Exam 2

Question 1

Shock

Answer 1

critical condition where the circulatory system fails to maintain adequate blood flow and is a poor delivery of oxygen and nutrients to vital organs (Hypotensive state)

Question 2

Hypovolemic Shock

Answer 2

Shock due to intravascular deficit (hemorrhage)

Question 3

Distributive Shock

Answer 3

Shock due to peripheral vasodilation, sepsis, anaphylactic, or neurogenic

Question 4

Cardiogenic Shock

Answer 4

Shock due to myocardial pump failure

Question 5

How should you treat shock associated with vasoconstriction

Answer 5

Address underlying causes: stop bleeding, give fluids, antibiotics, antihistamines, etc.

Maintain blood pressure

Initiate sympathomimetic Therapy:

Question 6

Is dopamine at high doses good for shock association with vasoconstriction or vasodilation

Answer 6

Vasodilation

Question 7

How do you treat anaphylactic shock?

Answer 7

Epinephrine (B2- bronchodilation, cardiovascular support via a2 and B1, and b2 inhibits mast cell migration)
Phenylephrine: prototypical a1 agonist vasoconstriction with minimal effects (no B stimulation)
Dobutamine (primarily B1 agonist) increases cardiac output tto treat myocardial insufficiency)

Question 8

How do you treat myocardial insufficiency?

Answer 8

Dobutamine as it increases cardiac output via B1 stimulation (no vasodilation) minimal effects on heart rate

Question 9

Spread of cardiac excitation

Answer 9

1) SA node
2) Internodal fibers and interatrial band
3) AV node
4) AV bundle
5) Right and left AV branches
6) Subendocardiac conductive network- spreads rapidly to the ventricles
7) Cardiomyocytes

Question 10

Depolarization (Phase 0)

Answer 10

Stimulus opens voltage regulated Na gates, goes rapidly to 30mV and close quickly

Question 11

Plataeu (Phase 2)

Answer 11

voltage gated Ca2+ channels and K channels are open, calcium flows in to trigger contraction

Question 12

Repolarizing (Phase 3)

Answer 12

Calcium channels close but K channels stay open to allow setting of resting membrane potential and return back to -90mV

Question 13

What would IV infusion of KCl do to the cardiac membrane potential

Answer 13

Short term- depolarize: increase heart rate
Long term- high dose: stop the cells from repolarizing- no heart beat and death

Question 14

What would sodium channel blocker administration do?

Answer 14

Impair the action potential and stop the heart beat (contractile cells only impaired)

Question 15

What would potassium channel blockers do the electrical activity in the heart?

Answer 15

Impair repolarization, many impact the plateau (phase 2), depolarization of cells (Both pacemaker and contractile cells are impacted

Question 16

What would calcium channel blocker do?

Answer 16

impaire conduction

Question 17

What would you target if you want to decrease heart rate and AV nodal conduction?

Answer 17

Muscarinic type 2 receptors

Question 18

What receptor Increases heart rate (SA node), atria and ventricle contraction and contraction velocity, and AV node automaticity and conduction velcoity

Answer 18

Beta-1

Question 19

What receptors constrict ateries

Answer 19

alpha 1

Question 20

What receptors dilate arteries to skeletal muscle

Answer 20

beta 2

Question 21

What receptor relaxes the detrusor

Answer 21

beta 2

Question 22

What receptor contracts the trigone and sphincter

Answer 22

alpha 1

Question 23

Bethanecol

Answer 23

Direct Cholinergic Agonist - M3 (contractions of the bladder) and relaxation of trigone and sphincter
Treats urinary retention when obstruction is absent

Question 24

Pilocarpin

Answer 24

Direct acting cholinergic agonist to induce pupil pressure and intraocular pressure during glaucoma