missed stuff pt 2 Flashcards
Ketone bodies are derived from acetyl CoA. What is the primary source of this acetyl CoA?
fatty acids
what are some important things derived from activated isoprenes?
dolichol, coenzyme Q or ubiquinone, carotinoids, and protein anchor lipids
when do you not use nitroprusside
primary HTN; it can’t be given long term
what is the MOA of minoxidil
Minoxidil activates potassium channels in vascular smooth muscle, which results in hyperpolarization and delayed activation of L-Type calcium channels to influx extracellular calcium
what is the MOA of fenoldopam
Fenoldopam is a D1 dopamine receptor agonist (GPCR coupled to Gs and cAMP in vascular smooth muscle) used to cause vasodilation in emergency control of blood pressure
A 50 year old man presents to clinic because his right calf cramps when he walks more than a mile. Currently, it does not compromise his activities but he wants to be pro-active in his health care. He reports compliance with daily aspirin and statin therapy. You explain that he has peripheral artery disease with intermittent claudication and because of this disease, his greatest health risk over the next five years is
MI/stroke
While autopsy studies have determined that atheromatous disease begins in adolescence, what percentage of patients greater than 70 years of age have symptomatic peripheral artery disease (PAD)
30%
which arrhythmias can be solved by walking around
AVNRT and AVRT
how is bloodflow to the heart changes with exercise
it isnt!
During aerobic exercise, blood flow to vascular beds in the muscles being exercised is due to
local metabolites (protons, lactate, CO2) causing vasodilation
what medication is contraindicated in variant angina
beta blockers
Several factors, including increased preload, increased afterload, higher contractility, and faster heart rate, causes the myocardial workload, and therefore, myocardial oxygen demand, to increase. What mechanism is the most likely means by which blood flow to the myocardium can adequately supply this increased demand
increasing coronary flow
A 23-year-old female is weight training and keeps on adding weight to achieve isometricity while doing bicep curls. Within 2 minutes of exerting this effort, she experiences a sharp pain in the biceps that slowly recedes after she dropped the barbell. What is the most likely reason for her experiencing the muscle pain
muscle constricting small vessels
what are the anterior and posterior landmarks of the carina
Anteriorly the sternal angle, posteriorly at T-4
a murmur is described as blowing decrescendo in early diastole. what is it?
aortic regurgitation
how does inspiration impact the murmur heard with tricuspid regurgitation
increases it
what would an increased hepatojugular reflex indicate
issues with the right heart, pericarditis, cardiac tamponade
in the presence of asthma, which drug class would you use to treat angina
CCBs
why is nifedipine not a great drug to treat angina
it reduces afterload and thus causes reflex tachycardia, which may make the symptoms worse
when would someone use milrinone
in late heart failure or as bridge therapy
how does hypothyroidism impact lipid disorders
it prevents LDLR receptors from functioning, increasing LDL
where are myxomas usually located? what is their character?
the left atrium; goopy and gelatinous
a patient has a tumor in their right ventricle with areas of hemorrhage and necrosis. what is it
angiosarcoma
what are aschoff bodies?
cells in the acute phase of rheumatic heart disease
describe heart complications of turners syndrome
can cause a bicuspid valve with vegetations as well as aortic coarctation
post-op abscess puts someone at risk for what complication
aortic aneurysm
what is the best method for diagnosing hypertrophic cardiomyopathy
an echo
what is the most common tumor in the adult heart
a metastatic one!
What pathologic feature do myxomas and mural thrombi have in common?
tendency to embolize
which two tumors can undergo spontaenous regression
rhabdomyomas and capillary hemangiomas
what 3 conditions do you rule out before considering familial hypercholesterolemia
hypothyroidism/hashimotos, nephrotic syndrome, and obstructive liver disease
hypertrophic cardiomyopathy preferentially thickens which part of the heart
the septum
loefflers endocarditis leads to what kind of cardiomyopathy
restrictive
a patient with a history of cancer has heart vegitations. what likely caused them?
fibrin and platelets, aka marantic endocarditis
what environment is associated with marantic endocarditis
hypercoagulable state/history of cancer
