Rx_1.11 (Cardio) Flashcards
1
Q
Feature/Dx?
A
- Aschoff module = perivascular fibrinoid necrosis
- Dx = rheumatic heart disease (rheumatic fever)
2
Q
Cardiac consequences of rheumatic fever
A
- autoimmune insult @ mitral valve ==>
- mitral stenosis +
- heart murmer
- pathology: aschoff nodule = perivascular fibrinoid necrosis
- w/excessive strain on heart/cardiovascular system ==> heart failure
3
Q
Patient from developing country + murmur + suden death ==> dx?
A
Most likely Rheumatic heart disease
4
Q
Presentation of PDA
A
- wide pulse pressure
- excercise intolerance
- continous machine-like murmur
5
Q
Important risk factor for PDA
A
- congenital rubella
- mother during pregnancy:
- maculopapular rask @ face ==> body
6
Q
Organisms that can cross placenta ==> congenital disease
A
- ToRCHeS:
- Toxoplasmosis
- Rubella
- Cytomegalovirus
- Herpesvirus/HIV
- Syphillis
7
Q
Cardiac drugs to avoid in DM patients taking sulfonylurea (glipizide)
A
- beta-blockers (e.g. metoprolol)
- can mask hypoglycemia (possible complication of DM drugs like sulfonylurea)
8
Q
MOA of sublingual tablet used to tx activity-induced chest pain
A
- drug = Nitroglycerin
- MOA =
- Nitric oxide ==> vasodilation via cGMP-dependent mechanism
- @ low dose: venodilation ==> decreased preload ==> decreased myocardial O2 demand
- @ high dose: venous + arteriolar dilation ==> decreased afterload
- can ==> hypotension and reflex tachycardia
9
Q
Adverse effects of Nitroglycerin
A
- development of tolerance
- dilation of facial and menigeal arterioles ==>
- flushing
- headache
10
Q
Tx of acute exacerbations of CHF w/pulmonary edema
A
- Loop diuretics
- furosemide
11
Q
Characteristics of “brown atrophy”
A
- acummulation of lipofuscin @ heart, liver, or spleen
- lipofuscin =
- “wear and tear” pigment
- oxidized and polymerized membrane lipids from autophagocytosed organelles
- benign finding @ elderly
12
Q
Direct-acting vs. indirect-acting sympathomimetics
A
- direct (e.g. isoproterenol):
- postsynaptic adrenergic receptors
- no interaction w/presynaptic neurons
- more selective for receptor activity
- direct (e.g. amphetamine):
- presynaptic adrenergic receptors
- no interaction w/postsynaptic neurons
- ability to enter CNS ==> undesirable stimulation
- less selective for receptor activity
13
Q
Mechanism of constriction of pupil
A
- calcium-calmodulin complex activates myosin light-chain kinase
- myosin light-chain kinase phosphorylates myosin
- myosin binds to actin
14
Q
Tx for elevated lipids + body pains + weakness + elevated creatine kinase ==> Dx?
A
- Dx = myositis or rhabdomyolysis
- complication of tx w/ statin + fibric acid derivative (e.g. gemfibrozil)
15
Q
Effects/MOA of digoxin
A
- MOA = inhibition of Na-K pump ==> increased intracell Na ==> reduces Ca extrusion via Na-Ca exchange ==>
- increased contractility (inotrope)
- ==> decreased end-systolic vol.
- ==> increased ejection fraction
- ==> CO
- ==> decreased sympathetic activity ==> reduced vascular resistance
- increased contractility (inotrope)
