DM Midterm Flashcards
Pick efferent arteriole:
Ang II mediated vasoconstriction is a regulatory mechanism that acts on the:
efferent arteriole
Vasoreactive (myogenic) reflex acts on the:
afferent arterial
B/L pelvoureteral obstruction is an example of what type of renal failure?
Post-renal failure
Hypovolemia, decreased cardiac output, decreased effective circulating volume (CHF, liver failure), impaired renal autoregulation (NSAIDs, ACE-I/ARB, Cyclosporine) would all cause what type of renal failure?
Pre-renal failure
What is NOT a risk factor for chronic kidney disease?
Dementia
Causes of chronic kidney disease:
- chronic glomerulonephritis
- systemic lupus erythematosus
- neoplasms
- polycystic kidney disease
- AIDs nephropathy
- diabetic nephropathy
Risk factors for chronic kidney disease include:
-age of greater than 60
-smoking
-obesity
-HTN (poorly controlled)
-diabetes
-nephrotoxins/drugs
-infections
-low birth weight
-chronic inflammation
Results of RIGHT-sided heart failure:
- pulmonary edema
- coughing
- peripheral edema (arms & legs mostly)
Results of LEFT-sided heart failure:
- affects all organ systems
- decreased kidney function (leads to fluid retention)
- pulmonary edema
- coughing
Which ventricle typically fails first in heart failure?
Left
What does the EF fraction measure?
amount of blood pumped out / amount of blood in chamber
What is a normal EF?
55-70%
What is considered severely below normal in regard to EF?
Less than 35%
Reduced left ventricular EF:
systolic failure
Heart failure with normal left ventricular EF:
diastolic failure
Signs of heart failure:
- rapid, shallow breathing
- inspiratory rales (crackles)
- increased HR
- distended jugular veins
- peripheral edema
- ascites
- cyanosis
- weight gain
- clubbing of fingers
Symptoms of heart failure:
- fatigue & weakness
- orthopnea- SOB in recumbent position
- exercise intolerance
- muscle fatigue
- weight gain
- GI distress (nausea, vomiting, constipation)
Therapy for stage A heart failure:
ACE inhibitors for ARBs
Therapy for stage B heart failure:
ACE inhibitors, ARBs, Beta-blocker
Therapy for stage C heart failure:
ACE inhibitors, Beta-blockers, Diuretics for fluid retention
LVAD is considered:
intermediate therapy
Signs of valvular heart disease include:
- murmurs
- syncope
- HF
- SOB
Symptoms of valvular heart disease include:
- HF
- exercise intolerance
- SOB
Procedures that do NOT require antibiotic prophylaxis in patient IE:
- anesthetic injection
- radiographic imaging
- placement of removable prosthodontics prosthesis
- placement of removable ortho appliances & brackets
- exfoliation of primary dentition
- bleeding of lip or oral mucosal trauma
- simple impressions
- optical scans
What is the antibiotic of choice for infective Endocarditis if a patient is allergic to PCN:
Azithromycin (or clindamycin)
What is NOT approved by the AHA for antibiotic prophylaxis:
Cephalexin
What do you give patient allergic to penicillin to take orally?
Azithromycin (or clindamycin)
Example of a true allergy:
Rash
Itching
Angioedema
Chest pain at rest:
unstable angina
The role of the macula densa:
glomerular BP
What organ system is responsible for finger clubbing?
Cardiovascular
Which of the following shoes immunity for hep B?
Anti-Hbs
Endocrine etiology of secondary HTN:
Increased catecholamines
What is produced in the adrenal cortex?
Cortisol, androgen, aldosterone
Norepinephrine is produced in the:
adrenal medualla (catecholamines are produced in adrenal medulla)
Hepatic encephalopathy is associated with:
Asterixis
What causes the poor wound healing seen in diabetics?
Impaired angiogenesis & cytokines
