Cardio 1- Exam 3

Question 1

Renin is release into circulation following one of three things. Name them

Answer 1

-Reduction in sodium delivered to the macula densa
-Drop in blood pressure
-Activation of SNS

Question 2

Where is angiotensinogen produced ?

Answer 2

Liver

Question 3

What 4 things can cause the production of angiotensinogen to increase?

Answer 3

-Corticosteriods
- Estrogens, including oral contraceptives
- Thyroid hormones
-During pregnancy

Question 4

What two substrates does Angiotensin converting enzymes work on?

Answer 4

-Ang I converts to Ang II
-Bradykinin, which is inactivated

Question 5

What does bradykinin produce?

Answer 5

NO and prostacyclin both potent vasodilators

Question 6

RAAS is a potent pressor agent by what kind of muscle contraction?

Answer 6

direct arteriolar smooth muscle contraction

Question 7

RAAS stimulates SNS to release ____ and _____

Answer 7

epinephrine and norepinephrine

Question 8

RAAS acts directly on the _____ of the adrenal cortex to stimulate ______ synthesis and release

Answer 8

zona glomerulosa

aldosterone synthesis

Question 9

RAAS acts on the kidney to cause ______, which ____ promixal tubular sodium reabsorption and _____ the release of renin

Answer 9

renal vasoconstriction

increases

inhibits

Question 10

RAAS (increases/decreases) the release of ADH and (increases/decreases) thirst

Answer 10

increases

increases

Question 11

RAAS stimulate mitosis for ____ and ____ muscle cells and contributes to ______

Answer 11

vascular and cardiac muscle cells

cardiovascular hypertrophy

Question 12

What are the first 4 steps in the RAAS?

Answer 12

1. Renin is release by the kidneys
2. Angiotensinogen is produced by the liver
3. Angiotensinogen converts to Ang I by renin
4. Ang I converts to Ang II through Angiotensin Converting Enzymes

Question 13

What is the main angiotensin receptor? What are some of its effects?

Answer 13

AT1

Vasoconstriction
Sympathetic activation
Cell growth
Sodium and fluid retention

Question 14

Renin inhibitors prevent ____ to ____

Answer 14

Angiotensinogen to be converted into Ang I

Question 15

ACE inhibitors block ___ to ____ conversion

Answer 15

Ang I to Ang II conversion

Question 16

ARBs, ______ gets made but the receptors are blocked

Answer 16

Ang II

Question 17

*****Aldosterone antagonists _____ water and sodium secretion

Answer 17

increase*** is this correct?

Question 18

_____ have a dual effect of blocking bradykinin and conversion Ang I to Ang II

Answer 18

Ace inhibitors

Bradykinin will increase, causes dry hacking cough

Question 19

ACE inhibitors have what ending?

Answer 19

-pril

Question 20

_____ is the only ACEI that is available IV

Answer 20

Enalaprilat

Question 21

_____ are the first line agents for HTN

Answer 21

ACE inhibitors

Question 22

What is considered a “normal” decrease in GFR and increase in SCr when first starting an ACEI

Answer 22

Decrease in GFR by less than 30%

increase in SCr or absolute increase less than 1mg/dL

Question 23

When would you NOT use a ACEI?

Answer 23

bilateral renal artery stenosis

Question 24

_____ is a synthetic steriod

Answer 24

Spironolactone

Question 25

_____ is a spironolactone analog

Answer 25

Epleronone

Question 26

_____ has a slow onset of action requiring several days before full therapeutic effect is achieved

Answer 26

Spironolactone

Question 27

______ has a much greater selectivity for the aldosterone receptor

Answer 27

Eplerenone

Question 28

______ is several hundredfold less active on androgen and progesterone receptors than spironlactone

Answer 28

Eplerenone

Question 29

What is a side effect of topical minoxidil?
name?

Answer 29

hypertrichosis

Rogaine

Question 30

What do you give a patient who is suspected of having cyanide poisoning?

Answer 30

Sodium thiosulfate

or

hydroxocobalamin

Question 31

______ may accumulate over the course of prolonged administration, usually several days of more, especially in patients with renal insufficiency

Answer 31

Thiocyanate

Question 32

What does thiocyanate accumulation present as?

Answer 32

weakness, disorientation, psychosis, muscle spasms and convulsion

Question 33

Is the ACEI dry hacking cough dose related?

Answer 33

not dose related, will also happen across the entire group of drugs