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PulmRenal > Weeks 6-10 > Flashcards

Weeks 6-10 Flashcards

1
Q

Vitamin B3 AKA

A

Niacin

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1
Q

What angina med can’t you take with your penis pills?

A

No nitrates with sildenafil

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2
Q

look at this picture

A

look at it

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2
Q

optic neuropathy, polyneuritis, malaise, weight loss, irritability, confusion, potentially fatal

A

vitamin B1 deficiency, korsokoff’s syndrome

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3
Q

hydrochlorothiazide side effects

A

dehydration, hyponatremia, hypokalemia, renal dysfunction, increase in serum uric acid

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4
Q

nifedipine and amlodipine, which is short acting?

A

nifedipine

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4
Q

Vitamin that is highly effective in raising HDL

A

Niacin (nicotinic acid)

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5
Q

med recommended for classes II - IV heart failure

A

Aldosterone blockers

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6
Q

prototype thiazide diuretics (2)

A

chlorthalidone, hydrochlorothiazide

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6
Q

look at this picture

A

look at it.

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7
Q

ezetimibe action

A

cholesterol absorption inhibitor, modest LDL lowering

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8
Q

2 aldosterone blockers

A

spironolactone, eplerenone

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8
Q

problems with furosemide toxicity

A

(OHHHHH DANG) Ototoxic, Hypokalemia (hypokalemic metabolic acidosis), Hypocalcemia, Hypomagnesemia, Hyperglycemia, Hyperlipidemia, Dehydration, Allergy (sulfonamide, but ethacrynic acid is ok), Nephritis (interstitial), Gout

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8
Q

Look at this picture

A

Look at it.

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9
Q

NYHA class I

A

no symptoms

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9
Q

acetazolamide X urine pH and Y body pH

A

increases urine, drops body

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9
Q

2 main manifestations of heart failure

A

SOB

Congestion

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10
Q

Vitamin B1 is used in the synthesis of

A

acetylcholine and GABA

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10
Q

clinical uses of thiazides

A

hypertension, CHF, nephrolithiasis (calcium), osteoporosis, diabetes insipidus

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11
Q

Med recommended for classes I and II heart failure

A

beta blockers

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12
Q

This drug decreases coronary tone, helping in angina

A

CCB’s

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12
Q

Stage B heart failure

A

structural heart disease, no s/sx

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14
Q

Clinical presentation of Vitamin B2 deficiency

A

Painful red tongue with sore throat, chapped and fissured lips (cheilosis), and inflammation of the corners of the mouth (angular cheilitis)

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14
Q

Stage C heart failure

A

structural heart disease with s/sx

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15
Q

Effect of calcitonin on serum calcium

A

lower

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16
Q

Meds for systolic heart failure not proven to decrease mortality

A

digoxin, diuretics

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16
Q

In management of ischemic heart disease, nitrates work best when prescribed with

A

CCB’s or Beta Blockers

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17
Q

diseases that elevate triglycerides

A

DM

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17
Q

clinical indications for furosemide

A

edema, acute pulmonary edema, increase urine flow in acute renal failure, hypertensive emergency, hypercalcemia and hyperkalemia (combined with fluid replacement)

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18
Q

crackles

wheezing

decreased breath sounds

left sided S3

mitral regurg murmur

increased P2 component of S2

A

pulmonary congestion of heart failure

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19
Q

Major side effects of bile acid sequestrants like cholestyramine

A

GI side effects (constipation, diarrhea, bloating, farts, and such)

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20
Q

If on isosorbide dinitrate, take it in the X because

A

morning, because body downregulates the effect of nitrates, need a nitrate free afternoon/evening

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20
Q

major side effect of amlodipine

A

peripheral edema

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21
Q

dihydropiridine CCB action

A

smooth muscle in peripheral vasculature

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21
Q

clinical uses of mannitol

A

decreases intraocular and intracranial pressure, prevention of acute renal failure in hypotension and acute tubular necrosis

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22
Q

2 cardioselective beta blockers

A

metoprolol and atenolol

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23
Q

Clinical presentation of B6 deficiency

A

seborrheic dermatitis-like eruption, atrophic glossitis with ulceration

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23
Q

Don’t give statins with

A

fibrates

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24
Q

2 statins for high intensity therapy

A

atorvastatin, rosuvastatin

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24
Q

2 types of congestion

A

pulmonary and systemic (guess which side of the heart is related to each)

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25
Q

NYHA class III

A

symptoms with less than ordinary activity

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25
Q

cholestyramine action

A

bile acid sequestrant, lowers LDL, also used in butt paste

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25
Q

Here’s another picture

A

picture time!

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26
Q

B12 AKA

A

Cobalamin

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27
Q

What do beta’s do goodly in heart failure?

A

prevent remodeling

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28
Q

seborrheic dermatitis-like eruption, atrophic glossitis with ulceration

A

Clinical presentation of B6 deficiency

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29
Q

prototype potassium sparing diuretics

A

spironolactone, amiloride

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29
Q

Stage B heart failure treatment

A

control BP

Statins if CV history

maybe an implantable defib? (if needed? it’s on the slide?)

Ace and Beta

maybe some ARB’s if Ace is contraindicated

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30
Q

Stage D heart failure

A

you gonna die (news flash: we all gonna die)

Refractory heart failure requiring specialized interventions

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31
Q

Recommended daily dose of calcium (calcium carbonate)

A

400-1200 mg (1-3 g)

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32
Q

2 dihydropiridine CCB’s

A

amlodipine and nifedipine

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32
Q

prototype carbonic anhydrase inhibitor

A

acetazolamide

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33
Q

prototype osmotic diuretic

A

mannitol

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34
Q

drugs that elevate triglycerides

A

estrogen, retinoic acid, beta blockers (not carvedilol), thiazides

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36
Q

The other nitrate, what makes it different?

A

Isosorbide dinitrate, longer acting

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38
Q

IM or IV iron

A

iron dextran

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39
Q

HFrEF first line

A

Ace and Beta

(The ambiguously Bi duo?)

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40
Q

most efficacious diuretics currently available

A

loop diuretics (furosemide)

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40
Q

JVD

Pleural effusion

Right sided S3

tricuspid regurg murmur

ascites

big fuckin liver

edema

A

systemic congestion of heart failure

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42
Q

Animals get Vitamin B1 from

A

diet (fungi, bacteria, plants)

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42
Q

Standard therapy in HFrEF

A

beta blocker + ACEi or ARB

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43
Q

furosemide drug interactions

A

antiarrhythmics (esp QT prolongers), Glucocorticoids, NSAIDS, aminoglycoside abx and cisplatin (increased risk of ototoxicity), other antihypertensives (additive effect)

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44
Q

4 statin benefit groups

A

people with ASCVD LDL >190 all healthy diabetics >40 age >40 ASCVD risk >7.5%

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45
Q

Where do we store B12

A

Liver (3000-5000 micrograms)

45
Q

Statin side effects

A

myalgias and maybe some rhabdo with the high intensity

46
Q

Calcitriol effects on serum calcium

A

increases by increasing gut uptake and potentially increasing uptake from bone

47
Q

MOA of nitroglycerin

A

relax vascular smooth muscle

48
Q

atorvastatin side effects

A

rhabdomyolysis with acute renal failure, liver function abnormalities

49
Q

The only indication for iron supplementation

A

Treatment or prevention of iron deficiency anemia

50
Q

side effects of amiloride and spironolactone

A

hyperkalemic metabolic acidosis

51
Q

Calcium carbonate is X% calcium

A

40%

52
Q

Stage C heart failure treatment

A

Ace and Beta

Diruetics

ARB if they can’t Ace

Aldosterone receptor antagonists

Nitrate-Hydralazine maybe

Digoxin (or not, whatever)

Omega fatty acids

53
Q

prototype loop diuretic

A

furosemide

55
Q

beta blocker contraindications

A

prinzmetal angina, severe bradycardia, asthma

56
Q

drugs that elevate LDL

A

diuretics, glucocorticoids

57
Q

Which thiazide shows better CV risk data?

A

chlorthalidone

58
Q

NYHA class II

A

symptoms with ordinary activity

60
Q

X% of body calcium is stored in bone

A

98%

61
Q

Using this supplement in women of childbearing age decreases the risk of neural tube defects

A

folic acid

62
Q

The most common cause of elevated right sided filling pressures is

A

elevated left sided filling pressures

63
Q

chronic action of thiazides

A

decrease peripheral resistance

64
Q

Duration of action for furosemide

A

2-4 hours

65
Q

Vitamin B3 Deficiency, AKA and clinical presentation

A

Pellagra: 3 D’s, diarrhea, dermatitis, dementia common in alcoholics and impoverished

66
Q

acute action of thiazides

A

decrease intravascular volume and cardiac output

67
Q

metoprolol side effects

A

hypotension, bradycardia, heart block

68
Q

another name for statins

A

HMG CoA reductase inhibitors

69
Q

Potassium sparing diuretics location of action and mechanism

A

collecting tubule, inhibits Na resorption which inhibits K secretion

70
Q

diseases that elevate LDL

A

biliary obstruction, nephrotic syndrome, hypothyroidism, obesity, pregnancy

71
Q

2 non dihydropiridine CCB’s

A

diltiazem and verapamil

73
Q

side effect of diltiazem

A

peripheral edema

74
Q

Stage A heart failure

A

High risk, that’s all

76
Q

Why are Tums no longer labeled as a calcium supplement?

A

They don’t contain vitamin D

77
Q

Common 2nd generation CCB

A

amlodipine

78
Q

X% of body phosphorus is stored in bone

A

85%

79
Q

conivaptan toxicity problems

A

nephrogenic diabetes insipidus, dry mouth, thirst, polyuria (you don’t say?!)

80
Q

classic go-to for cirrhosis

A

spironolactone

82
Q

Vitamin B6 is involved in the synthesis of

A

neurotransmitter, histamine, hemoglobin, (gene expression)

84
Q

Niacin side effects, method to prevent one

A

flushing, pretreat with aspirin and slowly titrate dose up, also inhibits tubular secretion of uric acid, which may worsen gout

85
Q

Vitamin B6 serves as a cofactor in metabolism of

A

amino acid, glucose, lipids

87
Q

Consequences of B12 deficiency

A

Megaloblastic, macrocytic anemia with CNS dysfunction, paresthesias, weakness, ataxia

88
Q

X are not directly helpful for angina

A

ACE inhibitors

89
Q

ACC and AHA prefer X over Y for survival rate post MI

A

Beta blockers over calcium channel blockers

91
Q

Lisinopril side effects

A

cough, renal dysfunction, angioedema, hyperkalemia

92
Q

action of fibrates

A

lower triglycerides, raise HDL

93
Q

Define surrogate endpoint

A

Something along the lines of “Who gives a fuck if we change some measurement or lab value? What matters is if the patient id dead.”

95
Q

Cause of pernicious anemia

A

defective secretion of intrinsic factor by gastric mucosal cells, necessary for absorption of vitamin B12

96
Q

NYHA class IV

A

symptoms at rest or with minimal activity

97
Q

initial antianginal therapy in all patients without contraindications

A

beta blockers

98
Q

conivaptan location of action

A

collecting duct

99
Q

2 fibrates

A

gemfibrozil and fenofibrate

100
Q

this should be used in all patients with a reduced EF to prevent heart failure

A

Ace and Beta

the ambiguously bi duo

102
Q

This supplement can correct B12 deficiency anemia, but does not prevent the permanent neuro damage

A

folic acid

103
Q

2 meds for management of fluid overload

A

furosemide and spironolactone

104
Q

diarrhea, dermatitis, dementia common in alcoholics and impoverished

A

B3 deficiency, pellagra

106
Q

nifedipine can worsen

A

angina

107
Q

Treatment for stage A heart failure

A

fix the things that make them at risk (smoking, lipids, etc)

107
Q

Painful red tongue with sore throat, chapped and fissured lips (cheilosis), and inflammation of the corners of the mouth (angular cheilitis)

A

Clinical presentation of Vitamin B2 deficiency

109
Q

prototype ADH antagonists

A

conivaptan

111
Q

action of diltiazem

A

peripheral smooth muscle and myocardium

113
Q

Hydralazine and nitrates decrease mortality in which patients with heart failure

A

African Americans

114
Q

What kind of MI should you not use nitrates with?

A

Right sided

116
Q

risk of fibrates

A

increased risk of myopathy when given with statins

117
Q

furosemide MOA

A

loop diuretic, inhibits Na/K/2Cl cotransport, decreasing reabsorption

119
Q

Arrange ferrous sulfate, gluconate, and fumarate in order from most to least elemental iron

A

fumarate sulfate gluconate

121
Q

Vitamin B6 AKA

A

Pyridoxine

122
Q

clinical indications of conivaptan

A

syndrome of inappropriate ADH secretion, CHF, autosomal dominant polycystic kidney disease

124
Q

B12 deficiency is almost always from

A

malabsorption (pernicious anemia)

125
Q

avoid non dihydropiridine CCB’s in patients with

A

heart failure

126
Q

This drug is no good for uncompensated heart failure

A

Betas

127
Q

Vitamin B1 AKA

A

Thiamine

128
Q

Nitrates mostly relax _____

A

Veins

130
Q

Vitamin B2 AKA

A

Riboflavin

132
Q

thiazide MOA

A

inhibits NaCl resorption in distal convoluted tubule

133
Q

verapamil mainly affects the

A

myocardium

134
Q

Thiazide interactions

A

QT prolongers, corticosteroids, NSAIDS, lithium, other antihypertensives

135
Q

Another name for Niacin / B3

A

Nicotinic acid

136
Q

Treatment for B12 malabsorption

A

1,000 micrograms IM daily for a week then monthly for life

137
Q

Thiazide toxicity problems

A

HAIG Hypo (Na, K, Mg), Hyperglycemia, Hyperlipidemia, Allergy, Impotence, Gout

138
Q

Megaloblastic, macrocytic anemia with CNS dysfunction, paresthesias, weakness, ataxia

A

Consequences of B12 deficiency

139
Q

Vitamin B1 deficiency, AKA and clinical presentation

A

Korsakoff’s syndrome: optic neuropathy, polyneuritis, malaise, weight loss, irritability, confusion, potentially fatal

140
Q

noncardioselective beta blocker

A

propanolol

141
Q

MOA for spironolactone

A

aldosterone antagonist, aldosterone promotes sodium retention. Spironolactone use results in retention of K and excretion of Na

142
Q

1,25-dihydroxyvitamin D3 AKA

A

Calcitriol

144
Q

Effect of calcitonin on bone

A

inhibits osteoclastic calcium resorption

145
Q

First line therapy in the treatment of chronic stable angina?

A

Beta Blockers, motherfuckers

146
Q

definition of clinical ASCVD

A

ACS, MI, angina, revascularization, stroke, TIA, atherosclerotic PAD

147
Q

diet influence to elevate triglycerides

A

EtOH

148
Q

Big no-no for ACEi

A

teratogenic

149
Q

Commonly used oral form of calcium

A

Calcium carbonate

150
Q

avoid ezetimibe in

A

patients with moderate to severe hepatic dysfunction

151
Q

________ has a shirt that looks like an ugly old couch

A

KeiKei

152
Q

Patients taking simvastatin along with inhibitors of X are at an increased risk for rhabdomyolysis

A

CyP450

153
Q

acetazolamide blocks X in the Y

A

NaHCO3 resorption in the proximal convoluted tubule

154
Q

clopidogrel side effects

A

bleeding

155
Q

Diuretic for open angle glaucoma

A

acetazolamide

156
Q

How long does it take to use up B12 left in the liver

A

5 years, we only use about 2 micrograms per day

157
Q

MOA for CCB’s

A

arteriolar vasodilators

158
Q

mannitol action

A

mobilizes intracellular fluid to extracellular space, initially expands intravascular volume, which is then eliminated via osmotic effect in kidneys

159
Q

Common drug and dose for high-intensity statin therapy

A

Atorvastatin 80

PulmRenal (2 decks)

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