CVS Flashcards
1
Q
-
They act on……,…….,………
Their C.U are
1
2
3
4
5
Their s.e are
1.
2.
3.p
A
-Asetazolamide
-prozolamide
Act on PCT, CNS, eyes
C. U.
1 mild hypertension
2 glaucoma
3 acute mountain sickness
4 adjuvant therapy for epileptic
5 basic drugs
S. E.
1. Hypokalemia
2. Metabolic acidosis
3. Hypersensitive reaction ( Stephen Johnsons like syndrome)
2
Q
Osmotic diuretics such as…………
Its s.e. is………….
A
Mannitol
Hyponatremia
3
Q
Hypertension + >55 pt, we start treating him by……..
If not controlled use……….
And if not controlled use…….
A
CCB
ACEI
Diuretics
4
Q
Hypertension +<55 pt start treating by…………. If not controlled use……….. And if not controlled use……….
A
ACEI
CCB
Diuretics
If also not controlled, it means that pt developed resistant hypertension, so we treat the cause
5
Q
Hypertension + any Heart disease use………
A
Selective or Non-selective B-blockers
6
Q
Hypertension + BPH use
A
a1-blockers( parzosin )
7
Q
Only Hypertension without Diabetes or Heart disease use…….
A
Aliskiren and stop ACEI
8
Q
Hypertension + Diabetes mellitus use
……
A
DOC is ACEI in adult and even eldery
9
Q
Hypertension + asthmatic avoid…..
A
B-blockers
10
Q
Isolated systolic hypertension (common in eldery) tt by :
1st line is…………….
2nd line is…………
A
1st. Dihydropyridine (second class of CCB)
2nd. Thiazide e.g. Clorthalidone and indapamide
11
Q
Hypertension + hypokalemia (d.t. Cushing syndrome) tt by……
A
DOC is Spironolactone
2nd choice is ACEI or ARB
12
Q
Hypertension + hypokalemia (d.t. Liddle’s syndrome) tt by…….
A
DOC is Amiloride or Triamlerene
2nd choice is ACEI or ARB
13
Q
Hypertension + hyperkalemia tt by…..
A
Thiazide and loop diuretics
14
Q
Preexisting hypertension in pregnancy is tt by………
A
a-methyl dopa
15
Q
Gestational hypertension(no proteinuria) in pregnancy is tt by………..
A
Oral Labetolol
16
Q
Pre-eclampsia hypertension( with proteinuria) in pregnancy is tt by……
A
Labetolol
Hydralazine
Nifedipine
17
Q
Eclampsia hypertension (with proteinuria and seizures) is tt by……..
A
i.v MgSO4
18
Q
Drug used in asthma abd break down of cGMP is
A
Caffeine
19
Q
S.E of Sildenafil :
A
Hypotension (⬆️cGMP)
Reflex tachycardia
VISUAL DISTRIBUTION 🤔
20
Q
Different between Pulm. embolism and MI is checked by……….
A
CTPA diagnostic test
21
Q
ttt of pulm. arterial hypertension (remember 5 choices) :
A
- CCB (vascular selective) e.g amlodipine
- Phosphodiesterase enzyme 5 inhibitors e.g Sildenafil or tadalafil (s.e of Sildenafil are 3 look at card 18)
- Prostacycline derivatives (PGI2) e.g epoprostenol, treprostinil, iloprost (causing VD and Anti-platelet)
- Endothelin receptor blockers e.g Bosentan or ambrisentan
- Anticoagulant to prevent thrombosis
22
Q
Pulmonary embolism is diagnosed by…….. But if pt has history of allergy to iodinated contrast media we diagnosed by……..
A
CTPA
V/Q SPECT
23
Q
Thrombus of the heart caused by :
1.
2.
3.
A
- HF
- Cardiac arrhythmia
- Endocarditis
24
Q
Ttt of pulmonary embolism is……….
A
Start with low molecular Heparin(e.g Fondaparinux or Enoxaparin) then maintain by Warfarin
We also give thrombolytics, fibrinolytics, plasminogen activators.
25
In case of MI, Stroke, pt use.........for life.
In case of pulmonary embolism, pt use.........for life
Aspirin
Warfarin
26
S.E of heparin :
1.
2.
3.
HIT is caused by :
1.
2.
3.
HIT is tt by :
1.
2.
3.
1. bleeding
2. Osteoporosis in long use
3. HIT
HIT Caused by
1. Trauma
2. Covid-19
3. Trauma
Ttt of HIT
1. Stop heparin
2. Use direct thrombin inhibitors
3. Argatroban (anticoagulant for HIT)
27
Argatroban is used in
Ttt of HIT as anticoagulant
28
S.E of Warfarin :
1.
2.
1. Bleeding
2. Cerebral hemorrhage in large dose
29
Measure heparin by.....
Measure Warfarin by......
APTT
INR
30
Plasminogen activators are :(plase family)
1.
2.
3.
Thrombolytics are:(kinase family)
1.
2.
1. Alteplase
2. Reteplase
3. Tenecteplase
1. Urokinase
2. Streptokinase
31
Never combined Sildenafil with Nitrate because they will l.t............
Hypotensive shock
32
Never combined cardio selective CCB(verapamil, diltiazem) with B-blockers because they will l.t.......
Cardiac arrest
33
2ry causes of hypertension is pregnancy and renal disease (chronic RF or Renal stenosis)
Chronic RF is tt by.....
Renal stenosis is tt by.....
ACEI
Aspirin, statin & amlodipine
34
Pheochromocytoma is tt by.......
Phenoxybenzamine with propranolol or labetolol
35
Cushing syndrome (⬆️cortisol) is tt by
1.
2.
1. Ketoconazole
2. Metyrapone
36
Drugs that cause arrhythmia :
1.
2.
3.
4.
1. 2nd generation antihistamines
2. B1-agonist
3. Indirect sympathomimetic( Qat, amphetamine and cocaine)
4. Digoxin
5. Erythromycin (metabolic inhibitor)
37
B2 presents in peripheral vessels, uterus and liver. (T or F)
T
38
Domperidone act as 5HT4......... And act also as D2 ..........
C.U of Domperidone :
1.
2.
Agonist
Antagonist
C.U is b
1. ⬆️ Gastric motility
2. Prevention of nausea and vomiting
n.b does not cross BBB
39
Na channel blockers:
A- prolonged AP such as :(amide suffex)
-
-
-
B- shorten AP such as :(ine suffex)
-
-
-
C- not affect AP such as :
-
-
A
-disopyramide
-procainamide
-quinidine
B
- phenytoin (anti epileptic)
- lidocaine ( local anesthesia)
- mexiletine
C
-propafenone
-flecainide
40
Selective B-blocker on heart:
-
-
-
Atenolol
Metoprolol
Bisoprolol
41
CHF AND ANGINA is tt by......... But in asthmatic pt we use.......
Selective B1-blockers
Ivabradine which block funny channels in SA node
42
HF is tt by :
. Bioprolol (T or F)
. Metoprolol (T or F)
. Carvedilol (T or F)
All are true
43
K channel blockers : (darone family)
.
.
.
. Amiodarone (contain 4% of iodine so it affect thyroid gland)
. Dronedarone
. Sotalol
They increase AP by ⬆️ ARP
44
Nicornadil is K channel opener used in Angina (T or F)
T
45
First and third class of CCB only used in ttt of arrhythmia, second is not used (T or F)
T
46
Anti arrhythmia drugs :
1st.
2nd.
3rd.
4th.
Others :
.
.
.
.
.
.
1st. Na Channel blockers
2nd. Selective B1-blockers
3rd. K channel blockers
4th. CCB
Others
. Atropine
. Digoxin
. MG. Sulphate( in emergency)
. Adenosine
. K in some kinds of arrhythmia
47
Paroxysmal Supraventricular tachycardia is tt by:
. DOC is........
. In asthmatic pt we use........ Instead of adenosine
Adenosine ( cause Bronchial construction)
Verapamil (not Nifedipine because it l.t reflex tachycardia)
48
Incase of AV block we tt by........
Asymptomatic (not tt)
Symptomatic ( use atropine or pacemaker)
49
In case of Wolf Parkinson white syndrome (AV is fast d.t bundle of Kent) is tt by :
1st. DOC is.........
2nd. DOC is........
1st. Catheter ablation
2nd. Flecainide
50
Thrombolytic drugs in case of MI should taken before 4 hours of MI starting, while in case of pulmonary embolism it should be taken before 12 of starting
True
51
Fibrinolytics are :
1.
2.
3.
4.
5.
1. Urokinase
2. Streptokinase
3. Alteplase
4. Tretiplase
5. Retiplase
52
Urokinase and streptokinase antidote is.......... &...........
Tranexamic acid & aminocaproic (snake venom)
53
In case of tursades de point we use......
Mg. Sulphate
54
Quinidine toxicity causes CINCHONISM (headache, tennitus, thrombocytopenia).... T or F
True
55
Ttt of vent. Tachycardia :
1st choice is..............
2nd choice is..............
Prophylactic drugs such as.....
S.E of amiodarone :
1.
2.
3.
So that we give pt.............to prevent s.e of amiodarone.
Amiodarone
Lidocaine (used as local anesthetic)
Sotalol
1. Photosensitivity
2. Pulmonary fibrosis
3. Hyper or hypothyroidism
We give dronedarone
56
Atrial fibrillation and atrial flutter are tt by :
Eldery pt :
Use............. +...............
Adult pt :
1st choice is............ +............ If pt without heart disease
2nd choice is............ +........... If pt with heart disease (e.g. MI)
Selective B-blockers ( bisoprolol, Atenolol, Metoprolol) + anticoagulant
If asthmatic pt DOC is IVABRADINE
Flecainide + anticoagulant
Amiodarone + anticoagulant
57
Embolism that may be formed in atrium during atrial fibrillation or flutter will l.t
. MI
. Stroke
. Peripheral Ischemic disease
True
58
Ectopic foci are usually asymptomatic, so we don't tt, but If was Symptomatic we tt by..........
B-blockers
59
Drugs that can lead to torsade de point :
.
.
.
.
.
.
.
. 1st and 3rd class of anti arrhythmic drugs
. 2nd generation antihistamines (also ketotifen)
. Amiodarone
. Erythromycin
. Domperidone
. Anti-psychotic drugs (phenothiazine)
. Anti-depressants drugs
60
Atrial fibrillation + HF is tt by.........
Atrial fibrillation + MI is tt by..........
Digoxin
Amiodarone
61
Mg. Sulphate uses:
1.
2.
3.
4.
5.
1. Torsade de point
2. Severe asthma
3. Antacids MgOH
4. Laxative
5. Eclampsia
62
Vent. Fibrillation is tt by
1............ Very fast
2............
3............
1. Mg. Sulphate بسرعة
2. De flutter
3. De fibrillation
63
Stable angina occurs d.t.........
Unstable angina occurs d.t..........
Vasospastic angina occurs d.t..........
Atherosclerosis
Embolism
VC of coronary artery
64
Ttt of angina :
1. ⬇️ Cardiac work drugs such as :
- B-blockers (selective & Non-selective)
- CCB (heart selective e.g verapamil)
2. ⬆️ O2 supply (VD) such as :
- CCB (vascular selective)
- Nitrates
- new drugs e.g Nicornadil
3. Adjuvant therapy
All are true
65
Ex of Nitrates include............and.........
They act by ⬆️ cGMP
Their s.e :
.
.
.
.
Nitroglycerin and isosorbide dinitrate
S.E :
. Hypotension
. Reflex tachycardia
. Headache
. Flushing
. TOLERANCE
. methemoglobinemia
66
Nitroglycerin is used for ttt of............
Acute angina only
67
Isosorbide dinitrate is used for ttt of.........
Resistant chronic angina as the last line of defense against chronic angina
68
Ttt of methemoglobinemia by...........and............
Vit. C and methylene blue
69
Nicorandil used in ttt of...........
Its s.e :
.
.
.
Resistant chronic angina
S.E
. Hypotension
. Reflex tachycardia
. Oral and anal ulcer (same behcet's disease)
70
Mechanism of action of nicorandil drug is :
1.
2.
1. K channel opener (on vascular sm.m of peripheral and coronary arteries)
2. Nitrate like action
71
Types of Adjuvant therapy of angina
1. Anticoagulant /antiplatelet e.g :
-
-
2. Anti-hyperlipidemia e.g :
-
-
- anticoagulant (Warfarin and heparin)
-antiplatelet (Aspirin and clopidogrel)
-statin
-fibrates
72
Aspirin and clopidogrel are antiplatelet (T or F)
True
73
Ttt of acute angina depends on..........
Nitroglycerin
74
In case of Vasospastic angina, we avoid...........and instead we use..........as DOC.
B-blockers( especially Non-selective which found in coronary artery)
CCB (vascular selective)
75
Ttt of chronic angina depends on........,............. &........
⬇️ Cardiac work
Vasodilators
Adjuvant therapy
76
Clinical uses of Nitrates :
.
.
.
.
. Angina
. Cyanide POISONING (using amyl Nitrate)
. MI
. Acute HF
77
Ttt of cyanide poisoning :
1. Hydroxycobalamine
2. Nitrate
3. Na thiosulphate
4. Vit. C and methylene blue
All are true
78
Ttt of MI :
1st line : give Aspirin
2nd line :
- morphine for pain
- meteclopramide or ondansetron for nausea and vomiting
- thrombolytic drugs if MI was not pass more than 12 hours
- anti anginal drugs (nitroglycerin)
- CCB and B-blockers
All are true
79
Acute heart failure is tt by............if pt doesn't have another problem. But if pt have RF, we tt by...........
If dobutamine is not give benifit, we use.........instead of it.
- dobutamine
- dopamine
- Adrenaline
80
Chronic heart failure is tt firstly by.........which ⬇️ preload and afterload, then give...............which ⬇️ afterload and finally give..............which ⬇️ preload.
ACEI / ARB
B-blockers
K sparing diuretics (Spironolactone)
81
In ttt of HF by ACEI, if resistant appears to them, we give ARB with......... Which inhibits neprilysin enzyme
Sacubitril
82
In ttt of HF by B-blockers, if resistant appears, we give............orally which is funny channel blockers
Ivabradine
Its s.e :
⬇️ Visual acuity
Severs bradycardia
83
Digoxin is positive inotropic and negative chronotropic (T or F)
S.E of it :
.
.
.
.
Management of s.e by :
.
.
.
True
S.E
. Low dose : bradycardia and hypotension
. Large dose : TACHYARRHYTHMIA
. Convulsions
. Headache
. GIT disturbances
Management :
. KCL (it inh. influx of calcium)
. Lidocaine (prevent TACHYARRHYTHMIA)
. Antidote for digoxin
84
TACHYARRHYTHMIA is prevented by..............
Lidocaine or diltiazem
85
The most common type of shock is...............and caused by.........,.........,........... But it tt by :
1.
2.
3.
Hypovolemic shock
Caused by burn, hemorrhage, diarrhea and vomiting.
Tt by
1. Ringer's solution
2. Normal saline
3. Blood transfusion
86
Cardiogenic shock caused by :
.
.
.
.
Ttt by :
1.
2.
3.
. MI
. Cardiac temponade
. Vent fibrillation
. Arrhythmia
Ttt:
Dobutamine
Dopamine
Adrenaline
87
Cardiac temponade is tt by :
1- Surgical (aspiration)
2- Drugs:
- NSAIDs
- Colchicine
- Corticosteroids
88
Endocrine shock is tt by...........
Hydrocortisone
89
Anaphylactic shock is tt by :
1.
2.
3.
1. Adrenaline
2. Chlorpheniramine
3. Hydrocortisone
90
Ttt of mild disruptive shock is..........
Ttt of severe disruptive (vascular) shock is...........and........
. Midodrine
. Phenylephrine and adrenaline
91
Septic shock is tt by..........
Antimicrobial drugs
92
Neurogenic shock is tt by..........
Vasoconstrictor drugs
93
Types of stroke :
. Ischemic
. Hemorrhagic
All are true
94
Stroke + hypertension tt by :
A.
B.
C.
A. Labetalol
B. Nifedipine
C. Na - nitroprusside ( a. and v. dilation)
95
In subarachidonic hemorrhage, we use.............drug.
Nimodipine
96
Colchicine act to prevent WBC from reaching site of information (T or F)
Colchicine uses :
1.
2.
3.
4.
True
1. Gout
2. Pseudogout
3. Familial Mediterranean Fever
4. Pericarditis
97
Ttt of endocarditis :
1- Streptococcal endocarditis tt by...........+...........
2- Staphylococcal endocarditis with native valve tt by......................
3- Staphylococcal endocarditis with synthetic valve tt by...............+...............+.............
. Amoxicilin + Gentamicin
. Flucloxacillin (cloxacilin, oxacillin, dicloxacilin)
. Rifampin + Vancomycin + gentamicin
98
.............acting as false catecholamine
Methyldopa
99
Ttt of rheumatic heart fever :
A. Antibiotics :
-..................or................. And if recurrent, use benzathine pencilline every month for prophylaxis
B. Analgesics :
- Aspirin (if pt improves, this indicates arthritis)
- prednisolone (if pt not improved by Aspirin)
Benzathine pencilline or benzomethyl pencilline
100
Malignant hypertension is tt by.....
Na-nitroprusside
101
C.U of verapamil :
Arrhythmia
Angina
Hypertension + arrhythmia
Hypertension + angina
Not used in HF
102
Prophylactic for cluster headache is.....
Prophylactic for migraine is.......
Verapamil
Propranolol
103
C.U of dihydropyridine :
Its s.e :
Angina and hypertension
Not used in arrhythmia
S.E
Gingival hyperplasia
Ankle edema
Others
104
C.U of diltiazem :
TACHYARRHYTHMIA
Topically for anal fissures
105
Resistant essential hypertension is tt by.....
Its s.e :
1.
2.
3.
4.
Aliskiren
S.E:
1. Hypotension
2. Hyperkalemia
3. TERATOGENIC
4. angioedema
106
C. U of ACEI :
1.
2.
3.
1. Hypertension
2. Diabetic nephropathy
3. Heart failure (DOC)
