Week 6a: Disorders of Systemic Blood Flow

Question 1

What are 3 types of atherogenic cholesterols?

Answer 1

LDL, VLDL and IDL

Question 2

What are 3 major complications of atherosclerosis?

Answer 2

ischemic heart disease, stroke and PVD

Question 3

what is an example of a codominant genetic disorder that is a cause of hyperlipidemia?

Answer 3

familial hypercholesterolemia

Question 4

what is an example of a autosomal dominant genetic disorder that is a cause of hyperlipidemia?

Answer 4

familial combined hyperlipidemia

Question 5

High level of cholesterol

Answer 5

US: < 240. CAN: < 6.2

Question 6

High level of LDL cholesterol

Answer 6

US: 160-189. CAN: 4.2-4.9

Question 7

Low level of HDL

Answer 7

US: < 40. CAN: < 1.0

Question 8

What are 3 important adverse effects of statins?

Answer 8

increased liver enzymes, increased risk for DM and rhabdomyolysis

Question 9

MoA of statins

Answer 9

Statins inhibit HMG-CoA Reductase, an enzyme necessary for cholesterol synthesis

Question 10

MoA of bile acid resins

Answer 10

bind to bile, preventing enterohepatic recirculation of bile thus more bile and more cholesterol is eliminated

Question 11

Prototype drug for bile acid resins

Answer 11

Cholestyramine (Olestyr, Questran)

Question 12

Niacin for dyslipdemia

Answer 12

produces more adverse effects than statins and can have additive effects with other drugs

Question 13

what is 2nd line treatment for hypertryglyceridemia but does not reduce LDL

Answer 13

Fibric acid drugs

Question 14

adverse effects of Cholestyramine

Answer 14

constipation, bloating, nausea and vomiting

Question 15

Serious adverse effects of cholestyramine

Answer 15

• Obstruction of GI tract
• Malabsorption syndrome – lack of bile reduces absorption of lipid soluble nutrients
• Hyperchloremic acidosis, related to loss of bicarbonate via GI tract

Question 16

Therapeutic effects of Gemfibrozil (Lopid)

Answer 16

Hypertriglyceridemia and VLDL
To prevent pancreatitis (when very high TG)
Can be used in conjunction with statins

Question 17

MoA of Ezetimibe (Zetia)

Answer 17

blocks absorption of cholesterol in intestinal lumen

Question 18

Tx for Kawasaki disease

Answer 18

IV gamma globulin and aspirin

Question 19

Tx for temporal arteritis

Answer 19

high dose corticosteroids without delay because of the significant risk of vision loss

Question 20

What are the 7 Ps of acute arterial embolism

Answer 20

• Pistol shot (acute onset)
• pallor
• polar (cold)
• pulselessness
• pain
• parenthesia
• paralysis

Question 21

what are risk factors for venous stasis?

Answer 21

• bed rest
• immobility
• spinal cord injury
• Acute MI
• CHF
• shock
• venous obstructions

Question 22

leg pain that worsens during walking but is relieved by rest may be caused by ______ insufficiency

Answer 22

arterial

Question 23

Pain that worsens with standing and is relieved by leg elevation and activity is caused by _____ insufficiency

Answer 23

venous

Question 24

Expected MAP

Answer 24

70-100 mmHg

Question 25

SBP in malignant hypertension

Answer 25

> 180mmHg

Question 26

Risks of malignant hypertension

Answer 26

organ endothelial damage, retinal bleed, CVA, and acute renal failure

Question 27

Major organs affected by hypertension

Answer 27

brain, heart and vasculature, eyes, kidneys and reproductive systems