Week 6a: Disorders of Systemic Blood Flow Flashcards
What are 3 types of atherogenic cholesterols?
LDL, VLDL and IDL
What are 3 major complications of atherosclerosis?
ischemic heart disease, stroke and PVD
what is an example of a codominant genetic disorder that is a cause of hyperlipidemia?
familial hypercholesterolemia
what is an example of a autosomal dominant genetic disorder that is a cause of hyperlipidemia?
familial combined hyperlipidemia
High level of cholesterol
US: < 240. CAN: < 6.2
High level of LDL cholesterol
US: 160-189. CAN: 4.2-4.9
Low level of HDL
US: < 40. CAN: < 1.0
What are 3 important adverse effects of statins?
increased liver enzymes, increased risk for DM and rhabdomyolysis
MoA of statins
Statins inhibit HMG-CoA Reductase, an enzyme necessary for cholesterol synthesis
MoA of bile acid resins
bind to bile, preventing enterohepatic recirculation of bile thus more bile and more cholesterol is eliminated
Prototype drug for bile acid resins
Cholestyramine (Olestyr, Questran)
Niacin for dyslipdemia
produces more adverse effects than statins and can have additive effects with other drugs
what is 2nd line treatment for hypertryglyceridemia but does not reduce LDL
Fibric acid drugs
adverse effects of Cholestyramine
constipation, bloating, nausea and vomiting
Serious adverse effects of cholestyramine
- 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
Therapeutic effects of Gemfibrozil (Lopid)
Hypertriglyceridemia and VLDL
To prevent pancreatitis (when very high TG)
Can be used in conjunction with statins
MoA of Ezetimibe (Zetia)
blocks absorption of cholesterol in intestinal lumen
Tx for Kawasaki disease
IV gamma globulin and aspirin
Tx for temporal arteritis
high dose corticosteroids without delay because of the significant risk of vision loss
What are the 7 Ps of acute arterial embolism
- Pistol shot (acute onset)
- pallor
- polar (cold)
- pulselessness
- pain
- parenthesia
- paralysis
what are risk factors for venous stasis?
- bed rest
- immobility
- spinal cord injury
- Acute MI
- CHF
- shock
- venous obstructions
leg pain that worsens during walking but is relieved by rest may be caused by ______ insufficiency
arterial
Pain that worsens with standing and is relieved by leg elevation and activity is caused by _____ insufficiency
venous
Expected MAP
70-100 mmHg
SBP in malignant hypertension
> 180mmHg
Risks of malignant hypertension
organ endothelial damage, retinal bleed, CVA, and acute renal failure
Major organs affected by hypertension
brain, heart and vasculature, eyes, kidneys and reproductive systems
