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ESUN MS2Unit4 > Kaplan > Flashcards

Kaplan Flashcards

1
Q

What does the relatively high resting potential of the slow response fiber indicate?

A

They can fire AP by themselves

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2
Q

What ions are responsible for the AP of slow response fiber?

A

Slow Ca current and then delayed K current

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3
Q

How are Na/Ca/K channels and pacemaker current in slow response fiber affected with beta 1 receptor? what about M2?

A

Gs open Na/Ca channel and close K channel for AP/steepen pacemaker current/Gi does the opposite—>flatten the pacemaker current

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4
Q

What is the m and h gate of Na channel?

A

M is the activation gate

H is the inactivation gate—>responsible for refractory period

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5
Q

What do class Ia/b/c Na channel blockers block?

A

Ia—>block activated form of Na channel (both m and h gate are opened)
Ib—>block inactivated form (m open, h closes)—>prevent the channel from going back to be activated and firing
Ic—>block resting

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6
Q

Which class of Na channel is used for arrhythmic post MI?

A

Class Ib

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7
Q

Na is reabsorbed the most in what part of the nephron? and what follows it?

A

Proximal tubule/bicarb, Cl and water

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8
Q

What is the permeability of thin descending limb?

A

Water reabsorption w/o solutes reabsoption

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9
Q

Diuretics causes ___ and ___?

A

Hypokalemia and alkalosis

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10
Q

Osmotic diuretics work on what part of the nephron and mainly which part?

A

the entire tubule/mainly on proximal tubule

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11
Q

Carbonic anhydrase inhibitor increase ___ and ___ con. inside of the lumen?

A

Na and HCO3-

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12
Q

What symptoms carbonic anhydrase inhibitor treat regarding acute mountain sickness?

A
  1. Respiratory alkalosis caused by hyperventilation

2. Edema caused by increase hydrostatic pressure from hypoxic vasoconstriction

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13
Q

How does renal stone happens with carbonic anhydrase?

A

Increase urine pH

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14
Q

Loop diuretics causes hypo___?

A

hypo every single ions!

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15
Q

For treating HTN, loop diuretics vaso___ by increasing ___? what drug can cancel this effect?

A

vasodilate/increasing prostaglandin/NSAIDs

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16
Q

Why is sulfonamide common in drugs and what drugs have sulfur in them? (watch for allergic reactions)

A

Sulfur containing drugs are lipid soluble and binds to protein/all the sulf- and thio- drugs have sulfur in them—>as well as carbonic anhydrase inhibitor, loop diuretics except for ethacrynic acid

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17
Q

Weak acid diuretic drugs (thiazide) that is secreted in the proximal tubule competes with ___? which causes ___?

A

Urinate/hyperuricemia (contraindicates in pt with gout)

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18
Q

Thiazide causes hypo/hypercalcemia? that as a result treats ___?

A

Hypercalcemia/nephrolithiasis (Ca stone)

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19
Q

Thiazide causes ___ release and should be avoided with ___ pts?

A

Insulin resistance—>hyperglycemia/hyperlipidemia/diabetes mellitus pts
Turn borderline diabetics into full blown diabetics

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20
Q

Diuretics causes drop of __ and __? but eventually ___ returns to normal?

A

BP and CO/CO

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21
Q

Which is more potent, ACEI or ARB?

A

ACEI (due to inhibition of the breakdown of bradykinin)

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22
Q

Why do use ACEI for chronic kidney disease?

A

e.g. HTN causes kidney failure—>kill a lot of glomeruli—>the remaining glomeruli compensate and over work—>RAS is activated—>further kidney damage and more glomeruli die—>if block RAS with ACEI—>kidney function decrease but eventually plateau (prevent burnout)

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23
Q

With a drug that decrease symp tone to decrease BP, you would expect to see?

A

No reflex tachy/orthostatic HoTN/increase parasymp

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24
Q

Alpha 2 receptor is G_ coupled?

A

Gi

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25
Q

Alpha 2 agonist drugs for HTN would interact with what other drugs?

A

TCA

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26
Q

Reserpine causes severe?

A

Depression

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27
Q

Beta blocker would decrease ___ so it is contraindicated in pt with high ___?

A

Lipolysis—>increase lipid in blood/lipid

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28
Q

What are the 2 groups of HTN drugs that do not have reflex tachycardia?

A

Alpha 2 agonist/beta blockers

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29
Q

What are the 2 drugs for HTN in during pregnancy?

A

Methyldopa/hydralazine

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30
Q

Long term use of minoxidil induces?

A

Diabetes

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31
Q

Which one has stronger vasodilating effect, dihydropridine or non-dihydropyridine?

A

Dihydropyridine

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32
Q

What drugs causes gingival hyperplasia?

A

Dihydropyridine

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33
Q

ACEI/ARB causes hyper or hypokalemia?

A

Hyperkalemia (lack of aldosterone)

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34
Q

Use ACEI/ARB for pt with renal stenosis will induce?

A

Acute renal failure

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35
Q

What would class Ia anti arrhythmic drugs do to phase 0 and the AP?

A

Decrease the slope of phase 0/prolonged AP

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36
Q

What is causing Quinidine’s pro arrhythmia effect?

A

M and Alpha blockade—->tachycardia

37
Q

Hyper or hypokalemia would worsen LQT?

A

Hyperkalemia

38
Q

What are the 4 drugs that cause SLE like syndrome?

A

Hydrazine/procainamide/isoniazid/methydopa

39
Q

How does thiazide treat nephrogenic diabetes insipidus?

A

Increase aldosterone release in distal tubule and increase water reabsorption

40
Q

What does class Ib drug do to the AP?

A

decreases the duration of AP

41
Q

Beta blocker for anti arrhythmia work on ___ and ___ node and promote ___?

A

SA and AV node/parasymp

42
Q

What does beta blocker do to the pacemaker AP?

A

Decrease the slope of phase 4—>takes longer for it to achieve another AP

43
Q

What drugs causes pul fibrosis?

A

Amiodarone/bleomycin

44
Q

Class IV anti arrhythmic drugs work on ___ and ___ in the heart? and what does do to the pacemaker AP?

A

SA and AV node/decrease phase 0

45
Q

You need to give ___ before you give quinidine?

46
Q

What is the mechanism of adenosine?

A

Gi coupled—>decrease cAMP—>decrease AV and SA node activity

47
Q

Carvedilo/labetolol/ACEI/ARB/spironolactone are used for?

A

Interfere with negative cardiac remodeling—>increase survival of CHF

48
Q

Digoxin is used for? and how does it work?

A

Increase contractility—>increase CO in CHF pts and also for SVT/inhibit Na/K pump—>increase intracellular Na and Ca leve

49
Q

What does milrinone do?

A

Increase contractility for heart failure pts

50
Q

What is the side effect of Digoxin?

A

Cardiac arrhythmia

51
Q

Digoxin interact with ___ to increase toxicity?

A

Diuretics (hypokalemia)

52
Q

What anti arrhythmic drugs treat SVT?

A

Class II and IV/adenosine/Digoxin

53
Q

What to give for WPW pts?

A

Class Ia and III

54
Q

How does nitrite work?

A

Venodilate at smooth muscle cell of the large veins—>decrease preload—>decrease cardiac work and O2 demand

55
Q

Difference in mechanism of dihydropyridine and non dihydropyridine?

A

Non di—->work on heart—>decrease contractility

di—>coronary vasodilator

56
Q

Don’t use beta blocker for ___ angina?

A

Vasospastic (printzmetal)

57
Q

How does cAMP cause smooth muscle relaxation?

A

cAMP phosphorylates (inactivate) myosin light chain kinase

58
Q

High cholesterol causes low ___ receptor on hepatocyte? which results in?

A

LDL (liver don’t need more fat anymore)/the formation of plaque

59
Q

What is the mechanism of statin?

A

Inhibit HMG-CoA—>decrease liver cholesterol—>increase LDL receptor—>decrease plasma LDL
Also decrease TG

60
Q

Statin should not be used with gemfibrozil because?

A

Increased risk for rhadomyolysis

61
Q

Bile aid sequestrants are contraindicated in hyperTG pts because?

A

It forces liver to take up LDL and then produces more VLDL—>causes hyperTG

62
Q

What can you give to counter the side effect of niacin?

63
Q

Asthma is under the category of ___? and it is characteristics of ?

A

COPD/bronchospasm

64
Q

What to give for acute and chronic asthmatic response?

A

Acute—>bronchodilator

Chronic—>anti-inflammatory

65
Q

What are the 3 factors that causes bronchoconstriction?

A

ACh/Adenosine/leukotriene

66
Q

What mediates bronchodilation? what kind of drugs can achieve these?

A

Increase cAMP and cGMP/Beta 2 agonist and phosphodiesterase inhibitor

67
Q

What is the side effect for beta 2 agonist for asthma?

A

Epi like effect—>fight or flight (anxiety and what not)/eventually go away

68
Q

What is the drug of choice for pt on beta blocker that experience bronchospasm?

A

Ipratropium

69
Q

What is status asthmaticus?

A

Acute asthma over 60 mins

70
Q

What else is cromoglycate and nedocromil used for?

A

Seasonal allergy

71
Q

Should we treat HTN in women more conservatively or aggressively?

A

Aggressively

72
Q

How does ACEI prevent kidney failure and diabetic nephropathy? and what do you expect to see at the beginning of the treatment?

A

ACEI decrease GFR purposely to reduce hyperfiltration–>eventually level off/increase in creatine due to decrease in GFR

73
Q

What is the first line treatment for HTN in general?

A

ACEI/diuretics

74
Q

Why thiazide is use the most for diuretics for HTN?

A

Long acting

75
Q

When do you use loop instead of thiazide for HTN?

A

When GFR is

76
Q

What should you consider when giving diuretics to athletes?

A

It dehydrate ppl, lowers CO and make people feel fatigue

77
Q

Thiazide might push people on the edge of being ___ to be ___?

78
Q

Beta blockers causes ___ unawareness

A

Hypoglycemic (caution to use with diabetics)

Beta blockers raise serum glucose

79
Q

HTN pt with CAD, give?

80
Q

Di or non-di are good for chronic kidney disease?

81
Q

Beta blocker can worsen?

82
Q

Does beta block increase or decrease serum lipid?

83
Q

What are beta blockers with sympathomimetic activity?

A

Partial agonist of beta receptors (less effective)

84
Q

EAD is worsen by high or low HR/long or short QT interval?

A

Low HR and long QT interval

85
Q

Mobitz type I AV block response to?

A

Anti parasymp (atropine)

86
Q

What to give pt with diastolic CHF?

A

Nitrite/diuretics

87
Q

What are the 3 beta blockers that decrease morbidity in HF?

A

Carvediolol/metoprolol/bisoprolol

88
Q

What is the side effect of nitrite besides HoTN?

89
Q

If a HF pt cant get ACEI or ARB, give what?

A

Hydralazine or nitrite

ESUN MS2Unit4 (5 decks)

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