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Step 1 First Aid 08: Cardiovascular

Step 1 First Aid 08: Cardiovascular

by rhymenoceros, May 2010

Subjects: 08 1 aid cardiovascular first step

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350 Cards in this Set

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	carotid sheath contents	internal jugular common carotid vagus nerve
	in carotid sheath, jugular is located ___ly carotid is located ___ly vagus is located ___ly	lateral medial posterior
	apex is perfused by ___	LAD
	anterior interventricular septum is perfused by ___	LAD
	posterior LV is perfused by ___	CFX
	2 branches of RCA	acute marginal a. posterior descending a.
	RV is perfused by ___	acute marginal a.
	posterior septum is perfused by ___	PDA
	SA node is perfused by ___	RCA (usually)
	AV node is perfused by ___	RCA (usually)
	inferior LV is perfused by ___	PDA
	80% of the time, posterior descending a. is from ___ the rest of the time it's from ___	RCA CFX
	most commonly occluded coronary	LAD
	most posterior part of heart	RA
	RA dilation can cause ___ (2)	dysphagia hoarseness
	dysphagia in RA dilation is from compression of ___	esophageal n. (plexus?)
	hoarseness in RA dilation is from compression of ___	recurrent laryngeal n.
	CO definition	SV*HR
	CO from Fick principle	(O2 consumption)/(A-V O2 difference)
	MAP definition (Ohm's law)	CO*TPR
	MAP estimate	2/3 DBP + 1/3 SBP
	pulse pressure definition	SBP - DBP
	pulse pressure is proportionate to ___	SV
	SV definition	EDV - ESV (see also Ohm's law)
	3 determinants of SV	preload contractility afterload
	2 electrolytes which affect contractility	Ca2+ Na+
	increased intracellular ___ causes increased/decreased contractility	Ca2+
	decreased extracelluar ___ causes increased/decreased contractility	Na+
	4 chemicals which affect contractility	catecholamines digitalis beta blockers (non DHP) CCBs
	3 physiological states which reduce contractility	acidosis hypoxia hypercapnea
	heart volume which measures preload	EDV
	pressure which measures afterload	MAP
	nitrates act as ___dilators and reduce ___	veno preload
	ejection fraction is ratio of ___ to ___ normal value is ___	SV EDV >55%
	Ohm's law for circulation	MAP = CO x TPR
	Pouiseuille's equation for resistance	R = 8x(viscosity)x(length)/(Pi x r^4)
	3 conditions with increased viscosity	polycythemia hyperproteinemia (e.g. MM) spherocytosis
	TPR is mostly controlled by ___ (vessels)	arterioles
	Guyton plot shows 2 plots: ___ and ___ the first has a ___ slope overall, and the second ___	CO vs. EDV venous return vs. P(RA) positive negative
	in Guyton plot, X-intercept of the venous return plot is equal to ___	MAP
	in Guyton plot, CO plot is modified by ___	contractility
	in Guyton plot, increased contractility does ___	increases slope of CO plot
	in Guyton plot, venous return plot is modified by ___ (2)	TPR blood volume
	in Guyton plot, increased TPR does ___	shifts venous return plot towards origin
	in Guyton plot, increased blood volume does ___	shifts venous return plot away from origin
	systole lasts from ___ to ___	mitral valve closure aortic valve closure
	cardiac cycle is plotted as ___ vs. ___ the cycle runs ___-wise	P V counter-clockwise
	the right hand segment of the cardiac cycle plot corresponds to ___ its location corresponds to ___	isovolumic contraction EDV
	the top of the cardiac cycle plot corresponds to ___ its location corrsponds to ___	rapid + reduced ejection contractility
	the left-hand segment of the cardiac cycle plot corresponds to ___ its location corresponds to ___	isovolumic relaxation ESV (approximately)
	the bottom of the cardiac cycle plot corresponds to ___	rapid + reduced ventricular filling
	S1 corresponds to ___ it is located at ___ on cardiac cycle plot it is loudest at ___	mitral + tricuspid valve closing lower R corner mitral point
	S2 corresponds to ___ it is located at ___ on cardiac cycle plot it is loudest at ___	aortic + pulmonic valve closing upper L corner LSB
	S3 is normal in ___ (2) it indicates ___ caused by ___ it is located at ___ on cardiac cycle plot	children pregnant women turbulent flow high filling pressure lower L corner
	S4 corresponds to ___ it indicates ___ caused by ___	atrial kick low compliance ventricular hypertrophy
	3 peaks in JVP	C wave V wave A wave
	C wave corresponds to ___	tricuspid valve bulging into RA during early systole
	V wave corresponds to ___	RA filling
	A wave corresponds to ___	atrial kick
	2 descents in JVP	x y
	x descent corresponds to ___	atrial relaxation during systole
	y descent corresponds to ___	atrial emptying during diastole
	in normal S2 splitting, ___ occurs before ___ ___ increases the difference	A2 P2 inspiration
	P2 is later in inspiration because	lower intrathoracic pressure pulls more blood into vena cava
	2 conditions causing wide S2 splitting	pulmonic stenosis RBBB
	fixed splitting is caused by ___	ASD
	paradoxical splitting is caused by ___ inspiration increases/decreases the split	aortic stenosis LBBB decreases
	VSD murmur is ___ it is loudest over ___	holosystolic tricuspid point
	aortic regurg is ___ it is loudest over ___	diastolic LSB
	pulmonic regurg is ___ it is loudest over ___	diastolic LSB
	pulmonic stenosis is ___ it is loudest over ___	systolic pulmonic point
	mitral regurg murmur is enhanced by maneuvers which ___, such as ___ (2)	raise TPR squatting hand grip
	tricuspid regurg murmur is enhanced by maneuvers which ___, such as ___	increase RA return inspiration
	extra sound associated with aortic stenosis this is caused by ___	ejection click abrupt stop of valve leaflets
	pulse in aortic stenosis is ___ (2)	weak late
	MVP murmur is a ___ murmur with ___ shape extra sound is ___, which is caused by ___	late systolic crescendo midsystolic click sudden tensing of chordae tendineae
	MVP murmur is enhanced by maneuvers which ___	increase TPR
	mitral stenosis is a ___ murmur extra sound is ___, caused by ___	late diastolic opening snap tensing of chordae
	PDA murmur is a ___ murmur it is maximal at ___ (time)	continuous S2
	most common valvular lesion	MVP
	phase 0 of cardiac AP is ___ it is due to ___	rapid upstroke Na+ influx
	phase 1 of cardiac AP it is due to ___ (2)	initial repolarization Na+ channel inactivation beginning of K+ efflux
	phase 2 of cardiac AP is ___ it is caused by ___ (2)	plateau Ca2+ influx K+ efflux (balancing Ca2+)
	phase 3 of cardiac AP is ___ it is caused by ___ (2)	rapid repolarization K+ efflux via slow channels Ca2+ channel closing
	phase 4 of cardiac AP is ___ it is caused by ___	resting potential Na+/K+ ATPase
	pacemaker cells are missing phases ___	1 2
	in pacemaker cells, phase 0 depolarization is ____ compared with myocyte this is because ___	slower pacemakers don't have fast Na+ channel
	phase 4 depolarization of pacemakers is due to ___ (3)	diminishing K+ efflux I_f Na+ channels I_f Ca2+ channels
	catacholamines affect phase 4 by ___ing	increasing I_f Na+ current increasing I_f Ca2+ current decreasing K+ efflux
	PR interval duration is normally <___s	0.2
	QRS complex represents QRS complex duration is normally <___s	ventricular depolarization 0.12
	QT interval represents	ventricular contraction
	order of conduction velocity: atria AV node Purkinje ventricles	Purkinje atria ventricles AV node
	long QT is risk factor for ___	torsades de pointes
	2 kinds of congenital long QT syndromes ___ is more common	Jervell and Lange-Nielsen Romano-Ward Romano-Ward
	Jervell and Lange-Nielsen is a ___ trait it is caused by a ___ defect ___ is an extracardiac sx	AR K+ channel deafness
	WPW sign on EKG	delta wave (early rise in QRS)
	AF tx: ___ or ___, and ___	beta blocker CCB warfarin
	1st degree AV block is ___ it is defined by ___	asymptomatic PR interval > 200 ms
	2nd degree AV block means ___ 2 kinds of 2nd degree AVB	some atrial spikes don't reach ventricles Mobitz I Mobitz II
	Mobitz I is aka ___ it means ___	Wenkebach gradual PR interval prolongation until a beat is dropped
	frequency of dropped beats in Mobitz I is fixed/variable the problem is at ___	fixed AV node
	Mobitz II means	constant PR but multiple P waves per QRS
	frequency of dropped beats in Mobitz II is fixed/variable the problem is at ___	variable His bundles
	Mobitz ___ is worse	II
	3rd degree AVB means	atria and ventricles fire independently
	QRS complexes in 3rd degree AVB are ___	wide
	infection which can cause 3rd degree AVB	Lyme disease
	3rd degree AVB tx	pacemaker
	ANP is released in response to ___ it causes ___	elevated atrial pressure generalized vascular relaxation
	ANP causes ___ of afferent arteriole and ___ of efferent	dilation constriction
	2 baroreceptors	aortic arch carotid sinus
	aortic arch is innervated by ___ branch of ___ it responds to high/low P	N. of Cyon R vagus high
	carotid sinus is innervated by ___ branch of ___ it responds to high/low P	Hering's n. Glossopharyngeal both
	fibers from N. of Cyon synapse in ___ fibers from Hering's nerve synapse in ___	NTS NTS
	2 peripheral vascular blood gas chemoreceptors	aortic body carotid body
	in Cushing reaction, ___ causes ___ which causes ___ (2)	high ICP cerebral ischemia HTN reflex bradycardia
	___ receives biggest share of CO, but ___ receives biggest share per g of tissue	liver kidney
	normal RA P normal LA P	<5 <12
	normal RV P: < ___/___	25 5
	normal aortic P: < ___/___	130/90
	3 metabolites controlling cardiac perfusion	O2 adenosine NO
	metabolite controlling brain perfusion	CO2
	lung perfusion is unique in that ___	hypoxia causes vasoconstriction
	3 metabolites controlling skeletal muscle perfusion	lactate adenosine K+
	neonatal cyanosis is due to ___ cyanosis later in life is due to ___	R -> L shunt L -> R shunt
	5 kinds of congenital R -> L shunt	tetralogy of Fallot TGV truncus arteriosus tricuspid atresia TAPVR
	4 parts of TOF	pulmonary stenosis RVH overriding aorta VSD
	truncus arteriosus means	VSD with common artery receiving mixed blood which subsequently branches to pulmonary & systemic
	TGV is caused by __	failure of aorticopulmonary septum to spiral
	infants get ___ coarctation adults get ___ coarctation	preductal postductal
	dyskaryosis associated with coarctation	Turner's syn
	valvular malformation associated with coarctation	bicuspid aortic valve
	PDA patency is maintained by ___ ___ can be used to close PDA	PGE low O2 indomethacin
	2 cardiac malformations associated with DiGeorge syndrome	TOF truncus arteriosus
	cardiac malformations associated with Down syndrome	septal defects (ASD, VSD, AV septal defect)
	3 cardiac malformations associated with congenital rubella	septal defects PDA pulmonic stenosis
	cardiac malformation associated with infant of diabetic mother	TGV
	___% of HTN is essential	90
	Mönckeberg arteriosclerosis affects ___ layer of vessel it is has severe/benign course	media benign
	atherosclerosis affects ___ layer of vessel	intima
	2 RFs for aortic dissection	HTN cystic medial necrosis
	cystic medial necrosis is an ___ trait associated with ___	AD Marfan's
	order of susceptibility to atherosclerosis of: abdominal aorta carotid a. coronary a.s popliteal a.s	AA coronary popliteal carotid
	angina implies coronary stenosis of ___%	75
	ECG sign of stable angina	ST depression
	ECG sign of unstable angina is ___ an exception to this is ___ which has ___	ST depression Prinzmetal angina STE
	unstable angina is caused by ___	thrombosis
	most commonly occluded coronaries IDOOF	LAD RCA circumflex
	post-MI changes are not present within the first ___ hours	4
	main MI complication within first 4 days is ___	arrhythmia
	main MI complication from 5 days to 7 weeks is ___ (2)	myocardial rupture tamponade
	post MI myocardial rupture can occur in ___	free wall IV septum papillary muscle
	main MI complication after 7 weeks is ___	ventricular aneurysm
	after MI, TnI rises after ___ and is elevated for ___	4 h 7-10 d
	2 ECG signs of transmural infarct	ST elevation pathological Q wave
	ECG sign of subendocardial infarct	ST depression
	papillary muscle rupture can cause ___	AV valve regurg
	8 causes of DCM	alcohol beri-beri (wet) coxsackie B virus chronic cocaine use Chagas' disease doxorubicin hemochromatosis postpartum
	in HOCM, ___ is obstructed by ___ (2)	cardiac outflow hypertrophic IV septum mitral valve leaflet
	___% of HOCM is hereditary	50
	hereditary HOCM is a ___ trait	AD
	neuro disorder associated with HOCM	Friedreich's ataxia
	heart in HOCM is ___-sized abnormal heart sound in HOCM	normal S4
	Tx for HOCM: ___ or ___	beta blocker non-DHP CCB
	abnormal heart sound in DCM	S3
	2 kinds of causes of restrictive CM	infiltration fibrosis
	3 kinds of infiltration causing restrictive CM	sarcoidosis amyloidosis hemochromatosis
	3 kinds of fibrosis causing restrictive CM	postradiation fibrosis endocardial fibroelastosis Löffler's syndrome
	age for endocardial fibroelastosis	<2
	histopath of Löffler's syndrome __ (2)	endomyocardial fibrosis hypereosinophilia
	most common sx of bacterial endocarditis	fever
	BE FROM JANE	Fever Roth Spots Osler nodes Murmur Janeway lesions Anemia Nail-bed (splinter) hemorrhages Emboli new murmur
	Roth spots are ___ surrounded by ___	white spots on retina hemorrhage
	Osler nodes are ___ on ___	tender raised lesions finger or toe pads
	Janeway lesions are ___ on ___	small red lesions palm or sole
	acute BE is caused by ___ (bug) vegetations are ___ on ___ valves	SA large previously normal
	subacute be is caused by ___ (bug) vegetations are ___ on ___ valves	Strep viridans small abnormal
	tricuspid BE is associated with ___ it is caused by ___ (3 bugs)	IVDA SA Pseudomonas Candida
	sterile endocarditis causes ___ vegetations this is associated with ___ (2)	marantic hypercoagulability malignancy
	bug causing BE in context of CRC	S. bovis
	bug causing BE in context of prosthetic valve	S. epidermidis
	bugs causing culture-negative BE	HACEK
	SLE can cause ___ endocarditis it mainly affects ___ valve, causing ___	Libman-Sacks mitral regurg
	Rheumatic disease is caused by ___itis caused by ___ aka ___ it is a type ___ hypersensitivity	pharyngitis GAS S. pyogenes 2
	rheumatic disease is a cross reaction between ___ and ___	Strep M protein heart glycoproteins
	Rheumatic disease FFEVERSS	Fever Fibrinous pericarditis Erythema marginatum Valve damage ESR high Red-hot joints (migratory polyarthritis) Subcutaneous nodules (Aschoff bodies) St. Vitus' dance
	infectious endocarditis has ___ vegetations located at ___	large line of closure/chordae
	rheumatic endocarditis has ___ (3) vegetations located at ___	multiple small linearly-arranged line of closure
	marantic endocarditis has ___ vegetations located at ___	small line of closure
	Libman-Sacks endocarditis has ___ (2) vegetations located at ___	small medium-sized both sides of lealet
	cardiac tamponade does ___ to relative pressures in heart chambers	makes them equal
	5 signs of cardiac tamponade	hypotension JVD distant heart sounds tachycardia pulsus paradoxus
	3 kinds of pericarditis	serous fibrinous hemorrhagic
	4 causes of serous pericarditis	SLE RA virus uremia
	3 causes of fibrinous pericarditis	uremia Dressler's (post-MI) rheumatic disease
	2 causes of hemorrhagic pericarditis	TB malignancy
	most common heart tumor is ___	mets
	2 most common cancers going to heart	melanoma lymphoma
	most common primary heart tumor in adults they are most commonly located in ___	myxoma atria
	most common primary heart tumor in kids it is associated with ___	rhabdomyoma tuberous sclerosis
	Raynaud's disease is caused by ___	arteriolar vasospasm
	3 kinds of vasculitis	Large artery Medium artery Small artery
	2 large vessel vasculitides	giant cell arteritis takayasu's arteritis
	2 kinds of small vessel vasculitides	pauci immune immune complex
	pauci immune vasculitis is associated with ___	ANCA
	3 pauci immune vasculitides	microscopic polyangiits Wegener's granulomatosis Churg-Strauss
	6 immune complex small vessel vasculitides	Behcet's essential cryoglobulinemic HSP cutaneous leukocytoclastic SLE serum sickness
	2 kinds of resistance vessels	small arteries arterioles
	small arteries are ___ in diameter	<2 mm
	in arterioles, ___ aren't identifiable	3 layers
	vasculitis is ___. it can cause ___ to tissues	inflammation of vessels causing luminal narrowing ischemia
	___ happens to an ischemic luminal organ	ulceration
	3 causes of vasculitis	immune complexes cell mediated immunity anti-endothelial Abs
	giant cell arteritis is a ___ inflammation of ___. it only affects people over ___. it affects women ___ times more frequently than men.	granulomatous external branches of carotid a. 50 2.5
	giant cell arteritis most commonly affects ___ (3) arteries.	temporal vertebral ophthalmic
	diagnosis of GCA is via ___	biopsy
	lab finding in GCA clinical finding in 50% of GCA	high ESR polymyalgia rheumatica
	treatment of GCA is with ___	high dose steroids
	takayasu's arteritis is aka (2)	granulomatous-sclerosing aortitis pulseless disease
	TA is ___. it mostly affects ___ in ___.	inflammation of aortic arch and tributaries young women far east
	TA presents with FAN MY SKIN ON Wednesday	Fever Arthritis Night sweats Myalgia Skin nodules Ocular disturbances Neurologic disturbances Weakened pulse in upper extremities
	3 kinds of medium artery vasculitis	polyarteritis nodosa Kawasaki's disease Buerger's disease
	PAN is caused by ___ ___% is associated with ___	immune complexes 30 HBV
	PAN involves ___ (2) but not ___ vessels	visceral renal pulmonary
	PAN is treated with ___ (2)	CS CTX
	histopath of PAN is ___ inflammation with ___ necrosis	transmural fibrinoid
	T/F: Kawasaki's is granulomatous	sometimes!
	Kawasaki presents with CRASH and BURN	Conjunctivitis desquamative Rash Adenopathy Strawberry tongue Hand + Foot swelling BURN: fever > 5 days
	complication of Kawasaki	coronary aneurysm
	tx for Kawasaki	IVIg aspirin
	Buerger's disease is aka ___ it is associated with ___	thromboangiitis obliterans smoking
	Buerger's presents with ___	claudication Raynaud's gangrene
	___ is most common childhood systemic vasculitis	HSP
	HSP affects this triad	skin joints GI
	HSP rash is ___ on ___	palpable purpura legs butt
	4 non-derm sx of HSP: PAIM	abdominal Pain Arthralgia Intestinal hemorrhage Melena
	HSP commonly follows ___ and is associated with ___	URI IgA nephropathy
	HSP immune complexes are made of ___	IgA
	pauci immune small vessel vasculitides stain positive for ___	ANCA
	ANCA stands for ___	anti-neutrophil cytoplasmic antibody
	2 ANCA patterns	perinuclear (P) cytoplasmic (C)
	P-ANCA corresponds to anti-___ Abs C-ANCA corresponds to anti-___ Abs	MPO proteinase 3
	C-ANCA is associated with ___ P-ANCA is associated with ___ (2)	Wegener's MPA Churg-Strauss
	of the ANCA vasculitides, ___ cause granulomas	Wegener's Churg-Strauss
	2 main parts of Wegener's	URT and LRT necrotizing granulomas glomerulonephritis
	Churg-Strauss affects ___ (3)	pulmonary vessels nerves heart
	2 histopath findings in Churg-Strauss	granulomas eosinophilia
	neurological manifestation of Churg-Strauss	peripheral neuropathy
	pyogenic granulomas are ___ they occur in ___ they are benign/malignant	capillary hemangiomas children pregnant women benign
	pyogenic granulomas present with ___ they occur most commonly on ___	pain bleeding maxillary gingiva
	angiosarcoma is a ___ growth occurring in ___ it is associated with ___ (3) exposure	malignant liver vinyl chloride thorotrast As
	glomus tumor is ___ growth of the glomus body, which is ___ and does ___ it is located ___ly	benign but painful smooth muscle thermoregulation
	3 kinds of capillary hemangioma	strawberry hemangioma cherry hemangioma pyogenic granuloma
	all ___ vasculitides are granulomatous other granulomatous vasculitides are ___ (3)	large artery Wegener's Churg-Strauss Kawasaki (sometimes)
	vascular smooth muscle contraction is triggered by ___	rise in [Ca2+]_i
	2 ionotropic ways to increase [Ca2+]_i 1 metabotropic way to increase [Ca2+]_i	L type calcium channel P2X ATP-gated channel Gq-coupled receptors
	GqPLRs activate ___ which releases ___ this causes ___	PLC IP3 Ca2+ release from SR
	4 agonists which trigger vasoconstriction via smooth muscle GqPLR	NE (alpha1 adrenergic) Ang 2 thromboxane endothelin
	Ca2+ causes contraction by activating ___ this activates ___	calmodulin myosin light-chain kinase
	phosphorylated myosin light chains do ___ this causes ___	crossbridging contraction
	3 pathways for smooth muscle relaxation	activation of myosin light chain phosphatase inactivation of MLCK K+ channel opening (hyperpolarization)
	MLCP activation is triggered by ___ this causes ___ which causes	guanylyl cyclase rise in cGMP MLCP activation
	smooth muscle guanlylyl cyclase can be activated by ___ (2)	NO ANP
	MLCK can be inactivated by ___	PKA
	___ activates ___ which causes ___ which activates PKA which inactivates ___	G_sPLR adenylyl cyclase rise in cAMP MLCK
	2 kinds of G_sPLRs which inactivate MLCK	beta_2 adrenergic IP (PGI2 receptor)
	NO acting on vascular smooth muscle comes from ___ it is synthesized by ___ from ___	endothelium eNOS Arg
	relaxing action of cGMP is terminated by ___ ___s like ___ are a nonselective inhibitor	PDE methylxanthines caffeine
	PDE3 is expressed in ___ (2) it is inhibited by ___ (2)	heart blood vessels amrinone milrinone
	PDE4 is expressed in ___ it is inhibited by ___ (2)	inflammatory cells CNS rolipram roflumilast
	2 effects of PDE4 inhibition	antiinflammatory antidepressant
	PDE5 is expressed in ___ (2) it is inhibited by ___	corpus cavernosum retina sildenafil
	3 ways to increase cGMP	PDEI nitrates hydralazine
	hydralazine works by ___ing (3) it mainly affects ___ it is not a first line antihypertensive because ___ it is first line for ___, however, along with ___	elevating cGMP K+ channel opening Ca2+ channel blocking arterioles it causes reflex tachycardia pregnancy methyldopa
	3 hydralazine SEs	SLE-like syndrome fluid retention nausea
	2 kinds of nitrates	organic non-organic
	2 organic nitrates they are converted to NO ___ly (2) they act on ___	nitroglycerin isosorbide dinitrate enzymatically non-enzymatically veins
	NTG is given ___ly (2) isosorbide dinitrate is given ___ly	sublingually via patch orally
	1 non-organic nitrate it is converted to NO ___ly it is given ___ly it acts on ___	sodium nitroprusside non-enzymatically IVly arteries and veins
	4 organic nitrate SEs	hypotension tachycardia flushing headache
	sodium nitroprusside SE	CN- toxicity
	organic nitrates are indicated for ___ (3) inorganic nitrates are indicated for ___ (2)	angina pectoris pulmonary edema erectile dysfunction hypertensive crisis malignant HTN
	2 K+ channel openers they are indicated for ___	minoxidil diazoxide severe HTN
	4 minoxidil SEs	pericardial effusion angina salt retention hypertrichosis
	in CAD, direct (cGMP) vasodilators can cause a problem called ___	ischemic steal
	ischemic steal means ___ it occurs because ___	blood is diverted to healthy tissue and away from ischemic tissue vasodilators are not delivered to collateral vessels
	___ prevent ischemic steal because they ___	nitrates distribute preferentially to collateral vessels
	3 drugs for malignant HTN	nitroprusside fenoldopam diazoxide
	fenoldopam is a ___ agonist it is distinguished by ___ing	dopamine D1 preserving RBF while reducing BP
	fenoldopam ___s renal ___	relaxes arterial smooth muscle
	diazoxide SE	hyperglycemia
	5 determinants of myocardial O2 consumption (MVO2)	EDV BP contractility HR ejection time
	nitrates cause ___ EDV ___ BP ___ contractility ___ HR ___ ejection time	lower lower higher higher lower
	beta blockers cause ___ EDV ___ BP ___ contractility ___ HR ___ ejection time	higher lower lower lower higher
	nifedipine has a MVO2 profile like ___ verapamil has a MVO2 profile like ___	nitrates beta blockers
	statins ___ LDL, ___ HDL, and ___ TAG	lower alot raise a little lower a little
	2 statin SEs	hepatotoxicity rhabdomyolysis
	niacin ___s LDL, ___s HDL, and ___s TAG	lowers raises lowers a little
	niacin works by ___ing (2)	inhibiting adipose lipolysis reducing hepatic VLDL secretion
	3 niacin SEs	flushing hyperglycemia hyperuricemia
	niacin flushing is mitigated by ___	aspirin
	bile acid binders such as ___ do ___ to LDL, ___ HDL, and ___ TAG	cholestyramine lower raise a little raise a little
	bile acid resins work by preventing ___ in the ___, which causes the liver to ___	bile acid reabsorption utilize more blood cholesterol to replace them
	bile acid resin SE	reduced fat-soluble vitamin absorption
	cholesterol absorption blockers such as ___ do ___ to LDL, ___ HDL, and ___ TAG	ezetimibe lower don't change don't change
	ezetimibe SE	LFT elevation (rare)
	fibrates ___ LDL, ___ HDL, and ___ TAG	lower a little raise a little lower a lot
	fibrates work by ___ing	upregulating lipoprotein lipase
	3 fibrate SEs	myositis hepatotoxicity cholelterol gallstones
	___ phosphorylates the cardiac L type Ca2+ channel when it does this, the channel's g_Ca2+ is ___ed	PKA increased
	___ action on ___ causes activation of PKA via ___ ___ action on ___ causes deactivation	catecholamine Beta_1 R adenylyl cyclase ACh M2R
	in addition to the L type Ca2+ channel, PKA phosphorylates ___ this causes the latter to ___ the result is ___	phospholamban stop inhibiting SERCA enhanced relaxation
	digitalis works by ___ing, which causes ___	blocking Na+/K+ ATPase inhibition of NCX
	normally NCX does ___ inhibiting it causes ___	takes Ca2+ out takes Na+ in increased [Ca2+]_i
	2 effects of increased [Ca2+]_i from digoxin	increased contractility bradycardia
	digoxin also increases ___ this can cause ___	automaticity arrhythmia
	digitalis causes stimulation of ___ nerve this can cause ___	vagus cholinergic toxicity
	cholinergic toxicity from digoxin includes (4)	nausea vomiting diarrhea xanthopsia
	digoxin toxicity is worsened by ___ (4)	renal failure hypokalemia quinidine amiodarone
	ECG changes in digoxin toxicity the more severe change is ___	long PR T inversion long PR
	electrolyte disturbances in digoxin toxicity	hypokalemia hypomagnesemia
	tx for digoxin toxicity (3)	anti-digoxin Fab IV lidocaine electrolyte correction
	class I antiarrhythmics work by ___ing they work preferentially on ___ this is called ___	Na+ channel block rapidly depolaizing cells state dependence
	class IA antiarrhythmics ___ the cardiac AP 3 class IA drugs	prolong quinidine procainamide disopyramide
	class IB antiarrhythmics ___ the cardiac AP 3 class IB drugs	shorten lidocaine mexiletine tocainide
	class IC antiarrhythmics ___ the cardiac AP 3 class IC drugs	don't change flecainide encainide propafenone
	class I antiarrhythmics do ___ to pacemaker cells	decrease phase 4 slope
	class I subclass indicated post-MI	IB
	class I subclass contraindicated post-MI	IC
	class I subclass indicated for SVT	IA
	class I subclass indicated for ventricular tachycardia	IA
	class I subclass indicated for digoxin toxicity	IB
	class II antiarrhythmics work via they work best on ___, and cause ___	beta block AV node long PR
	beta block SEs	erectile dysfunction asthma exacerbation sedation
	endocrine risk from beta block	masking adrenergic signs of hypoglycemia
	if hypoglycemia from beta block becomes severe, use ___	glucagon
	metoprolol SE	dyslipidemia
	short acting beta blocker	esmolol
	class III antiarrhythmics do ___ class III drugs	K+ channel block sotalol ibutilide bretylium dofetilide amiodarone
	class III drugs do ___ to AP they have a risk of ___	prolong long QT
	6 amiodarone SEs	pulmonary fibrosis hepatotoxicity hypothyroidism hyperthyroidism corneal deposits skin deposits
	because of SEs, it's important to get ___ (3) checked when using amiodarone	PFTs LFTs TFTs
	class IV antiarrhythmics do ___ 2 class IV drugs	calcium channel block diltiazem verapamil
	class IV drugs work primarily on ___ they do ___ to AP	AV node prolong
	ECG segment prolonged by class IV durgs	PR
	3 class IV drugs SEs	constipation flushing edema
	adenosine works by ___ing this causes ___ it is indicated for ___ it is blocked by ___	increasing K+ leak reduced Ca2+ current SVT theophylline
	___ is effective in torsade de pointe	Mg2+
	___ depresses ectopic pacemakers in hypokalemia	K+

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