From Excel Flashcards
How does the baroreceptor reflex work?
In response to hypotension will decrease baroreceptor afferent firing and increase sympathetic efferent firing
What is the triad associated with cardiac tamponade called? What pressure difference does it cause that makes breathing difficult?
Beck Triad: JVD, hypotension, distant heart sounds. Increased pressure in pericardial space relative to pleural space
Young smoker (man) presents with acute onset fever, malaise, muscle pain, HTN, abd pain, bloody stool, prerenal failure 6 mon after HBV infect- what does he have? Treat?
Polyarteritis Nodosa (PAN), associated heavily with prior Hep B infection, medium vessel vasc. Treat w/ cyclophos+ corticosteroids
What is the advantage of esmolol versus other beta1 antagonists (e.g. metroprolol)?
REALLY rapid onset and short acting
How does nitroglycerin alleviate angina?
Vasodilates and decreases preload, decreases myocardial oxygen demands
What affect does mitral stenosis have on pressure? What disease is it associated with?
Increases left atrial pressure; rheumatic fever
What HTN drugs are contraindicated in pregnancy? Which are not?
Don’t use ACEIs or ARBS. Can use labetol, methydopa, hydralazine, HCTZ (continue dose don’t raise thiazide)
What is the shared mechanism of class 1 antiarrhythmics?
Use dependency; affect channels that depolarize more
What bacteria most commonly causes subacute bacterial endocarditis in people with damaged valves? What are clinical signs?
Strep Viridians (e.g. Strep Sanguini)—Roth spots (Retinal spots) and Janeway lesions (nontender lesions on hands)
What is a distinguishing feature between cardiac conditions caused by Staph aureus and Strep Viridians? (also how similar?)
They both bacterial endocarditis, but S. aureus happens in epople with non damaged valves while Virdians happens in epople with damaged valves
What is a possible adverse effect of norepinephrine (in cardiac terms)?
In addition to HTN, a decrease in heart rate—reflex bradycardia (can maintain CO easier with increase in SV so HR goes down)
Order by conduction velocity: Bundle of His, AV node, Purkinje fibers
Purkinje fibers (throughout vent), Bundle of His (the start), AV Node (small cells, few gap junctions)
What arteries cause the peripheral disease that leads to pain when walking for a few minutes (in lower extremeties)?
Arteries causing Peripheral Arterial Disease—in particular popliteal artery is probably narrowed
How would a PDA present?
Later in childhood, with blueish gray discoloration and SOB, decreased physical actiivty. NORMAL at birth. Continous murmur at 2nd and 3rd intercostals
What cardiac condition do patients with SLE typically get? What are their symptoms?; describe it (including name for it)
Mitral regurg; typically asymptomatic; Libman-Sacks Endocarditis (LSE), small vegetations with fibrin and inflammatory cells on both sides of valve
What class ofa ntiarrhythmics is associated with Torsades de Pointes? Name one
Class 1A; qunidine
What class of antiarrhythmics involves blockage of K+ channels, prolonging the refractory period? What antiarrhythmic in this class has a shit load of side effects?
Class III, Amidarone
How will an acute occlusion of RCA present? On ECG?
MI in posterior; so ST elevaiton in leads II, III, aVF.
How does Digoxin work?
Inhibits Na/K+ pump; more intracellular Na+ (which inhibits Na/Ca+ pump); increases intracellular Ca2+, increases contractility
How does cardiac tamponade present on ECG? What can cause it?
Low voltage QRS complexes and electrical alterans (alternating hegihts of QRS complexes), aortic disseciton
What is contraindicated for hydralazine? Why?
Angina; increases myocardial oxygen demand by vasodilating
What is pulsus paradoxus? What often has it?
A decrease in systolic pressure by 10mmHg during inspiration; cardiac tamponade
How can you distinguish between cardiac tamponade and constrictive pericarditis?
Tamponade has pulsus paradoxus; pericarditis often has hepatomegaly and ascites and general liver failure. Tamponade is also more acute
What drugs can cause lupus like symptoms (especially cardiac one)?
SHIPP-E (Sulfa, Hydralazine, isonazide, Procainamide, Phenytoin, Etanercept)
