Final Flashcards
1
Q
non-DHP are prescribed the MOST for what
what are they?
A
Rate Control in A Fib
Diltiazem & verapamil
2
Q
Dihydropryridines are prescribed the MOST for what
what are they?
A
Amplodipine & nifedapine
3
Q
Chronic low vitamin K induces calcification
A
CAD
4
Q
Safest Drug Class for HTN in whites
A
Diuretics
5
Q
Safest Drug Class for HTN in african americans
A
CCB-amlopdipine
6
Q
Potassium Sparing
A
Spironolactone
7
Q
Potassium Depleating
A
HCTZ and LISINOPRIL
8
Q
Most common S/E of lisinopril
A
Cough
9
Q
Alternatives to BB in ND care for Rate control in a-fib:
A
Parasympathetic improvement with acetylcholine.
10
Q
Nitro Contraindication
A
COPD and R MI
11
Q
Steps for MI in office
A
Call 911 Aspirin 02 if pulse ox <92% Start IV line Maybe nitro
12
Q
HFrEF
A
Systolic Heart failure, MI, Ischemia, Ischemic cardiomyopathy
13
Q
HFpEF
A
Diastolic Heartfailure
fibrosis, stiff rigidity of walls, filling is impared
14
Q
Fibrosis
A
Selenium
15
Q
What is effective at reversing diastolic HF
A
Coq10
16
Q
Which drugs can cause HF most commonly
A
Chemotherapy drugs
17
Q
Hakasumo cardiomyopathy
A
HF from severe stress and ballooning.
18
Q
MC for LHF:
A
Ischemic MI
19
Q
MC for RHF
A
LHF
20
Q
Reduced EF in systolic:
A
Echo
21
Q
DX for DVT
A
D-DImer and CT Angiography
22
Q
How long do you monitor a DVT for
A
3-6 months
23
Q
positive ionotrop, increased contractility of heart used for a fib and systolic heart failure
A
Digoxin
24
Q
natural positive ionotrope used for systolic heart failure
A
Taurene
25
Natural Beta Blockers used in tachyarrhytmias
Lycopus and leonorus:
26
3 L’s for systolic heart failure:
Lasix, lanoxin, lying down
27
Ach protocol:
• : induces skeletal muscle contraction and inhibits cardiac muscle contraction
o Indications: Tachycardia, Afib, PVC and PACS
o Always give with panthothene ( frequent pvcs or elevated TG) or pantothenic acid
28
Best for Vasodilation
L-Arginine
29
Natural HMG Coa reductase inhibitor
RYR
30
3’gs of Platlet aggregation inhibiton Natural Anti-coagulants, decrease platlet aggregation
Gingko, Garlic, Ginseng:
31
6 Things that Decrease Platlet aggregation
Fish oil, ginkgo, garlic, natookinase, aspirin and Plavix
32
3 things that optimize blood visocity
Nattokinase, prolytic enzymes, ginko:
33
Natural Calcium Channel Blocker:
Magnesium
34
lowers Bp, improves circulation, reduces cholesterol absorption
Caynne Pepper
35
best for decreasing elevated triglycerides
Pantethine:
36
Post MI Meds:
BALL
37
Post Stent:
• Plavix, statin, Ace, Beta Blocker
38
Diebetics:
ALL
39
Natural Treatments for bronchiectasis
NAC, Nebulized hypertonic saline, bromelain, proteolytic enzymes
40
First line Antibiotic for pneumonia
azithromycin
41
• Patients with other risks or antibiotics use in the past 3 months:
z-pack and amoxicillin
42
Acute Asthma attack formula
• ephedra capsicum and lobelia
43
Herbs contraindicated in HTN
Glycerrhrhiza, ephedra
44
Stronger antibiotic for pneumonia
Stronger
45
Good For Asthma
| inhibits airway hyperresponsiveness, improves FEV1
Butterbur
46
Goof for Asthma
| reduces eosophils and can improve FEV1
Ginko:
47
improves asthma symptoms
Tylophora
48
ASTHMA AGGRIVATORS
ACE-I AND L-ARGININE
49
3 c's for valvular dz
convllaria, cactus and cratataeguss
50
* Epinephrine:
| * Adults, children, IM IV
* Adults: .3-.5
* Children: .05-.2
* IM: 1:1,000
* IV: 1:10,000
51
A flutter-
saw tooth
52
A fib-
no p wave
53
V fib:
no true qrs rapid discharges
54
Torsade de points
and small
55
1st degree heart block:
: prolonged PR interval >.20 seconds, no drop in QRS (if R is far from p you have a first degree)
56
2nd degree Type I
Type 1: Wenkebach: “longer longer longer drop”
57
2nd degree type 2
Type 2: There no lengthening but sudden dropped beats,, if some “p’s don’t get through then you have morbitz two
58
3rd degree heart block
prolonged PR interval no correlation between p wave a QRS if “ps and q’s don’t agree then you have a third degree
59
Right Bundle Branch block
RsR’, rabbit ear
60
CURB-65:
Pneumonia hospitalization
confusion to person place and time, BUN > 19mg/dl, Respirations >30, Blood pressure <90/60, >65
61
Fev1/FVC:
obstructive(
62
FEF25-75
early airway obstruction, measures the small airways, <60%
63
FROM JANE
endocartitis, fever, roth spots, osler nodes, murmur, janeway lesion lesons, anemina, nail bed hemorrhage, embolism
64
Jones Criteria
rheumatic heart disease, 2 major or2 minor and one major
Major: migratory polyarthritis, carditis and valvulitis, cns involvement, subacute
Minor: arthralgia, fever, increased, prolonged PR on EKG
65
Aortic Stenosis hemodynamically compromised when
66
Mitral regurg hemodynamically compromised when
rule of 55
67
Systolic Heart failure Ejection fraction
<40
68
Diastolic HF:
>50-65
69
Rales (crackles):
bronchitis, pneumonia, fibrosis CHF
70
Rhonchi or wheezes
asthma, bronchitis(clears with cough) CHF
71
Rubs
Pleurisy
72
Bronchophy(99) or Whispered pect (1,2,3):
Consolidation
73
Egophony: eee-Aa
consolidation
74
Meds that cause orthostasis
ace, nitrates, b-blockers, arbs, ca blockers
75
TEE
Left Atrial appendage in A fib
76
TTE
Mitral regurg, aortic stenosis CHF
77
CHAD
```
Should I anti-coagulate
Chf (1)
HTN (1)
Age >75 (1)
DM(1)
Stroke/TIA(2)
=0(aspirin 81-325mg), 1(aspirin or couadin), 2(coudamadin INr 2-3)
```
78
CHADVASC:
```
CHF
HTN (1)
Age >75 (2)
DM(1)
Stroke/TIA(2)
Vacular DZ: PAD, MI, Aorta calci) *1)
Age 65-75 (1)
Sex F (1)
0 truly no risk, 1 aspirin, 2, Coumadin INR 2-3)
```
79
HASBLED
```
Bleed risk
HTN
Abnl renal or liver fxn
Stroke
Bleeding past
Labile INR
>65
drugs or alcohol
```
each gets 1 point if >3 anticoagulate with caution
80
Best or HTN with anxiety
Rauwolfia
81
Loop and Thiazides are?
Potassium depleting
Hypomagnesemia
Hyperuricemia
Hyperglycemia
82
COPD TX
```
o bronchodilate (ephedra, belladonna, lobelia),
o rescue inhaler,
o expectorants (lobelia, ephemdra, lomatia, NAC),
o antitussives (tessalon perls, codeine
```
83
PAD TX
• Tx arterial PAD
o check homocysteine (want <7)
if high, supp w folate and arginine and g-tocopherol
o Rutin- flavonoids- inc. capillary permeability
o Ginkgo- improves vascularization, antioxidant, reduces platelet aggregation
o Ruscus- anti-inflamm., diminishes vascular permeability
o Vasodilation: crataegus, magnesium, L-arginine
o Chelation
84
Lp(a)
carotid atherosclerosis and early mi risk, cerebral infarction
85
ApoA1:
best predictor of early MI in young men
86
LP-PLA2:
best marker for CAD in diabetics and post menopausal women
87
CRP
men with high CRP have 3x incidence of MI
88
THR
220-age-resting x.6+resting
89
Temporal arteritis
prevent blindness, large arteries
90
Polyarteritis nodosa
• Segmental inflammation & necrosis of medium sized muscular arteries
tx with high dose prednisone
91
Tx for PAD
o check homocysteine (want <7)
♣ if high, supp w folate and arginine and g-tocopherol
o Rutin- flavonoids- inc. capillary permeability
o Ginkgo- improves vascularization, antioxidant, reduces platelet aggregation
o Ruscus- anti-inflamm., diminishes vascular permeability
o Vasodilation: crataegus, magnesium, L-arginine
Chelation
92
Thromboangiitis Obliterans (Buerger’s Dz)
• small and med. arteries and veins, NOT coronary arteries
| Smokers
93
Tx for PVD
• Horse chestnut (Aesculus)
o reduces capillary permeability and edema, improves circulation, improves venous tone
o 600-700 mg seed extract
o Drug Int: Warfarin, Coumarin: alfalfa, celery, chamomile, fenugreek, red clover etc.
• Ayurvedic herbs: Arjuna bark, Coleus, Guggul
o Dec: TC, LDL, TGs, Inc: HDL, inhibit platelet agg.
• Witch Hazel (Hamamelis Virginiana)
o Anti-inflamm. Astringent, hemostatic
o Rub into lower extremities
