Heart

Question 0

What is BNP and its value that corresponds with heart failure?

Answer 0

B-type Natriuretic peptide (and also A type) are antagonists to the RAAS system. They are excreted when there is high blood pressure, and cause increased GFR.
Normal value is around 100ng/L. A value over 1200ng/L is definitely heart failure.

Question 1

What is Beriberi?

Answer 1

Thiamin (vitamin B deficiency) predominant in white rice eating countries. Can cause polyneuritis, heart disease, edema.

Question 2

Ace Inhibitors two functions

Answer 2

block conversion of Angiotensin I to II, thus promoting vasodilation and decreasing sodium retention

Decrease bradykinin degradation, thus increasing Prostaglandin and NO secretion, causing vasodilation

Question 3

Drug of choice for CHF

Answer 3

Diuretics:
loop diuretic
thiazide
K sparing

Question 4

Loop diuretics adverse effects

Answer 4

azotemia > increase in uric acid

hypokalemia

Question 5

K+ sparing agent name, mode of action

Answer 5

Spironolactone

Inhibits aldosterone

***improves survival in CHF b/c of its effect on RAAS

Question 6

Digitalis indications

Answer 6

only in severe heart failure
positive ionotropic

***does not reduce mortality but does reduce hospitalization and symptoms

Question 7

Digitalis toxicity

Answer 7

sinus bradycardia*
2nd degree A/V block*
Atrial tachycardia***

nausea, headache

Question 8

vasodilator (name)

MOA

Answer 8

HYDRALAZINE:arterial vasodilation > reduced afterload, O2 consumption
increases stroke volume

NITRATE: venous dilation > reduced preload

Question 9

Amiodarone
MOA
AE

Answer 9

Class III antiarrhythmic, prolongs phase 3 cardiac AP
slows intra-cardiac conduction

pulmonary fibrosis***
hyper/hypo thyroidism