonspecific B1& B2 blockers?

A

propanolol
carvediolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

specific B1 blocker uses

A

HTN, angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

specific B1 blocker adverse effects

A

fatigue
vertigo/dizziness
bradycardia
hypotensino
bronchospasm
CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

specific B1 blocker CIs/cautions

A

enhances effects of digitalis

abrupt discontinuation is dangerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

nonspecific B1 & B2 blocker uses

A

HTN, angina, arrythmias, migraines, essential tremors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

nonspecific B1 & B2 blocker adverse effects

A

fatigue
bradycardia
hypotension
nausea/vomiting
diarrhea
CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

nonspecific B1 & B2 blocker CIs/cautions

A

abrupt discontinuation is dangerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is a general guideline on if a drug may require a tapering schedule?

A

if it has a significant suppresive effect on physiology; rebound sx or bronchospasm may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

types of ca channel blockers

A

verapamil
diltiazem
amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

CCBs uses

A

angina, HTN
afib/flutter (-zems)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

CCB (-ils) adverse effects

A

constipation
hypotension
dizziness
edema
nausea
CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

CCB (-zems) adverse effects

A

headache
edema
dizziness
arryhtmias
CHF
nausea
constipation
rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

CCB (-pines) adverse effects

A

dizzinesss
CHF
MI
edema
headache
weakness
nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

CCB CI/cautions

A

AVOID IN CHF (AE), pregnancy

ils/zems: increased levels with cimetidine

-pines: capsule passed in stool, medicine released in gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

angiotensin agents are all potassium-___

A

sparing (downstream block of aldosterone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

ACE-is names

A

lisinopril
ramipril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

ACE-is uses

A

HTN
HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

ACE-is adverse effects

A

dry persistent cough
hyperkalemia
angioedema
tachycardia
hypotension
urticaria
rash
renal dysfunction
headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

ACE-is CI

A

pregnancy (potential effect on fetal lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

ARBs drug names

A

valsartan
irbesartan
losartan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

ARBs MOA

A

blockage of ang-2 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

ARBs uses

A

HTN in those with ACE intolerance due to cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

ARBs adverse effects

A

hypotension
renal dysfunction
hyperkalemia (reabs Hcl, excretes K)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

clonidine MOA / uses

A

stimulates alpha 2 adrenoreceptors in brain stem ; emergency BP lowering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

reserpine/rauwolfia MOA

A

peripheral anti-adrenergic; depletes catecholamines tores in PNS (and maybe CNS)

86
Q

reserpine/rauwolfia adverse effects

A

drowsiness
sedation
nervousness
depression
dec HR
nasal congestion
nausea/diarrhea
PS predominance
DEPRESSION/SUICIDALITY

87
Q

**

reserpine/rauwolfia CI/cautions

A

do NOT administer MAO inhibitors and reserpine within 2 weeks of each other

88
Q

standard dose of reserpine

A

.1- .25 mg qd to bid

89
Q

The cause of heart failure is the area that the heart is ____. The sx are ___.

A

The cause of heart failure is the area that the heart is pumping into. The sx are the area drained into the side of heart.

right heart (causes: pulm, left heart; sx: JVD)
left heart (causes: CAD, sys HTN; sx: pulm edema/HTN, rhonchi)

90
Q

classification of CHF

A

A: RFs
B1: left ventricular dysfunction
B2: mild limitations, fatigue, dyspnea with normal activities
C: moderate limitations, sx with ADL
D: severe, sx at rest

91
Q

sx of CHF

A

dyspnea on exertion
paroxysmal nocturnal dyspnea
orthopnea

92
Q

diagnostic tool used in CHF

A

echocardiogram
- distinguishes systolic and diastolic dysfunction
- identifies underlying valve disease or ischemic heart damage
- quantifies CHF severity
- assess chamber sidze, EF, wall thickness

93
Q

adaptive mechanisms in CHF

A
  • ventricular dilation > inc diastolic pressure and PE (L HF) and/or systemic edema (R HF)
  • reduced kidney blood flow > inc salt/water retention > inc blood volume > inc HBP > inc afterload
  • symp stimulation > peripheral tissue blood to heart > inc BP
  • tachycardia and inc contractility
94
Q

left CHF sx

A

DOE
chronic dry cough
fatigue
teachycardia, cardiac asthma, rust sputum, rales, displaced apical impulse, nocturia, pallor, low BP

95
Q

right CHF sx

A

fatigue
distended neck veins
pedal/pitting edema
ascites
large liver
triscupid regug
orthopnea
PND

96
Q

pathologies that produce right CHF sx

A

lung dz
pul embolus
volume overload
mitral stenosis

97
Q

what is cor pulmonale

A

pulmonary heart dz; right ventricular hypertrophy and eventual failure from pulmonary dz

98
Q

causes of cor pulmonale

A

COPD
pulm fibrosis or emboli
scleroderma
primary pulm HTN
alveolar hypoxia

99
Q

cor pulmonale sx

A

chronic cough
exertional dyspnea
wheezing
fatigue
weakness
cyanosis
clubbing
epigastric pulsations
hepatomegaly
polycythemia

100
Q

what is the ankle brachial index used for?

A

assessing peripheral/vascular disease

101
Q

normal achkle-brachial ratio vs PVD

A

> 0.95 is normal
< 0.95 = PVD

102
Q

if a carotid bruit is heard on examination, what would be your next step?

A

carotid ultrasound

103
Q

a carotid bruit is indication of what

A

stenosis by atherosclerotic plaque; increased risk of stroke at 1 year

104
Q

name the large-vessel vasculitis’

A

giant cell arteritis
takayasu’s disease

105
Q

name the medium-vessel vasculitis’

A

polyarteritis nodosa
kawasaki’s disease

106
Q

name the small-vessel vasculitis’

A

ANCA associated SV vasculitis
non-ANCA SV vasculitis

107
Q

Small vessel vasculitis will often present as what?

A

dermatologic presentation; palpable purura > 24 hours, urticaria

with systemic sx

108
Q

most common etiology of aortic aneuryms

A

atheroma
most are adominal

109
Q

signs/sx aortic aneurysm

A

pain in abdomen or low back
<5 cm asx
pulsatile mass with tenderness and bruit over mass

110
Q

where does aortic dissection occur?

A

asc aorta

111
Q

what is aortic dissection caused by?

A

a break in the intima allowing blood to flow in a plane between the media and adventitia

112
Q

signs/sx aortic dissection

A

severe chest or neck pain, may radiate to back and later abdomen

peripheral pulses and BP may be unequal

syncope, hemiplegia, paralysis of lower extremities may occur

113
Q

what imaging is best for aortic dissection?

A

CT and transesophageal echocardiography

114
Q

pain that is sharp, constant, and unrelated to movement is typically associated with what pathology?

A

aortic dissection

115
Q

signs/sx of atrial tachycardia/SVT

A

originate at atrial pacemarker at rate of 140-250 / min
QRS narrow but shape normal
common

116
Q

signs/sx of atrial flutter

A

originate at atrial pacemarker at rate of 240-340 / min but some are blocked at AV node; multiple p waves “irregularly irregular”

saw tooth like deflections (flutter waves)

palpitations, sweating, weakness, dizziness, syncope

117
Q

differentiating if extra beats are atrial or ventricular

A

if there is a P wave = extra beat from atria

no P wave, bizarre complexes = ventricular

118
Q

ventricular fibrillation

A

multiple sites in ventricle fire impulses in uncoordinated fashion; terminal

119
Q

presenting sign of heart block

A

sudden onset of syncope

120
Q

what types of murmurs are almost always indicative of heart disease?

A

diastolic murmurs

121
Q

what might a midsystolic murmur indicate?

A

aortic/pulmonic stenosis

122
Q

what might a pansystolic/holosystolic murmur indicate?

A

mitral/tricuspid regurg
VSD

123
Q

what could a diastolic rumble murmur indicate?

A

mitral stenosis

124
Q

what could a decrescendo-immeidate diastolic mumur indicate?

A

aortic regurgitation

125
Q

in what situations would thrombolysis be indicated?

A

arrythmias
prosthetic valves
hypercoaguable (thick) blood: high fibrinogen, dehydration

126
Q

warfarin (coumadin) drug class and MOA

A

anti-thrombotic
vitamin K antagonist (extrinsic 2, 7, 9, 10)

127
Q

warfarin adverse effects

A

prolonged bleeding
hemorrhage
diarrhea
fever

128
Q

warfarin monitoring

A

monitor prothrombin time

129
Q

heparin drug class and MOA

A

anti-thrombotic (usually IV/inpatient)

inhibits clotting factors by binding to antithrombin 3 (AT3) and enhancing thrombin blockade of AT3

129
Q

heparin uses

A

prevention of DVT, embolism, DIC

130
Q

heparin adverse effects

A

hemorrhage, cutaneous necrosis, chills, pruritis, fever

131
Q

heparin CI/caution

A

caution with menstruating people, pts with liver dz, or pts with blood dz

132
Q

clopidogrel and aspirin MOA

A

antithrombics that prevent formation of platelet aggregating substance; thromboxane A2

133
Q

clopidogrel & aspirin uses

A

reduce risk of MI/stroke

134
Q

clopidogrel & aspirin adverse effects

A

salicylism (ASA)
GI distress
bleeding
tinnitus
rash
occult blood

135
Q

preventative aspirin dosing

A

75-162 mg
(avg is one baby aspirin 81 mg)

136
Q

classes of arrythmics

A

Class 1 & 3: specific to antiarrhytmics
class 2 & 4: also anti-hypertensives

137
Q

class 1 antiarrythmics

A

digoxin (glycoside)
lidocaine (blocks Na channels)
flecainide (blocks Na channels)

138
Q

digoxin MOA

A

inhibits sodium/potassium pump to inc intracellular calcium (ca drives the cardiac AP plateau)

139
Q

digoxin adverse effects

A

fatigue
arrthymias
muscular weakness
agitation
blurred vision
anorexia
nausea

140
Q

digoxin cautions

A

monitor blood levels; toxicity may be life threatening, can have flu like sx

yellow halo around vision may develop

monitor K levels (hypokalemia inc digoxin MOA)

141
Q

quinidine MOA

A

dec automaticity, conduction velocity; and prolongs refractory period

has anticholinergic effects

142
Q

quinidine adverse effects

A

arrythmia
nausea/vomiting
diarrhea
cichonism
fever
vertigo
headache

143
Q

quinidine caution/CI

A

prolongs QRS and QT intervals on EKG

144
Q

what is cinchonism?

A

toxicity of quinine and quinidine (cinchona alkaloids) causing meiniers like sx:
- tinnitus and hearing loss
- headache
- nausea
- dizziness/vertigo
- visual changes

145
Q

class II antiarrythmics

A

beta blockers

146
Q

class IV antiarrythmics

A

CCBs

147
Q

class III antiarrythmics

A

amiodarone

148
Q

amiodarone MOA

A
  • delay in repolarization
  • prolongation in AP
  • slowing of electricl conduction
  • reduction in SA node fct
  • dec conduction through accessory pathways

K channel blocker

149
Q

amiodarone adverse effects

A

common to have significant side effects

most significant: lung toxicity
hyper/hypothyroid
AV nodal block
bradycardia

rare: liver toxicity

150
Q

CCBs and BBs are used for what purposes within cardiology?

A

anti-hypertensive
anti-arrythmic
anti-anginal

151
Q

signs/sx endocarditis

A

petechiae on palate or conjunctiva on nail beds, splinter hemorrhages

cough, dyspnea, arthralgia, diarrhea, pallor, splenomegaly, abd/flank pain
murmurs

152
Q

dx endocarditis

A

blood cultures are definitive dx tool
echo confirms the vegetations

153
Q

how is ST segment elevation differentiated between an MI and pericarditis?

A

pericarditis: diffuse
MI: regional

154
Q

nitroglycerin relieves chest pain from what condition(s)

A

ONLY angina

155
Q

anti-anginal drugs

A

vasodilators
CCBs, BBs

156
Q

nitroglycerin MOA

A

inc blood supply to heart, dec preload and afterload

157
Q

nitroglycerin adverse effects

A

headache
dizziness
hypotension
tachycardia
bradycardia
rash

158
Q

amyl nitrate uses and MOA

A

anti-anginal: unknown; thought to be dilution of arterial and venous system

antidote for cyanide poisoning

159
Q

NTG acute angina dosing

A

1 SL tablet every 5 mins for 3 doses

160
Q

what other supplements may be used for angina?

A

L-arginine
magnesium glycinate
zinc

161
Q

MI sx occur ____
(constantly, occassionaly, cyclically)

A

cyclically; on a 3-5 min cycle

162
Q

MI workup: cardiac enzyme timeline

A

2-4 hours post MI: tropinin 1 inc
4-6 hours post: CK/MB inc
4-8 hours post: myoglobin inc
6-36 hours post: AST
12-48 hours post: LDH1 > LDH 2

163
Q

Class I antiarrythmics MOA

A

blockade of fast Na channels/delay in ventricular depolarization

164
Q

Class II antiarrythmics MOA

A

delayed atrial > ventricular depolarization

165
Q

Class III antiarrythmics MOA

A

blockade of potassium channels/delayed repolarization

166
Q

Class IV antiarrythmics MOA

A

delayed atrial > ventricular depolarization

167
Q

what type of drug are doxazosin and terazosin?

A

alpha 1 antagonists

168
Q

what drug acts as a sympathomimetic on the CV system? what are its uses?

A

epinephrine (beta agonist); HF, bradycardoa, cardiac stabilization before pacemaker implantation

169
Q

what type of drug is colesevelam? what does it do?

A

bile sequestrant; cholesterol lowering

170
Q

what type of drug is gemfibrozil? what does it do?

A

fibrate; lowers cholesterol/TG

171
Q

what drugs are the vasodilators?

A

hydralazine
nitroglycerin
isosorbide mononitrate

172
Q

potassium chloride uses

A

electrolyte (IV)

173
Q

BBs CI/cautions

A

AVOID in asthma, diabetes
taper d/c to avoid rebound HTN

174
Q

first choice drug class for HTN in pts over 55

A

CCB or thiazide diuretic

175
Q

for a pt under 55 with uncomplicated HTN, what would the first choice drug class be?

A

ACEis

176
Q

ARBs CI

A

pregnancy

177
Q

clonidine AEs

A

vasodilation
dec peripheral resistance (mental depression, swelling of lower limbs/feet)

178
Q

alpha 1 antagonists MOA

A

bind to alpha 1 rec > dec norepi > dec vascular resistance systemically

179
Q

alpha 1 antagonists AEs

A

syncope (first dose)
asthenia
rare priapism or ED

180
Q

alpha 1 antagonists uses

A

HTN, BPH

181
Q

adverse effects gemfibrozil

A

inc homocysteine
DVT
SOB
PE
hemopytsis

182
Q

MOA gemfibrozil

A

fibrate; inhibits liver uptake of FFas > inhibits VLDL secretion, may inc HDL

183
Q

digoxin CI

A

BB
CCB
antibiotics
verapamil
amiodarone
quinidine
K wasting diuretics

184
Q

vasodilators AEs

A

headache

185
Q

hydralazine caution

A

prolonged tx may cause lupus
depletes B6
intensifies hypotension with alcohol/other BP drugs

186
Q

nitroglycerin dosing

A

SL 1 tab every 5 mins, max 3 doses

187
Q

isosorbide mononitrate CI

A

phosphodiesterase inhibitors (sildenafil)

188
Q

potassium chloride caution

A

can cause death due to cardiac AP termination

189
Q

what herbs are used for angina?

A

allium sativa
crataegus oxycantha
leonarus cardiaca

190
Q

what herbs are used for atherosclerosis

A

allium cepa
allium sativum
ginkgo biloba

191
Q

what herbs are used for afib

A

convallaria majalis
leonarus cardiaca

192
Q

what herbs are used for atrial premature beats

A

crataegys oxycantha
leonarus cardiaca

193
Q

what herbs are used for capillary fragility

A

aesculus hippocastanum
arnica montana

194
Q

what herbs are used for CHF

A

convallaria majalis
crataegus oxycantha
digitalis purpura

195
Q

what herbs are used for chronic venous insufficiency

A

aesculus hippocastanum
centella asiatica
hamamelis virginiana
vaccinium myrtillus

196
Q

what herbs are used for edema

A

aesculus hippocastanum
taraxacum officinale

197
Q

what herbs are used for bradycardia

A

glycyrrhiza glabra
rosmarinus officinalis

198
Q

what herbs are used for hypotension

A

convallaria majalis
glycyrrhiza glabra

199
Q

what herbs are used for HTN

A

allium cepa (mild)
allium sativum (mild)
crataegus oxycantha
rauwolfia serpentina (severe)
veratrum viride (severe)

200
Q

what herbs are used for hyperlipidemia/dyslipidemia

A

allium sepa
allium sativum
cynara scolymus

201
Q

what herbs are used for post ischemic stroke recovery

A

ginkgo biloba
rosmarinus officinalis

202
Q

what herbs are used for raynaud’s dz

A

CV stimulants

capsicum frutescens
rosmarinus officinalis
rauwolfia serpentina
zingiber officinale

203
Q

what herbs are used for thrombophlebitis

A

aesculus hippocastanum
hamamelis virginiana

204
Q

what herbs are used for varicose veins

A

venous tonics
aesculus hippocastanum
centella asiatica
vaccinum myrtillus

205
Q

CV tonics

A

crataegus laevigata (hawthorn)
ginkgo bilboa

206
Q

positive inotropes/neg chronotrope herbs

A

convallia majus (lily of the valley)
digitalis purpurea (foxglove)

207
Q

rhythm balancing herbs

A

selenicerus glandiflorus (night blooming cerus/cactus grandiflorus)
leonurus cardiaca (motherwort)

208
Q

hypotensive herbs

A

Coleus forskohlii (coleus) – gentle
Olea europaea (olive)
Rauvolfia serpentina (Indian snakeroot) – potent
Veratrum viride (false hellebore), V. album – dangerous

209
Q

venous tonics

A

Aesculus hippocastanum (horse chestnut) – moderate
Hamamelis virginiana (witch hazel) – gentle
Vaccinium myrtillus (bilberry)

NPLEX II TIA (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions