9/7/12 pt. II

Question 0

Procainamide, disopyramide, and quinidine are what type of drug?

Answer 0

Class IA antiarrhythmic

Question 1

Class I anti-arrhythmics affect ____ channels in the following states:
IA: _______
IB: _______
IC: _______

Answer 1

fast sodium channels;
open
inactive
resting

Question 2

What is the main adverse cardiac side effect of quinidine? Mech?

Answer 2

tachycardia; anti-muscarinic and anti-alpha-adrenergic actions (reflex tach)

Question 3

What drug can be used to prevent the tachycardia often associated with quinidine, e.g. in a patient w/ A-fib?

Answer 3

digoxin

Question 4

What is cinchonism?

Answer 4

Side effects of quinidine or quinine. ocular, auditory, CNS, and GI dysfunction.

Question 5

Is TMP-SMX (bactrim) a CYP450 inducer or inhibitor?

Answer 5

Inhibitor

Question 6

What are the side effects of reserpine use as an antihypertensive?

Answer 6

nasal congestion, increased gastric acid–>peptic ulcer, depression

Question 7

What is the RLS in NE synthesis, as well as the one targeted in tx of pheochromocytoma?

Answer 7

Tyr –> DOPA via Tyr hydroxylase

Question 8

Cyclosporin and tacrolimus are both what kind of immunosuppressants?

Answer 8

calcineurin inhibitors

Question 9

What effect of digoxin toxicity can cause V-tach and V-fib? Mech?

Answer 9

delayed afterdepolarizations d/t increased intracellular calcium (escapes sarcoplasmic reticulum to initiate an early depolarization)

Question 10

What effect of digoxin allows it to slow the HR? Mech?

Answer 10

Slowed AV nodal conduction via stimulation of the vagus nerve.

Question 11

Define delayed afterdepolarization.

Answer 11

early depolarization of the cardiomyocyte in phase 4 of th AP

Question 12

Define early afterdepolarization.

Answer 12

early depolarization of the cardiomycyte in phase 2 or 3 of the AP.

Question 13

Name 3 causes of early afterdepolarization.

Answer 13

1. hypokalemia
2. bradycardia
3. type IA antiarrhythmics (e.g. quinidine)

Question 14

What can early afterdepolarizations cause?

Answer 14

tach, torsade, and other arrhythmias

Question 15

How does digoxin increae intracellular calcium?

Answer 15

Blockade of Na+/K+ ATPase, thereby inhibiting the Na+/Ca++ exchanger.

Question 16

PVC, thorotrast, or arsenic exposure is associated with development of what rare vascular neoplasm?

Answer 16

liver angiosarcoma

Question 17

What is the cause of death in infants w/ severe, uncorrected coarctation of the aorta?

Answer 17

CHF

Question 18

What is “nutcracker syndrome”?

Answer 18

Compression of the left renal v. between the aorta and SMA. Causes left varicocele/LLQ pain, hematuria, and left flank pain

Question 19

What is SMA syndrome?

Answer 19

compression of the 3rd pt of the duodenum between the SMA and aorta.

Question 20

Renal cell carcinoma originates in cells of which structure?

Answer 20

proximal tubule

Question 21

Renal cell carcinomas, the most common type of renal neoplasm, are also known as _______.

Answer 21

Clear cell carcinoma

Question 22

Restrictive lung disease characterized by bilateral hilar lymphadenopathy, noncaseating granulomas, increased ACE and Ca++.

Answer 22

Sarcoidosis

Question 23

What is the tx for sarcoidosis?

Answer 23

steroids

Question 24

What is the primary defect in thalassemias?

Answer 24

mRNA processing

Question 25

What is, by far, the most common cause of lumenal narrowing leading to claudication in larger, named arteries, such as the common femoral a.?

Answer 25

athersclerosis

Question 26

Concentric, onion-like thickening of arteriolar walls affecting the kidneys, retina, and intestines is usually caused by _______?

Answer 26

malignant htn

Question 27

Medication-induced fat redistribution is caused by which 2 types of drugs?

Answer 27

corticosteroids and HAART