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309 Cards in this Set
- Front
- Back
What supplies the Posterior Descending Artery (PD artery)?
|
80% of time= RCA
20% of time- Circumflex A |
|
What artery supplies the RV?
|
Acute Marginal A
|
|
What artery supplies the apex and anterior interventricular septum?
|
LAD
|
|
What artery supplies the posterior LV?
|
Circumflex A
|
|
Coronary Artery occlusion most commonly occurs in the ___________artery.
|
LAD
|
|
Pulse pressure = _________ -__________.
|
systolic pressure - diastolic pressure
|
|
______________= SV x HR
|
CO
|
|
_____________=2/3 diastolic P + 1/3 systolic P
|
MAP
|
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___________= CO x TPR
|
MAP
|
|
____________= EDV-ESV
|
SV
|
|
enlargement of the LA can lead to _________ and _____________.
|
Dysphagia
Hoarseness |
|
SV is affected by what 3 variables?
|
CAP
Contractility Afterload Preload |
|
What 4 things would increase contractility?
|
Catecholamines
Increase Intracellular Ca Decrease Extracellular Sodium Digitalis |
|
5 things that would decrease Contractility?
|
B1 blockade
Heart Failure Acidosis Hypoxia/Hypercapnea Non-dihydropyridine Ca channel blockers |
|
______________is proportional to initial length of cardiac muscle fiber (preload).
|
Force of Contraction
|
|
What is the Ejection Fraction?
|
index of ventricular contractility
|
|
Normal Ejection Fraction?
|
> or = to 55%
|
|
How do you calculate the Ejection Fraction?
|
EF= SV/EDV= EDV-ESV/ EDV
|
|
Resistance is directly proportional to _________.
|
Viscosity
|
|
Resistance is indirectly proportional to __________.
|
radius to the 4th power
|
|
What accounts for most of the TPR?
|
Arterioles
|
|
Viscosity depends mostly on __________.
|
Hematocrit
|
|
3 examples of increased Viscosity?
|
Polycythemia
Hyperproteinemic states (multiple myeloma) Hereditary Spherocytosis |
|
Shift along the SAME line on the Cardiac and vascular function curve?
|
change in PRELOAD
|
|
Shift to a DIFFERENT line on the Cardiac and vascular function curve?
|
change in AFTERLOAD or IONOTROPY
|
|
What is the meaning of the X-intercept of venous return curve?
|
Mean Systemic Pressure
|
|
What is the name for when the CO and Venous Return are equal?
|
Operating Point of Heart
|
|
What is Isovolumetric Contraction?
|
period between mitral valve closure and aortic valve opening. Period of HIGHEST O2 consumption
|
|
What is Isovolumic Relaxation?
|
period between Aortic Valve closing and mitral valve opening
|
|
Period right after mitral valve opening? (on Cardiac cycle curve)
|
Rapid Filling
|
|
Period just before mitral valve closure? (on Cardiac cycle)
|
Reduced filling
|
|
S1 sound?
|
mitral and tricuspid valve closure
|
|
S2 sound?
|
aortic and pulmonary valve closure
|
|
S3 sound?
|
early diastole during rapid ventricular filling. Common in Dilated ventricles, kids, and pregnant women)
|
|
S4 sound?
|
late diastole, high atrial pressure. Common in Ventricular Hypertrophy. Stiff LV.
|
|
JVP a wave?
|
atrial contraction
|
|
JVP c wave?
|
RV contraction
|
|
JVP v wave?
|
increase in right atrial pressure
|
|
What is S2 splitting?
|
Aortic valve closes before Pulmonic, this difference is increased with inspiration
|
|
splitting assoc. with Pulmonic Stenosis or RBBB?
|
WIDE splitting
|
|
Splitting assoc. with ASD?
|
Fixed Splitting
|
|
Splitting assoc. with Aortic Stenosis or LBBB?
|
Paradoxical Splitting ( A2 and P2 reverse, so P2 comes first)
|
|
Right sided heart sounds increase intensity with ______________.
|
Inspiration
|
|
Left sided heart sounds increase intensity with _________.
|
Expiration
|
|
Systolic Heart Sounds include ____________and ____________.
|
Aortic/Pulmonary Stenosis
Mitral/Tricus. Regurgitation |
|
Diastolic Heart Sounds include __________and ___________.
|
Aortic/Pulmonary Regurg.
Mitral/Tricus. Stenosis |
|
Holosystolic, high pitched blowing murmur?
|
Mitral/Tricuspital Regurgitation
|
|
Crescendo-Decrescendo systolic ejection murmur following an Ejection Click?
|
Aortic Stenosis
|
|
Age-related Calicifications + Pulsus Parvus et Tardus
|
Aortic Stenosis
|
|
Holosystolic Harsh sounding murmur?
|
VSD
|
|
Late systolic crescendo murmur with midsystolic click?
|
Mitral Prolapse
|
|
Immediate high pitched blowing diastolic murmur?
|
Aortic Regurgitation
|
|
Bounding pulses + Head bobbing?
|
Aortic Regurgitation
|
|
Delayed rumbling late diastolic murmur following an Opening Snap?
|
Mitral Stenosis
|
|
Continuous, Machine like murmur due to congenital rubella or prematurity?
|
PDA
|
|
Voltage gated Na channels open during what phase of ventricular AP?
|
Phase 0- Rapid Upstroke
|
|
During what phase of ventricular AP is there initial repolarization with inactivation of Na channels and opening of K channels?
|
Phase 1
|
|
What phase of ventricular contraction is the plateau?
|
Phase 2
|
|
During what phase of ventricular contraction is there Ca influx that balances the K efflux?
|
Phase 2- plateau
|
|
Phase of Ventricular AP with opening of slow K channels and closing of K channels?
|
Phase 3- rapid repolarization
|
|
During what phase of Ventricular AP is there high K permeability thru the K channels?
|
Phase 4- resting potential
|
|
Upstroke phase of Pacemaker AP?
|
Phase 0
|
|
What phase of the Pacemaker AP determines Heart Rate?
|
Phase 4- slow diastolic depolarization
|
|
What phase of the Pacemaker AP is the membrane potential spontaneously depolarized as the Na conductance increases?
|
Phase 4
|
|
What part of the EKG represents conduction delay thru the AV node?
|
PR interval
|
|
PR interval is normally ___________.
|
<200 msec
|
|
QRS complex is normally ______________.
|
<120 msec
|
|
What part of the EKG represents mechanical contraction of the ventricles?
|
QT interval
|
|
T wave inversion indicates ____________.
|
recent MI
|
|
What would cause an U wave?
|
Hypokalemia
Bradycardia |
|
Prolonged QT intervals can lead to ___________, ventricular tachycardia.
|
Torsades de Pointes
|
|
Defects in cardiac sodium or potassium channels?
|
Congenital long QT syndromes- can present with congenital sensorineural deafness
|
|
Ventricular Preexcitation Syndrome?
|
Wolff-Parkinson-White Syndrome
|
|
Delta wave on EKG (shoulder)?
|
Wolff-Parkinson-White SYndrome
|
|
Accessory conduction pathway from atria to ventricle (bundle of Kent), that results in ventricles depolarizing too early?
|
Wolff-Parkinson-White Syndrome
|
|
Wolff-Parkinson-White syndrome may cause reentry current and may lead to ____________.
|
Supraventricular Tachycardia
|
|
Irregulary irregular with NO P waves?
|
A Fib
|
|
Sawtooth appearance, rapid succession of identical p waves?
|
Atrial Flutter
|
|
prolonged PR interval? (>200 msec)
|
1st degree AV block
|
|
Progressive lengthening of PR interval leading to a dropped beat? (not followed by a QRS complex)
|
AV block- 2nd degree (Mobitz Type I)
|
|
Dropped beats on EKG?
|
AV block- second degree, Mobitz Type II
|
|
P waves and QRS complexes beat independently?
|
AV 3rd degree block
|
|
Erratic rhythm with no identifiable waves?
|
V Fib
|
|
How do the kidneys increase TPR?
|
Angiotensin II (vasoconstriction)
|
|
How do the kidneys increase CO?
|
Aldosterone (increase blood volume)
|
|
What contributes to the "escape from aldosterone" mechanism and is released by the atria?
|
ANP
|
|
What receptors are important in response to severe hemorrhage?
|
Baroreceptors
|
|
Carotid Sinus?
|
Baroreceptors
|
|
Carotid Body?
|
Chemoreceptors
|
|
How does Carotid Massage decrease HR?
|
increases pressure on the Carotid A leading to increase in stretch and then leading to increase in afferent barorecptor firing
|
|
Peripheral carotid bodies and aortic bodies respond to changes in ____________.
|
decrease PO2
increase PCO2 decrease pH |
|
Central chemoreceptors respond to changes in ______________.
|
PCO2
pH |
|
What is the Cushing Triad?
|
HTN
Bradycardia Respiratory Depression |
|
What organ is responsible for the largest share of systemic CO?
|
Liver
|
|
Good approximation of LA pressure?
|
PCWP
|
|
How is Pulmonary capillary wedge pressure measured?
|
Swan-Ganz Catheter
|
|
How do lungs autoregulate?
|
Hypoxia = vasoCONSTRICTION= so that only well-ventilated areas are perfused
|
|
_________determine fluid movement thru capillary membranes.
|
Starling Forces
|
|
Kf?
|
Capillary permeability
|
|
What causes Right-to-Left shunts?
|
5 T's
Tetralogy Transposition Truncus Tricuspid TAPVR |
|
Failure of Truncus Arteriosus to divide into Pulmonary Trunk and Aorta?
|
Peristent Truncus Arteriosus
|
|
absence of Tricuspid Valve + Hypoplastic RV?
|
Tricuspid Atresia
|
|
What is TAPVR?
|
Pulmonary Veins drain into Right heart circulation
|
|
Late Cyanosis?
|
Left-to-Right SHunts
|
|
Early Cyanosis?
|
Right-to-Left Shunts
|
|
What would cause Left-to-Right shunts?
|
VSD
ASD PDA |
|
MC congenital cardiac anomaly?
|
VSD
|
|
Eisenmenger's Syndrome?
|
shunt reverses from L to R shunt to a R to L shunt
|
|
Clubbing and polycythemia?
|
Late Cyanosis
|
|
4 characteristics seen with Tetralogy of Fallot
|
Pulmonary Stenosis
RVH Overriding Aorta VSD |
|
Xray of Boot-Shaped Heart?
|
Tetralogy of Fallot
|
|
Anterosuperior displacement of the Infundibular septum?
|
Tetralogy of Fallot
|
|
Patient learns to squat to improve their cardio symptoms?
|
Tetralogy of Fallot
|
|
Failure of aorticopulmonary septum to spiral?
|
Transposition of Great Vessels
|
|
Anomaly causing seperation of systemic and pulmonary circulations?
|
Transposition of Great Vessels
|
|
Coarctation of the Aorta - Infantile type?
|
PRE-ductal Coarctation
|
|
Preductal Coarctation is assoc. with ____________.
|
Turner's Syndrome
|
|
Rib Notching, HTN in UE, weak pulses in LE?
|
POSTDuctal Coarctation
|
|
Late cyanosis in the LE's? (differential cyanosis)
|
Uncorrected PDA
|
|
___________closes PDA.
|
Indomethacin
|
|
What maintains a patent PDA?
|
Prostaglandins
low O2 tension |
|
Cardiac anomalies seen with 22q11 syndromes?
|
Truncus Arterisosus
Tetralogy of Fallot |
|
Cardiac anomaly assoc. with Down's Syndrome?
|
Endocardial Cushion Defects (ASD, VSD, AV septal defect)
|
|
Cardiac defect assoc. w/ Turners?
|
PREductal Coarctation of Aorta
|
|
Cardiac defects assoc. with Congenital Rubella?
|
Septal Defects
PDA Pulmonary A Stenosis |
|
Cardiac defects assoc.with Marfans?
|
Aortic Insufficiency
|
|
Cardiac defects seen in infants of diabetic mothers?
|
Transposition of Great Vessels
|
|
Definition of HTN?
|
>140/ 90
|
|
Plaques in BV walls?
|
Atheromas
|
|
Plaques or nodules composed of lipid-laden histiocytes in the skin?
|
Xanthomas
|
|
Plaques or nodules composed of lipid-laden macrophages in the eyelids?
|
Xanthelasma
|
|
Lipid deposit in Achille's tendon?
|
Tendinous Xanthoma
|
|
Lipid deposit in cornea?
|
Arcus Senilis
|
|
Calcification in the media of the arteries?
|
Monckeberg Arteriosclerosis
|
|
"pipestem" arteries= calcification in media of Radial or Ulnar Arteries?
|
Monckeberg Arteriosclerosis
|
|
Hyaline Arteriosclerosis?
|
due to Essential HTN or DM
|
|
Hyperplastic Arteriolosclerosis?
|
Malignant HTN
"onion skinning" |
|
Fibrous plaques and Atheromas in the INTIMA of arteries?
|
Atherosclerosis
|
|
MC location of Atherosclerosis?
|
Abdominal Aorta
|
|
longitudinal intraluminal tear forming a false lumen?
|
Aortic Dissection
|
|
Mediastinal widening on Chest Xray?
|
Aortic Dissection
|
|
Tearing chest pain that is radiating to the back?
|
Aortic Dissection
|
|
Retrosternal chest pain with exertion?
|
Stable Angina
|
|
Stable angina on EKG?
|
ST depression
|
|
Angina that occurs due to coronary artery spasm?
|
Prinzmetal's Variant
|
|
Prinzmetal's Variant Angina on EKG?
|
ST elevation
|
|
worsening chest pain at rest or with minimal exertion?
|
Unstable/Crescendo Angina
|
|
Unstable angina on ECG?
|
ST depression
|
|
Sudden cardiac death is death from cardiac causes within _________of symptoms.
|
1 hour
|
|
progressive onset of CHF over many years due to chronic ischemic myocardial damage?
|
Chronic Ischemic Heart Dx
|
|
During an MI, what is seen withing the first 12-24 hours?
|
Contraction bands
|
|
Early coagulative necrosis begins _____________ after an MI.
|
4 hours
|
|
How long after an MI is there acute inflammation, dilated vessels and extensive coagulative necrosis?
|
2-4 days
|
|
When is there central yellow-brown softening after an MI?
|
5-10 days= Hyperemic Border
|
|
When after a MI are you at increased risk for a free wall rupture, tamponade, papillary muscle rupture, interventricular septal rupture?
|
5-10 days
|
|
When after an MI are you at highest risk for a Ventricular Aneurysm?
|
7 weeks
|
|
When after a MI is the contracted scar complete and the area is gray/white?
|
7 weeks
|
|
How do you diagnose an MI within the first 6 hours?
|
ECG
|
|
What is a specific marker for diagnosis of MI, rises after fust 4 hours and remains high for 7-10 days?
|
Cardiac Troponin I
|
|
What is useful for diagnosing reinfarction on top of acute MI?
|
CK-MB
|
|
ECG findings of ST elevation + Q waves?
|
Transmural Infarct
|
|
ECG findings of ST depression?
|
Subendocardial infarct
|
|
Infarct of the entire wall?
|
Transmural
|
|
Infarct of <50% of ventricle wall?
|
Subendocardial
|
|
What lead on an ECG would show Q waves due to Anterior wall infarct? (LAD)
|
V1-4
|
|
Anteroseptal infarct on ECG?
(LAD) |
V1-2
|
|
Anterolateral infarct on ECG?
(circumflex) |
V4-6
|
|
Lateral wall infarct on ECG?
(Circumflex) |
I, aVL
|
|
Inferior wall infarct on ECG?
(RCA) |
II, III, aVF
|
|
friction rub 3-5 days post MI?
|
Postinfarction Fibrinous Pericarditis
|
|
Fibrinous Pericarditis several weeks post MI?
|
Dressler's Syndrome
|
|
Cardiomyopathy with ECCENTRIC hypertrophy?
|
Dilated (Congestive)
|
|
MC Cardiomyopathy?
|
Dilated
|
|
Cardiomyopathy assoc. with S3?
|
Dilated
|
|
Cardiomyopathy assoc. with Friedrich's Ataxia?
|
Hypertrophic
|
|
Sudden death in young athletes?
|
Hypertrophic Cardiomyopathy
|
|
Cardiomyopathy assoc. w/ S4?
|
Hypertrophic
|
|
Cardiomyopathy with CONCENTRIC hypertrophy?
|
Hypertrophic
|
|
Loffler's syndrome is assoc. with what Cardiomyopathy?
|
Restrictive
|
|
Isolated Right Sided Heart Failure?
|
Cor Pulmonale
|
|
Round white spots on retina surrounded by hemorrhage?
|
Roth Spots
|
|
When do you see Roth spots?
|
Bacterial Endocarditis
|
|
tender raised lesions on fingers and toes that is seen with Bacterial endocarditis?
|
Osler's Nodes
|
|
Small erytheatous lesions on palm or sole, seen with bacterial endocarditis?
|
Janeway Lesions
|
|
Large vegetations on previously normal valve, with rapid onset?
|
Acute Bacterial Endocarditis- S. AUREUS
|
|
small vegetations on congenitally abnormal or diseased valves?
|
Subacute Bacterial Endocarditis- Viridans Streptococci---insidious onset, after dental exam
|
|
Verroucous, sterile vegetations?
|
Libman-Sacks endocarditis
|
|
Aschoff Bodies?
|
Rheumatic Heart Dx
|
|
Activated histiocytes seen with Rheumatic Heart Dx?
|
Anitschkow's cells
|
|
consequence of pharygeal infection with group A B-hemolytic streptococci?
|
Rheumatic Heart Dx
|
|
Migratory Polyarthritis, increased ESR, Chorea, and FEVER?
|
Rheumatic HEart Dx
|
|
Pulsus Paradoxus?
|
Kussmaul's Pulse= decrease in amplitude of pulse during inspirtation
|
|
equilibration of diastolic pressures in all 4 chambers?
|
Cardiac Tamponade
|
|
HYPOtension
increase JVD distant heart sounds increase HR Pulsus Paradoxus What is your ddx? |
Cardiac Tamponade
|
|
"tree bark" appearance of aorta?
|
Syphilitic Heart Dx
|
|
heart dx that can cause dilation of the aorta and valve ring?
|
Syphilis
|
|
MC primary cardiac tumor in adults?
|
Myxomas
|
|
"ball valve" in the LA?
|
Myxomas
|
|
MC primary cardiac tumor in children?
|
Rhabdomyomas- assoc. with Tuberous Sclerosis
|
|
dilated veins due to chronically increased venous pressures?
|
Varicose Veins
|
|
arteriolar vasospams in resonse to cold temperatures or emotional stress?
|
Raynaud's Dx
|
|
Triad of focal necrotizing vasulitis, necrotizing granulomas in lung and upper airways, and necrotizing glomerulonephritis?
|
Wegener's Granulomatosis
|
|
c-ANCA + chest xrays with large nodular densities?
|
Wegener's Granulomatosis
|
|
Trx for Wegener's Granulomatosis?
|
Cyclophosphamide & Corticosteroids
|
|
Vasculitis limited to the kidney?
|
Primary Pauci-Immune Crescentic-Glomerulonephritis
|
|
Granulomatous Vasculitis with Eosinophilia + pANCA?
|
Churg-Strauss Syndrome
|
|
presents with asthma, sinusitis, skin lesions, and peripheral neuropathy?
|
Churg Strauss Syndrome
|
|
Presents with Port wine stain, itracerebral AVM, seizures and early onset glaucoma?
|
Sturge Weber Dx
|
|
MC form of childhood systemic vasculitis?
|
Henoch-Schonlein Purpura
|
|
skin rash on buttocks and legs of a kid?
|
Henoch-Schonlein Purpura
|
|
Common triad of Henoch Schonlein Purpura?
|
Skin
Joints GI |
|
IgA immune complexes that cause skin, joint and GI problems following an URI?
|
Henoch-Schonlein Purpura
|
|
aka Thromboangiitis Obliterans?
|
Buerger's Dx
|
|
Thrombosing vasculitis seen in smokers?
|
Buerger's Dx
|
|
necrotizing vasculitis in infants/children?
|
Kawasaki Dx
|
|
Fever, Conjunctivitis, Strawberry Tongue, lymphadenitis, and skin rash in small child??
|
Kawasaki Dx
|
|
Immune complex mediated transmural vasculitis with fibrinoid necrosis?
|
Polyarteritis Nodosa
|
|
Polyarteritis Nodosa is found in 30% of pts with __________.
|
Hep B seropositivity
|
|
Polyarteritis Nodosa trx?
|
Corticosteroids
Cyclophosphamide |
|
Kawasaki Dx trx?
|
IV immunoglobulin
Aspirin |
|
Buerger's Dx trx?
|
Smoking cessation
|
|
Fever, weight loss, malaise, abdominal pain, melena, HA, HTN, neuro dysfxn, and cutaneous eruptions (of different ages)?
|
Polyarteritis Nodosa
|
|
"pulseless dx"
|
Takayasu's Arteritis
|
|
granulamatous thickening of Aortic Arch and/or proximal great vesels?
|
Takayasu's Arteritis
|
|
Asian females <40 with an increased ESR?
|
Takayasu's Arteritis
|
|
Fever, Arthritis, Night sweats, myalgia, skin nodules, ocular disturbances, and weak pulses in UE's?
|
Takayasu's Arteritis
|
|
MC vasculitis affecting medium and large arteries?
|
Temporal Arteritis
|
|
Unilateral HA, jaw claudication and impaired vision that can lead to irreversible blindness??
|
Temporal Arteritis
|
|
Elderly female with increased ESR and headaches?
|
Temporal Arteritis
|
|
Temporal Arteritis trx?
|
High dose steroids
|
|
benign capillary hemangioma of infancy?
|
Strawberry Hemangioma (will regress with age)
|
|
benign capillary hemangioma of the elderly?
|
Cherry Hemangioma (does NOT regress, worse with age)
|
|
Pyogenic Granuloma?
|
polypoid capillary hemangioma that can ulcerate and bleed
|
|
Capillary hemangioma assoc. with trauma and pregnancy?
|
Pyogenic Granuloma
|
|
Cavernous Lymphangioma of the neck seen with Turners?
|
Cystic Hygroma
|
|
Benign, painful red-blue tumor under the fingernails?
|
Glomus Tumor
|
|
benign capillary skin papules found in AIDS pts?
|
Bacillary Angiomatosis
|
|
Capillary skin papules caused by Bartonella Henselae infxn?
|
Bacillary ANgiomatosi
|
|
lymphatic malignancy assoc. with persistent lymphedema?
|
Lymphangiosarcoma
|
|
Endothelial malignancy of the skin assoc. with HHV-8 and HIV?
|
Kaposi's Sarcoma
|
|
What is CONTRAindicated in decompensated CHF trx?
|
B blockers
|
|
________are protective against daibetic nephropathy.
|
ACE inhibitors
|
|
Antihypertensive trx that decreases afterload?
|
Hydralazine
|
|
1st line therapy for HTN in pregnancy, with methyldopa?
|
Hydralazine
|
|
What is Hydralazine used for?
|
Severe HTN
CHF HTN in pregnancy co-admin. with B-blockers to prevent reflex tachycardia |
|
What antihypertenise therapy has a toxicity of Lupus-like syndrome?
|
Hydralazine
|
|
Calcium channel blocker that reduces muscle contractility of Vascular Smooth Muscle?
|
Nifedipine the MOST
|
|
Calcium channel blocker that reduces muscle contractility of the Heart the most?
|
Verapamil
|
|
Toxicity assoc. with Calcium Channel blockers?
|
Cardiac Depression
AV block peripheral edema flushing dizziness constipation |
|
What drug causes your veins to vasodilate by releasing Nitric Oxide and thus decrease preload?
|
Nitroglycerin
Isosorbide DInitrate |
|
Clinical uses for Nitroglycerin & Isosorbide Dinitrate?
|
Angina
Pulmonary Edema Aphrodisiac/Erection enhancer |
|
Nitroglycerin toxicity?
|
Monday Disease
Reflex Tachycardia HYPOtension flushing HA |
|
Malignant hypertension trx that releases NO and causes increase in cGMP?
|
Nitroprusside
|
|
Malignant HTN trx that can cause Cyanide poisoning?
|
Nitroprusside
|
|
Fenoldopam MOA?
|
D1 receptor agonist- relaxes RENAL vascular smooth muscle
|
|
Malignant HTN trx that relaxes RENAL vascular smooth muscle?
|
Fenoldopam
|
|
Malignant HTN trx that is a K+ channel opener?
|
Diazoxide
|
|
Diazoxide for Malignant HTN, can cause ______________.
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Hyperglycemia
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Goal of Antianginal therapy?
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reduce myocardial O2 consumption
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What anti-anginal trx reduces EDV and thus decreases preload?
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Nitrates
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anti-anginal trx that reduces blood pressure?
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Nitrates AND B-blockers
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What anti-anginal trx will decrease Contractility?
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B-BLockers
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What anti-anginal trx will decrease HR?
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B-blockers
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What anti-anginal trx will decrease Ejection Fraction?
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Nitrates
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What Ca channel blocker is similar to effects of NItrates?
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Nifedipine
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What Ca Channel blocker is similar in effects to B-blockers?
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Verapamil
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HMG-Coa Reductase inhibitors SE?
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Hepatoxicity
Rhabdomyolysis |
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What inhibits lipolysis in adipose tissue and reduces VLDL hepatic secretion?
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Niacin
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Goal of Antianginal therapy?
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reduce myocardial O2 consumption
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What anti-anginal trx reduces EDV and thus decreases preload?
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Nitrates
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anti-anginal trx that reduces blood pressure?
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Nitrates AND B-blockers
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What anti-anginal trx will decrease Contractility?
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B-BLockers
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What anti-anginal trx will decrease HR?
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B-blockers
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What anti-anginal trx will decrease Ejection Fraction?
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Nitrates
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What Ca channel blocker is similar to effects of NItrates?
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Nifedipine
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What Ca Channel blocker is similar in effects to B-blockers?
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Verapamil
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HMG-Coa Reductase inhibitors SE?
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Hepatoxicity
Rhabdomyolysis |
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What inhibits lipolysis in adipose tissue and reduces VLDL hepatic secretion?
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Niacin
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Niacin SE's?
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Red, flushed face
Hyperglycemia Hyperuricemia |
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Bile acid resin SE's?
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bad taste
GI discomfort Cholesterol gallstones |
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What upregulates lipoprotein lipase and decreases the effect of triglycerides?
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"fibrates"
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"fibrates" SE's?
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Myositis
Hepatotoxicity Cholesterol Gallstones |
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Cardiac Glycosides MOA?
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direct inhibition of Na/K ATPase which leads to indirect inhibition of Na/Ca exchanger.
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Clinical use of Cardiac Glycosides?
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CHF
A Fib |
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Digoxin toxicty antidote?
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slowly normalize K+
Lidocaine Cardiac Pacer Anti-Dig Fab fragments Mg+ |
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Antiarrythmic that decreases slope of phase 0?
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Na Channel blockers
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What Antiarrythmic increases AP duration and can be used for atrial and ventricular arrythmias?
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Class IA
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Antiarrythmic used POST-MI?
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Class 1B
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Antiarrythmic used for acute ventricular arrhythmias and digitalis induced arrythmias?
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Class 1B
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Antiarrythmic that decreases AP duration?
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Class 1B
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Antiarrythmic that has no effect on AP duration and is only used as last resort for refractory tachyarrhythmias?
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Class 1C
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Antiarrythmic that CONTRAindicated post-MI?
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Class 1C
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Quinidine Toxicity?
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Cinchonism- HA, tinnitus
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Procainamide toxicity?
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reversible SLE-like syndrome
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Class 1C toxicity?
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Proarrythmic, prolongs refractory period in AV node
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Antiarrythmic toxicity that can cause local anesthetics, CNS stimulation/depression, and Cardiovascular depression?
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Class 1B
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What suppresses abnormal pacemakers by decreasing slope of phase 4?
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B-blockers
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Clinical uses for Class II antiarrythmics?
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Vtach
SVT Slow ventricular rate during afib and aflutter |
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Class II antiarrythmic toxicity?
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Impotence
Exacerbation of Asthma CV effects AV block CNS effects may mask hypoglycemia |
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Class II antiarrythmic that can cause dyslipidemia?
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Metoprolol
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What increases AP duration by blocking K channels?
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Class III antiarrythmics
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Sotalol SE?
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Torsades de Pointes
Excessive B block |
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Bretylium SE?
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new arrythmias
HYPOtension |
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Amiodarone SE?
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Pulmonary Fibrosis
Hepatotoxicity Hypo/Hyperthryoidism corneal deposits blue/gray skin deposits photodermatitis |
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What antiarrhytmic is used in prevention of nodal arrythmias?
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Class IV
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Class IV anti-arrythmics work on what phase?
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Phase 0 and Phase 2
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DOC in diagnosing/abolishing Supraventricular tachycardia?
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Adenosine
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What depresses ectopic pacemakers in Hypokalemia?
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K+
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antiarrythmic effective in torsades de pointes and digoxin toxicity?
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Mg+
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