Quiz3.chromatog,TLC,HPT,adme(2,3,4),BB,stroke,arrhythmias

Question 1

In chromatography, what describes the number of theoretical plates per column?

Answer 1

Efficiency

Question 2

What is the clinic blood pressure target for an 85-year-old?

Answer 2

150/90mmHg

Question 3

What are complications of persistent hypertension?

Answer 3

-stroke
-Retinopathy
-CHD
-renal failure
All examples of target organ damage thag occurs with HPT

Question 4

Give a risk factor for hypertension?

Answer 4

Type 1 diabetes

Question 5

What are the treatment pathways for hypertension?

Answer 5

-above 55yrs CCB
-ALL diabetic patients ACEi

Question 6

What are three characteristics of drug undergoing passive diffusion must have?

Answer 6

1. Small molecule
2. preferably unionised
3. lipophilic molecule

Question 7

3 facts about passive diffusion?

Answer 7

1. Drug must be in solution
2. Drug moves down conc gradient
3. Drug CAN move forward and backwards across membrane

Question 8

What is volume of distribution?

Answer 8

Volume of distribution is the tendency of drug molecules to leave the plasma and enter other cells, for example, target cells and organs.

Question 9

What is one non modifiable risk factor of stroke and 4 modifiable risk factors?

Answer 9

Non mod = previous MI
Modifiable = hpt, diabetes, hyperlipidaemia and smoking

Question 10

What is the emergency treatment for an ischaemic stroke?

Answer 10

• clot busting /thrombolytic agent within 4.5hrs ~ alteplase
• loading dose of antiplatelet ~ aspirin 300mg
• secondary prevention ~ clopidogrel 75mg
  -lipid and lifestyle modification also

Question 11

When would anticoagulation be recommended for patient following an ischaemic stroke?

Answer 11

NICE recommends anticoagulation recommended in patients with atrial fibrillation or a flutter

Question 12

What are four risk factors for atrial fibrillation?

Answer 12

Hypertension, diabetes mellitus, advancing age, male sex

Question 13

What are the five C’s of arrhythmia management?

Answer 13

Causes
Control
Coagulation
Cardioversion
Cure

Question 14

What is the Vaughan Williams classification for antiarrhythmic drugs?

Answer 14

Class 1 -sodium channel blocker - lidocaine, encainide
Class 2- beta blocker - atenolol, metoprolol
Class 3- potassium channel blocker -amiodarone, d-sotalol
Class 4-calcium channel blocker -verapamil, diltiazem

Question 15

Which oral anticoagulant would you give an AF patient with stroke risk?

Answer 15

Preferably a DOAC (suffix -xaban), or warfarin. This is patient dependent, can decide either, should be counselled on both.

Question 16

What may sway a patient from taking warfarin as their oral anticoagulant for AF stroke risk?

Answer 16

Warfarin requires heavy monitoring (INR) and frequent dose changes, also many interactions (OTC and prescribed meds) therefore patient may not want all this hassle

Question 17

For long term rate control therapy in an AF patient, what can you give?

Answer 17

Either a beta blocker or a rate limiting calcium channel blocker (NOT DHPCCB) eg verapamil or diltiazem