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Flashcards in 4. Cardio Deck (70)
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1

What substances act on smooth muscle myosin light-chain kinase? (3)

How does this affect blood pressure?

1. Ca2+ channel blockers
2. Epinephrine B2
3. Prostaglandin E2

2 and 3 act to increase cAMP, inhibiting myosin light-chain kinase, which will decrease phosphorylation of myosin

- all the above lead to vasodilation, and decrease in BP

2

Describe the chain of events in which hypotension (vasodilators) causes reflex tachycardia

- baroreceptors in the carotid sinus sense low BP
- decrease stretch of carotid sinus
- decreased stimulation of CN9 (which transmits to solitary nucleus of medulla)
- decreased inhibition of sympathetic output => more sym

3

What would you most suspect the cause of HTN to be in a pt with paroxysms of increased sympathetic tone: anxiety, palpitations, diaphoresis

pheo

4

What would you most suspect the cause of HTN to be in a pt age of onset 20-50

essential HTN

5

What would you most suspect the cause of HTN to be in a pt with abdominal bruit

renal artery stenosis

6

What would you most suspect the cause of HTN to be in a pt with BP in arms > legs

coarct

7

What would you most suspect the cause of HTN to be in a pt with family hx of HTN

essential HTN

8

What would you most suspect the cause of HTN to be in a pt with tachycardia, heat intolerance, diarrhea

hyperthyroidism

9

What would you most suspect the cause of HTN to be in a pt with hyperkalemia

renal insufficiency

10

What would you most suspect the cause of HTN to be in a pt with hypokalemia

renal artery stenosis
- b/c body's response to poor renal perfusion is to activate RAAS (=> aldo leads to potassium wasting)

11

What would you most suspect the cause of HTN to be in a pt with central obesity, moon-shaped face, hirsutism

Cushing

12

What would you most suspect the cause of HTN to be in a young pt with acute onset tachy

cocaine, amphetamine

13

What would you most suspect the cause of HTN to be in a pt with proteinuria?

renal disease

14

What category of BP medication is preferred in the treatment of aortic dissection?

b-blocker

15

Which antihypertensive class or drug fits each of the following S/Es?
- hypertrichosis

Minoxidil

16

Which antihypertensive class or drug fits each of the following S/Es?
- cyanide toxicity

sodium nitroprusside

17

Which antihypertensive class or drug fits each of the following S/Es?
- reflex tachycardia

any vasodilators

18

Which antihypertensive class or drug fits each of the following S/Es?
- cough

ACE-i

19

Which antihypertensive class or drug fits each of the following S/Es?
- possible development of drug-induced lupus

hydralazine

- remember SHIPP

20

Which antihypertensive class or drug fits each of the following S/Es?
- possible angioedema

ACE-i and ARBs

21

Which antiHTN are particularly beneficial to heart failure pts? (4)

- ACE-i or ARB
- aldosterone antagonist
- b-blockers (carvedilol, metoprolol, bisoprolol)

22

Which antiHTN are safe to use in pregnancy? (4)

- hydralazine
- methyldopa
- labetolol
- nifedipine

Hypertensive Moms Love Nifedipine

23

What is the most likely cause of chest pain in a pt who has ST segment elevation only during brief episodes of chest pain?

Prinzmetal angina

24

Which lipid-lowering agent matches
SE: facial flushing

niacin

25

Which lipid-lowering agent matches
SE: elevated LFTs, myositis

statins, fibrates

26

Which lipid-lowering agent matches
SE: GI discomfort, bad taste

bile acid resins

27

Which lipid-lowering agent matches
- best effect on HDL

niacin

28

Which lipid-lowering agent matches
- best effect on trig/VLDL

fibrates

29

Which lipid-lowering agent matches
- best effect on LDL/cholesterol

statin (HMG-CoA reductase inhibitors)

30

Which lipid-lowering agent matches
- binds C. diff toxin

Cholestyramine (bile acid resin)
- can use in C. diff pt