CVS Flashcards
mention the cv risk factors
modifiable: family history, age, sex, ethenity.
non: HT, tobacco, diet, physical inactive, obesity, blood lipids,
what are the main causes of secondary hypertrnsion.
1_Renal causes: interstitial nephritis, renal a stenosis, polysystic k, SLE
2_Endocrine disorder: cushing, conns synd, pheochromocytoma.
3_estrogen therapy
4_pregnancy
5_coarctation of aorta.
what are the needed lab investigation for a pt with hypertension?
1_renal status: urine analysis, BUN, s creatinine
Described the symptoms of the following and how they are measured:
1_cushing syn
2_pheochromocytoma
3_hyperaldosteronism
1_HT, central obesity, glucose intolerance
measure 24h urine free cortisol, overnight dexamethasone suppresion test.
2_HT, weight loss, glu intolerance, palpitation, pounding headache, pallor.
measure 24h urinary metanephrine excretion.
3_HT, hypokalemia.
screening test: plasma renin activity «low in primary hyperaldestor»
what’s the normal value of HDL,and when does it change?
1_male more than 45 mg, F more 35
2_increase: vigrous exercise, moderate consumption of alcohol
insulin treatment and estrogen
3_decrease: familial hypoalphalipoproteinemia, elevated serum TG, obesity, stress, smoking, DM, recent illness: MI, stroke, trauma, starvation, hypothyroidism, liver ds, nephrosis, uremia
how to calculate LDL levels, and when dose it increase
1_from Friewald formula=total cholesterol _(HDL+TG/5)
2_familial hypercholestrolemia
familial combined hyperlipidemia
Diet high in cholesterol
DM, pregnancy, hypothyroidism, nephrotic syndrome, CRF
what does lipid profile include? how much are the normal and risk values?
1_total cholesterol: 200mg or less is normal, more than 240 is high
2_HDL: 60 mg is good, less than 40 mg is low, risky
3_LDL: less than 100 is ideal, 190 or more is very high
4_TG: less than 150 is good, more than200 is risky
mention the classifications of dyslipidemia.
type , Lipoprotein, lipid 1_chylomicrons TG 2a_LDL, cholesterol 2b_LDL/VLDL, cholesterol/TG 3_IDL/chylomicron. Cholesterol/TG 4_VLDL , TG 5_VLDL/chylomicron. Cholesterol/TG 6_very low levels of HDL
Regarding creatinine phosphatase: 1_where does it found 2_ values diagnostic in MI 3_isoenzymes 4_normal level
1_heart, skeletal. m, brain
2_CK b/w 160-1600 u/l,, CK. MB: more than 6
3_aCK. MB: heart m, increase in acute MI and cardiac surgery.
B_CK. MM: skeletal m, but also express MB in loe levels
C_CK. BB: brain, increase in malignant HT, Uremia, brain anoxia, necrosis of large intestine
D_CK. MIMI: mitochonderial, increase in MI Reyes syndrome, malignant tumors, necrotic liver disease.
4_female, less than 100,pathological: more than 120
male, less than 159,
pathological more than 160
Mention the causes of increased CK. MB
1_MI 2_Cardiogenic shock 3_myocarditis 4_post operative 5_cardiac defibrillation
Mention the causes of increasred CK. in skeletal m
1_sport 2_IM injection 3_operation 4_multiple traumas 5_muscle dystrophy 6_myasthenia graves and dystrophic myotonia 7_Arterial emboli 8_malignant hyperthermia 9_hypothyroidism 10_hypokalemia 11_intoxication and alcoholism 12_infectous diseases 13_Epilepsy
when dose myoglobin increase?
1_cardiac m damage
2_skeletal m damage
3_familial«Meyer. Betz ds»
4_high fever, stress, hyperthermia and vigrous sport.
5_diabetic acidosis, hypokalemia, barbiturate poisining
mention the different isoenzymes of LDH and there location
1_heart, RBC 2_Heart, RBC 3_lymph t, lungs, platelets, pancreas 4_liver, skeletal m 5_liver, skeletal m
when dose LDH increase?
1_MI 2_Hemolytic anemia 1 3_paraxosymal nocturnal hemoglobinuria 2-3 4_lymphoma 2_3 5_Duchenen 2_3 6_pulmonary embolism 3_4 7_liver ds 5 8_skeletal m ds 5 9_dermatomyositis, polymyositis 10_malignant tumors
regarding GOT, GPT
1_where
2_how much
3_elevation indicate what
1_muscle, liver, brain 2_GOT: 5_35,GPT: 7_56 3_liver disease, biliary tract skeletal muscle damage MI «GOT»
In a patient with MI what are the possible abnormal results in blood test?
1_increase hematocrit 2_leukocytosis 3_increase ESR 4_Increase C. R. P 5_in arterial blood gas: deceased ph, decrease PO2,increase glucose 6_increase urea nitrogen, creatinine 7_decrease potassium, albumin 8_increase TG 9_increase cholesterol
Mention the major and minor jones crteria.
J🖤NES PEACE. Major: 1_joints(polyarthritis, hot sollwen joints) 2_heart(carditis, valve damage) 3_Subcutaneous nodules 4_Erythema marginatum 5_Sydenham chorea
Minor: 1_previous RF 2_ECG with PR prolongation 3_Arthralgia 4_CRP, ESR elevation 5_elevated Temperature
when dose ASO becomes necessary?
1_direct diagnosis: scarlet fever, eryspieles, streptococcus pharyngitis, tonsillitis.
2_indirect diagnosis: RF, GN
when can we found elevated CRP
1_active bacterial infection 2_active RF 3_Active MI 4_Active rheumatic arthritis 5_Active TB
why CRP is more sensetive and rpidly responding indicator than ESR?
CRP show an earlier and more intense increase.
The disappearance of it precedes ESR in recovery
CRP disappear also when inflammatory process is supressed: anti inflammatory agent, salicylate, steroids.
In clinical findings of RF what dose the following indicate:
1_Antifibrinolysin
2_ASTZ
3_ESR
1_increase in RF, recent Hemolytic infection
2_sensetive test, useful in excluding RF
3_Sensetive test of R activity
Mention the 2 pn in heart failure and their source
when they are secreated
1_BNP
2_NT_PRO_BNP
cardiac ventricles
released in direct proportion to ventricular volume and pressure overload.
Mention the clinical significant of BNP
1_differentiate HF in pt with dyspnea from other causes in atypical presentation
2_has a high negative value «very sensetive», when test is _ heart failure can be excluded.
3_following up the pt on treatment.
In CCF what can you see in liver function tests?
1_congestive hepatomegaly, cardiac cirrhosis. 2_increase serum bilirubin«frank jaundice» 3_increase urine urobilinogen 4_increase LDL 5_mild to moderate increase in serum ALP 6_SGOT, SGPT increase 7_hypoalbuminemia 8_increase prothrombin time
In CCF what are the findings in relation to fluid and electrolytes
1_delusional hyponatremia
2total body sodium increase but plasma sodium and chloride decrease
3
4_hyperkalemia in severe case, and may decrease with diuretics
5_hyperaldesteronism
6_iron defeciency
What are the renal changes in CCF
1_slight albuminuria
2_isolated RBC, hyaline, granular casts
3oliguria
4 urine is concentrated, specific gravity more than 1020
mention the pssible adverse effects of thiazide and loop diuertics
1_alkalosis 2_decrease potassium, magnesium 3_decrease GFR 4_Decrease lithium clearance 5_increase serum glucose, uric acid, calcium 6_increase totak cholesterol, LDL, TG
universal difenition and classification of heart failure
gillary
