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MD3001 > MD3001 Week 3 > Flashcards

MD3001 Week 3 Flashcards

1
Q

congenitally corrected transposition of great vessels

A

defect where great arteries and ventricles both rotate

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2
Q

this heart disease may cause squatting

A

Fallot’s tetralogy can have this interesting presentation

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3
Q

Maladie de Roger

A

restrictive VSD

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4
Q

Rashkind

A

name for atrial septostomy (making hole in atrium)

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5
Q

Blaylock shunt

A

shunt from subclavian to PA

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6
Q

what congenital heart disease always causes cyanosis but never PH?

A

Fallot’s has these effects on cyanosis and PH

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7
Q

in Fallot’s, how is murmur from VSD and and pulmonary stenosis related?

A

in this congenital heart disease, murmur from VSD and degree of pulmonary stenosis are inversely related (bigger VSD, smaller murmur)

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8
Q

What are Janeway lesions indicative of?

A

painless flat lesions on palm or sole indicative of infective endocarditis

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9
Q

what causes Malar flush?

A

mitral stenosis causes this symptom

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10
Q

2 effects on eyes that raised cholesterol has

A
  1. xanthelasma (fatty deposits around eyes)

2. corneal arcus (white ring in iris)

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11
Q

what heart disease causes slow rising pulse?

A

aortic stenosis causes this type of pulse

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12
Q

what heart disease causes collapsing pulse?

A

aortic regurgitation causes this type of pulse

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13
Q

4 manoeuvres to accentuate murmurs in CV exam

A
  1. bell on apex turned on L side in expiration (mitral stenosis)
  2. diaphragm on L axilla (mitral regurgitation)
  3. diaphragm on lower L sternal edge sitting upwards in expiration (aortic regurgitation)
  4. diaphragm on carotids (aortic radiation/carotid bruits)
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14
Q

what type of murmur does aortic regurgitation cause?

A

this type of regurgitation causes diastolic murmur

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15
Q

what heart defect causes a continuous murmur?

A

patent ductus arteriosus causes this type of murmur?

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16
Q

2 mutated genes in Down’s Syndrome (trisomy 21)

A
  1. DSCAM

2. COLRAM

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17
Q

TBX1

A

a dimeric transcription factor sometimes absent causing DiGeorge

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18
Q

xanthoma

A

visible cholesterol deposits found in familial hypercholesterolemia

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19
Q

indication of definite familial hypercholesterolemia

A

cholesterol >7.5mM + xanthoma in patient or 1/2nd degree relative OR DNA confirmation

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20
Q

indication of possible familial hypercholesterolemia

A

cholesterol >7.5mM + family history of MI <50yo in 2nd degree relative or <60yo in 1st degree relative OR family history of cholesterol >7.5mM

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21
Q

compound heterozygote

A

presence of 2 diff mutant alleles at a gene l tocus

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22
Q

what directly causes decrease in coronary flow (3)?

A
  1. shortening diastole (eg. increase HR)
  2. increase L ventricular EDP (eg. aortic stenosis)
  3. reduce diastolic arterial pressure (eg. mitral/aortic valve incompetence)
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23
Q

3 types of angina

A
  1. chronic stable angina (fixed stenosis)
  2. unstable angina (thrombus)
  3. prinzmetal’s varient angina (vasospasm)
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24
Q

2 beta blockers

A
  1. bisoprolol

2. atenolol

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25
Q

rate limiting Ca antagonists (2)

A
  1. verapamil

2. diltiazem

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26
Q

dihydropyridine Ca antagonists (2)

A
  1. amlodipine

2. lercanidipine

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27
Q

side effects of Ca antagonists (3)

A
  1. headache
  2. constipation
  3. ankle oedema
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28
Q

what type of angina do dihydropyridine Ca antagonists treat?

A

this type of Ca antagonist Prinzmetal angina instead of BB and most anginas alongside BB

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29
Q

how are organic nitrates used for stable angina?

A

sublingual glyceryl trinitrate taken before exertion or isosorbide mononitrate taken long before treats this type of angina

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30
Q

how are organic nitrates used for unstable angina?

A

intravenous glyceryl trinitrate treats this type of angina

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31
Q

funny f-type Na+ channel inhibitor and its use

A

ivabradine used to treat angina

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32
Q

what organ gets the most blood flow per amount of tissue?

A

kidneys are very susceptible to drugs b/c of this

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33
Q

example of effect of weak acids binding to a saturable site on albumin

A

Warfarin and Aspirin bind to this specific site, thus ingesting Aspiring would release more Warfarin

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34
Q

cause of hyperalbuminemia

A

dehydration has this effect on albumin

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35
Q

causes of hypoalbuminemia (4)

A
  1. burns
  2. renal disease
  3. hepatic disease
  4. malnutrition
    has this effect on albumin
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36
Q

how do large lipophobic molecules pass capillary wall? (2)

A
  1. fused invaginations

2. sinusoids/discontinuous capillary

37
Q

what entrances through capillary allow small but not large lipophobic molecules? (2)

A
  1. tight junction

2. fenestrated capillary

38
Q

Hickman and Broviac lines

A

skin-tunnelled CVCs (2)

39
Q

extravasation

A

harmful leakage of IV into extravascular tissue usually caused by vesicant

40
Q

vesicant

A

blister agent

41
Q

infiltration

A

harmless leakage of IV into extravascular tissue

42
Q

why is vancomycin difficult to administer?

A

this drug is difficult to administer b/c it has a long half life so it takes a while to be effective, but can cause red man syndrome if given too quickly or too much

43
Q

how to gauge how much vancomycin to administer?

A

stat loading dose

44
Q

bioavailability

A

fraction of unchanged drug that reaches systemic circulation

45
Q

clearance

A

volume of blood/plasma cleared of drug in a unit time

46
Q

plasma steady state conc (Css)

A

rate of drug administered (Ko)/clearance

47
Q

what does elimination half-life (t1/2) depend on?

A

this directly depends on volume of distribution (Vd) and inversely on clearance (CL)

48
Q

apparent volume of distribution (Vd)

A

total amount of drug in body/blood plasma concentration of drug

49
Q

is primary or secondary hypertension more common

A

primary (idiopathic) cause of this CV condition is more common than secondary

50
Q

possible causes of secondary hypertension

A
  • renal disease (bad BP control)
  • diabetes thus damaged endothelium
  • endocrine disorders
  • coarctation of aorta
  • some drugs (contraceptives, NSAIDS, etc)
  • pregnancy (pre-eclampsia and eventually eclampsia)
51
Q

top 2 most common deaths caused by hypertension

A
  1. heart failure (50%)

2. MI (20%)

52
Q

how does hypertension cause heart failure? (2)

A
  1. LV hypertrophy from increased TPR

2. volume overload due to renal failure

53
Q

each 2mmHg rise in systolic BP is associated w/ increased risk of mortality of what? (2)

A
  1. stroke 10%

2. heart disease (7%)

54
Q

describe symptoms of class I hypertension

A

this class of hypertension has narrows retinal arteries

55
Q

describe symptoms of class II hypertension

A

this class of hypertension has

  • some LV hypertrophy, L axis deviation
  • change in retinal veins
  • microalbuminuria
56
Q

describe symptoms of class II hypertension

A

this class of hypertension has

  • marked LV hypertrophy, massive L axis deviation, inverted T waves
  • retinal oedema/haemorrhage
  • marked albuminuria
  • falling creatinine clearance
57
Q

life expectancy of the 3 classes of hypertension

A

I: 38-40yrs
II: 15-20yrs
III: 8-10yrs

58
Q

to which patients would you offer antihypertensive drugs? (2)

A
  1. stage II hypertension

2. stage I hypertension w/ either target organ damage or 10yr CV risk

59
Q

to which hypertensive patients would you offer specialist referral?

A

you would offer this to patients <40yo w/ stage I hypertension

60
Q

what would you offer to patients >40yo w/ stage I hypertension? (3)

A
  1. lifestyle interventions
  2. patient education
  3. annual review to monitor BP, provide support, discuss
61
Q

2 ACE inhibitors

A
  1. ramipril

2. lisinopril

62
Q

an a-adrenoreceptor blocker

A

doxazosin

63
Q

role of spironolactone

A

this drug is a K+ sparing diuretic and aldosterone antagonist

64
Q

side effects of ACE inhibitors (4)

A
  1. persistent dry cough
  2. dizziness
  3. tiredness
  4. headaches
65
Q

side effects of ARBs (3)

A
  1. dizziness
  2. headaches
  3. back/leg pain
66
Q

side effects of Ca2+ antagonists (4)

A
  1. flushes
  2. headaches
  3. ankle oedema
  4. dizziness
67
Q

most common sites for central line insertion (2)

A
  1. L internal jugular vein

2. L subclavian vein

68
Q

normal central venous pressure

A

3-8mmHg

69
Q

nicorandil

A

combines activate not K+ ATP channels w/ nitrovasodilator actions so vascular smooth muscle harder to depolarize

70
Q

type of drug administered by intermittent infusion (4)

A
  1. unstable drug
  2. long half life
  3. concentration dependent effects
  4. less compatibility concerns
71
Q

most likely cause of RV failure

A

cardiomyopathy is most likely cause of this heart failure

72
Q

shunt ratio

A

ratio b/w pulmonary and systemic flow Qp:Qs

73
Q

Waterston shunt

A

shunt from central PA to aorta

74
Q

polycythaemia

A

condition of too many RBCs

75
Q

which type of ASD is often complicated by other lesions

A

ostium primum ASD differs from ostium second ASD in this way

76
Q

treatments for TGA

A
  • maintain arterial duct
  • atrial septostomy
  • radical switch procedure
  • mustard procedure
77
Q

CATCH-22

A 
Cardiac abnormalities
Abnormal facies
Thyme aplasia
Cleft palate
Hypothyroidism
78
Q

what chromosome region is deleted in DiGeorge Syndrome?

A

22q11.2

79
Q

what disease shows locus heterogeneity?

A

hypertrophic cardiomyopathy shows this type of genetic mutation

80
Q

what mutation occurs in long QT?

A

this disease is caused by channelopathy in either K+ or Na+ channels and delays ventricular repolarization

81
Q

describe vasodilator effect of Ca antagonists for angina

A

this angina drug dilates resistance vessels, thus reducing after load, and coronary vessels (variant angina)

82
Q

describe vasodilator effect of organic nitrates (glyceryl trinitrate and isosorbide mononitrate)

A

this anti-anginal drug acts on veins to decrease cardiac preload and dilate collateral coronary vessels

83
Q

define health promotion

A

process of enabling people to increase control over and improve their health

84
Q

methods of health promotion (5)

A
  1. provide info (ex. pamphlets)
  2. enhance motivation (ex. cognitive behavioural therapy)
  3. behavioural methods (ex. exercise class)
  4. health behaviour maintenance (ex. avoid tempting situations)
  5. combined program (ex. weight watchers)
85
Q

stage model of behavioural change (6)

A
  1. pre-contemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
  6. relapse
86
Q

concentration of albumin in plasma

A

this protein is 40g/L in plasma

87
Q

volume of interstitial fluid in 70kg adult

A

12L of this fluid in a 70kg adult

88
Q

volume of intracellular fluid in 70kg adult

A

27L of this fluid in a 70kg adult

89
Q

volume of plasma in 70kg adult

A

3L of this fluid in a 70kg adult

MD3001 (10 decks)

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