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MIDTERMS COVERAGE > CARDIOVASCULAR SYSTEM > Flashcards

CARDIOVASCULAR SYSTEM Flashcards

1
Q

Cardiovascular System has

A

-Heart
-Blood
-Blood vessels

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2
Q

The heart is a

A

PUMP

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3
Q

It pumps blood through a system of

A

Blood vessels that has a limited volume capacity

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4
Q

Maintains regular rate and rhythm

A

Electric conduction system

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5
Q

When the heart can no longer pump enough blood to meet the metabolic demands of the body

A

Heart Failure

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6
Q

When blood volume is great compared to the space available inside blood vessels

A

Hypertension

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7
Q

When the electrical conduction pathway malfunction

A

Arrhythmia

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8
Q

The heart’s way of signaling that some of the cells are not getting enough oxygen

A

Angina

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9
Q

When oxygen-starved areas of the heart begin dying

A

Myocardial Infarction

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10
Q

Cardiovascular Drugs

A

Anti-hypertensives
Drugs for Heart Failure
Anti-anginal and Drugs for MI
Anti-arrhythmic Agents

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11
Q

Determinants of Blood Pressure

A

-Cardiac Output
-Stroke Volume
-Heart Rate
-Fluid Content of Blood
-Total Peripheral Resistance

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12
Q

-Volume of blood pumped out by the heart in 1 minute

-Approximately 2.2 - 3.5 L/min/m2 BSA

-Determined by Stroke Volume (SV) and Heart Rate (HR)

A

Cardiac Output

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13
Q

-Volume of blood pumped out by the heart in every contraction

-Determined by inotropic activity and venous return

A

Stroke Volume

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14
Q

Strength of cardiac contraction

A

Inotropic activity

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15
Q

Cardiac preload; amount of blood delivered to the heart from the veins; affected by the tone of the veins

A

Venous Return

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16
Q

Speed of Heart Contraction

A

Heart Rate

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17
Q

Resistance or pressure encountered by the heart as it pumps out blood into the peripheral circulation (cardiac afterload)

A

Total Peripheral Resistance (TPR)

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18
Q

The period during which the ventricles are contracting

A

Systole

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19
Q

The period during which the ventricles are relaxed and filling with blood

A

Diastole

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20
Q

Hypertension with no identifiable cause

A

Essential Hypertension

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21
Q

Resulting from identifiable causes

A

Secondary Hypertension

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22
Q

Firs Line treatment of Hypertension

A

Diuretics and beta blockers

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23
Q

Alternative treatment of Hypertension for px who cannot tolerate first line agents

A

ACE inhibitors
ARBs
Alpha Blockers
Calcium Channel Blockers

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24
Q

Anti-Hypertensive Drugs

A

-Diuretics
-Sympathoplegics
-Vasodilators
-Calcium Channel Blockers (CCBs)
-ACE inhibitors
-Angiotension II Receptor Blockers (ARBs)

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25
Q

Agents that cause urinary loss of Na+ and H20

A

Diuretics

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26
Q

Five Major Classes

A
  1. Thiazides and thiazide-like
  2. Loop Diuretics
  3. Potassium-sparing
  4. Carbonic anhydrase inhibitors
  5. Osmotic diuretics
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27
Q

Carbonic Anhydrase Inhibitors

A

Acetazolamide
Brinzolamide
Dorzolamide

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28
Q

Side Effects of Carbonic Anhydrase Inhibitors

A

-metabolic acidosis
-bone marrow depression (sulfonamide-like toxicity)
-allergic reactions (Stevens-Johnson’s Syndrome)

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29
Q

-aka high ceiling diuretics

-act on the thick ascending Loop of Henle

A

Loop Diuretics

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30
Q

Loop Diuretics Drugs

A

Furosemide
Bumetanide
Torsemide
Ethacrynic Acid

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31
Q

Side effect of this drugs include hypovolemia, ototoxicity, increase serum creatinine

A

Loop Diuretics

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32
Q

-Bicarbonate is lost in the urine
- INCREASED calcium excretion (Hypocalcemia)

A

Hypokalemia

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33
Q

This side effects are due to the electrolyte imbalances

A

Ototoxicity

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34
Q

Thiazide Diuretics Drugs

A

-Chlorothiazide
-Hydrochlorothiazide
-Chlorthalidone
-Indapamide

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35
Q

-First line drug for uncomplicated hypertension as recommended by JNC 7

-Effective initial therapy together with beta-blockers

-Also used for Nephrogenic Diabetes

A

Thiazide Diuretics

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36
Q

Side effects of Thiazide Diuretics

A

Hypokalemia
Hyponatremia
Hyperuricemia
Hyperglycemia
Hyperlipidemia

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37
Q

Decreased calcium excretion

A

Hypercalcemia

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38
Q

Decreased uric acid secretion

A

Hyperuricemia

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39
Q

Potassium-Sparing Diuretics

A

Spironolactone
Eprenolone
Amiloride
Triamterene

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40
Q

For patients where potassium loss is significant and supplementation is not feasible

A

Potassium-Sparing Diuretics

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41
Q

Potassium-Sparing Diuretics Precaution

A

Avoid in px with acute renal failure

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42
Q

Potassium Rich Foods (TOPP PNBB’s)

A

T-Tomatoes
O-Oranges
P-Peaches
P-Potatoes
P-Prunes
N-Nuts
B-Banana
B- Broccoli
S- Spinach

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43
Q

Side effects of Potassium-Sparing Diuretics

A

-Hyperkalemia
-Gynecomastia
-Impotence
-Sterility

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44
Q

Increase the osmotic pressure at the proximal convoluted tubule and Loop of Henle preventing water reabsorption

A

Osmotic Diuretics

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45
Q

Osmotic Diuretics Drugs

A

-Mannitol
-Sorbitol
-Urea

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46
Q

Sympathoplegics drugs

A

Centrally Acting
Peripherally-acting
Alpha-1 Blockers
Beta Blockers

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47
Q

Centrally-Acting Sympathoplegics

A

-Clonidine (Leading to vasodilation)
-Methyldopa
-Guanfacine
-Guanabenz

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48
Q

Used in the management of HTN in pregnancy (pre-eclampsia, eclampsia)

A

Methyldopa

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49
Q

Indicator of a possible immune-mediated hemolytic anemia

A

Coomb’s Test

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50
Q

Peripherally-Acting Sympathoplegics

A

Trimethaphan
Reserpine
Guanethidine
Guanadrel

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51
Q

-Ganglionic receptor blocker
-Given via IV infusion
-Used in hypertensive emergencies caused by pulmonary edema or aortic aneurism when other agents cannot be used

A

Trimethaphan

52
Q

-Plant alkaloid
-Inhibits catecholamine (NE, Epi, Dopamine, Serotonin) storage

A

Reserpine

53
Q

Alpha 1 Blockers Drugs (ends with sin)

A

Prazosin
Doxazosin
Alfazosin
Terazosin

54
Q

Inhibit the alpha-1 receptors, resulting to vasodilation of arteries and veins

A

Alpha-1 Blockers

55
Q

Used for initial therapy of HTN; effective for patients with rapid testing HR or concomitant IHD

A

Beta Blockers

56
Q

Beta Blockers contraindicated to:

A

Patients with bronchospastic disease:

COPD
Bronchial Asthma

57
Q

Beta Blockers Selective Drugs “olol” (BBEAAM)

A

B-Betatoxol
B- Bisoprolol
E- Esmolol
A- Acebutolol
A-Atenolol
M- Metoprolol

58
Q

Beta Blockers Membrane Stabilizing Activity (PPALM)

A

P-Proponolol
P- Pindolol
A-Acebutolol
L-Labetalol
M- Metoprolol

59
Q

-Second line Agents

-Directly relax the peripheral vascular smooth muscles

A

Vasodilators

60
Q

Common S/E of Vasodilators

A

-Reflex tachycardia
-Peripheral edema

61
Q

Vasodilators drugs

A

-Hydralazine
-Diazoxide
-Minoxidil
-Sodium Nitroprusside

62
Q

Used in the management of HTN in pregnancy

A

Hydralazine

63
Q

Used in the emergency treatment of hypertensive crisis

A

Diazoxide

64
Q

1st line drug for almost all types of HTNsive emergencies

A

Sodium Nitroprusside

65
Q

Sodium Nitroprusside must protect from

A

LIGHT

66
Q

Alternative for the mgt of HTN

A

CALCIUM CHANNEL BLOCKERS

67
Q

block CA channels in the blood vessels

A

Dihydropyridine

68
Q

Block CA channels both in the heart and blood vessels

A

Non-Dihydropyridine

69
Q

Short acting drugs for ACE Inhibitors

A

Captopril

70
Q

Long Acting Drug for ACE Inhibitors

A

Enalapril
Lisinopril
Perindopril

71
Q

Direct inhibitors of angiotensin II receptors

A

Angiotensin II Receptor Blocker (ARBs)

72
Q

What kind of drugs is this:

Losartan
Valdesartan
Candesartan

A

ARB or Angiotensin II Receptor Blocker

73
Q

-Is the failure of the heart as a pump

-Inability of the heart to pump sufficient amount of blood to the body

A

Congestive Heart Failure

74
Q

-uncommon
-caused by excessive need for cardiac output
-high metabolic demands

A

High-output

75
Q

-caused by disorders that impair the pumping ability of the heart (IHD)
-normal, metabolic demands, heart unable to meet them

A

Low-output

76
Q

-long Term compensatory mechanism

-increased in the number of contractile elements in myocardial cells as a means of increasing their myocardial performance

A

Myocardial Hypertrophy

77
Q

is the intrinsic ability of the heart to adapt to changing volumes of inflowing blood

A

Frank-Starling Mechanism

78
Q

Drugs for CHF

A

-Inotropic Agents
-Unloaders

79
Q

Inotropic Agents

A

Cardiac glycosides
Beta Agonists
Phosphodiesterase Inhibitors

80
Q

Unloaders

A

ACE Inhibitors & ARBS
Beta Blockers
Diuretics
Vasodilators

81
Q

From digitalis species

A

Cardiac Glycosides

82
Q
  • -75% Bioavailable
    –half-life: 36-40 hours
    –20-40% protein bound
    –excreted in the urine
A

Digoxin

83
Q

->90% Bioavailable
–half-life: 168 hours
–>90% protein bound
–excreted in the bile

A

Digitoxin

84
Q

Beta-1 Agonists drugs

A

-Dopamine
-Dobutamine

85
Q

-Given as IV infusion
-primarily used in the management of acute heart failure in the hospital setting

A

Dobutamine

86
Q

–preload and afterload unloaders
–vasodilating effect
–Captopril, Enalapril

A

ACE Inhibitors & ARBS

87
Q

-vasodilating effect
–Carvedilol,labetalol

A

Beta Blockers

88
Q

-preload unloaders
–Spironolactone

A

Diuretics

89
Q

-Hydralazine
-Nitroprusside

A

Vasodilator

89
Q

-Hydralazine
-Nitroprusside

A

Vasodilator

90
Q

Drugs that have been found to be useful in one or more types of heart failure include all of the following EXCEPT

A.Na+/K+ ATPase inhibitors
B.Alpha-adrenoceptor agonists
C.Beta-adrenoceptor agonists
D.ACE inhibitors

A

B. Alpha-adrenoceptor agonists

91
Q

The mechanism of action of digitalis is associated with

A. A decrease in calcium uptake by the sarcoplasmic reticulum
B. An increase in ATP synthesis
C.A modification of the actin molecule
D. An increase in systolic intracellular calcium levels
E. A block of cardiac B adrenoceptors

A

D. An increase in systolic intracellular calcium levels

92
Q

A 65-year old woman has been admitted to the coronary care unit with a left ventricular myocardial infarction. If this patient develops acute severe heart failure with mark pulmonary edema, which one of the following would be most useful?

A. Digoxin
B.Furosemide
C.Minoxidil
D.Propanolol
E.Spironolactone

A

B. Furosemide

93
Q

Drugs associated with clinically useful or physiologically important positive inotropic effects include all of the following EXCEPT

A. Amrinone
B. Captopril
C. Digoxin
D. Dobutamine
E. Norepinphrine

A

B. Captopril

94
Q

Successful therapy of heart failure with digoxin will result in which one of the following?

A. Decreased heart rate
B. Increased afterload
C. Increased aldosterone
D. Increased renin secretion
E. Increased sympathetic outflow to the heart

A

A. Decreased Heart Rate

95
Q

Which of the following has been shown to prolong life in patients with chronic congestive failure but has a negative inotropic effect on cardiac contractility?

A. Carvedilol
B. Digoxin
C. Dobutamine
D. Enalapril
E. Furosemide

A

A. Carvedilol

96
Q

Which of the following is the drug of choice in treating suicidal overdose of digitoxin?

A. Digoxin antibodies
B. Lidocaine
C. Magnesium
D. Phenytoin
E. Potassium

A

A. Digoxin antibodies

97
Q

Occurs when the coronary arteries become so narrowed by atherosclerosis that they are unable to deliver sufficient blood to the heart muscle

A

Coronary Artery Disease

98
Q

–episodic, reversible oxygen insufficiency
–severe chest pains generally radiating to the left shoulder and down the inner side of the arm
–usually precipitated by physical exertion or emotional stress

A

Angina Pectoris

99
Q

–deprivation of oxygen to a portion of the myocardium (reversible)

A

Myocardial Ischemia

100
Q

severe, prolonged deprivation of oxygen to a portion of the myocardium that leads to myocardial tissue necrosis (reversible)

A

Myocardial Infarction

101
Q

-chest pain
*a symptom of myocardial ischemia in the absence of an infaction

A

Angina Pectoris

102
Q

Drugs for Angina Pectoris

A

-Nitrates
-Beta Blockers
-Calcium Channel Blockers

103
Q

Decrease oxygen demand and facilitate coronary blood flow

A

Nitrate

104
Q

Drug of choice for stable angina

A

Beta Blockers

105
Q

Unstable angina with no CI; IV doses given after 3 sublingual nitroglycerin tabs have failed to relieve pain

A

Morphine

106
Q

Indefinite in px with stable or unstable angina

A

Aspirin

107
Q

Together with aspirin 🡪hospitalized px with unstable angina until resolved

A

Heparin, Enoxaparin, Dalteparin

108
Q

Results from prolonged myocardial ischemia, precipitated in most cases by an occlusive coronary thrombus at the site of a pre-existing atherosclerotic plaque

A

MI

109
Q

persistent, severe chest pain or pressure 🡪“crushing”, “squeezing” or heavy “an elephant sitting on the chest”

A

Myocardial Infarction

110
Q

Immediate treatment for myocardial infarction (MONA)

A

Morphine
Oxygen
Nitroglycerine
ASA

111
Q

Drugs for MI

A

-Nitrates
-Oxygen
-Morphine
-Thrombolytic Agents

112
Q

For patients who have chest pain and who may be ischemic

A

Oxygen

113
Q

Causes venous pooling and reduces preload, cardiac workload, and oxygen consumption

A

Morphine

114
Q

prevents platelet aggregation; shown to reduce post-infarct mortality

A

Aspirin

115
Q

prevent re-occlusion once a coronary artery has been opened

A

Heparin

116
Q

reduce mortality, prevent recurrent MI

A

Warfarin

117
Q

used for px who develop ventricular arrhythmia

A

Lidocaine

118
Q

decrease incidence of reinfarction in px with non-Q-wave infarcts; not for acute mgt.

A

Calcium Channel Blockers

119
Q

2 years later, Mr. Green returns complaining that his nitroglycerin works well when he takes it for an acute attack but that he is having frequent attacks now and would like something to prevent them. Useful drugs for the prophylaxis of angina of effort include which one of the following?

A. Amyl nitrite
B. Diltiazem
C. Sublingual isosorbide dinitrate
D. Sublingual nitroglycerin

A

B. Diltiazem

120
Q

The major common determinant of myocardial oxygen consumption is

A. Blood volume
B.Cardiac output
C.Diastolic blood pressure
D.Heart rate
E.Myocardial fiber tension

A

D. Heart rate

121
Q

You are considering therapeutic options for a new patient who presents with hypertension and angina. In considering adverse effects, you note that an adverse effect which nitroglycerin, prazosin, and ganglion blockers have in common is

A

Orthostatic Hypotension

122
Q

A patient is admitted to the emergency department following a drug overdose. He is noted to have severe tachycardia. He has been receiving therapy for hypertension and angina. A drug that often causes tachycardia is

A. Diltiazem
B. Guanethidine
C. Isosorbide dinitrate
D.Propanolol
E.Verapamil

A
123
Q

Anti-arrhythmic Agents

A

-Sodium Channel Blockers
-Beta Adrenergic Blockers
-Potassium Channel Blockers
-Calcium Channel Blockers

124
Q

Quinidine and Procainamide is in a class of

A

Class IA

MIDTERMS COVERAGE (7 decks)

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