DM Midterm

Question 1

Pick efferent arteriole:

Question 2

Ang II mediated vasoconstriction is a regulatory mechanism that acts on the:

Answer 2

efferent arteriole

Question 3

Vasoreactive (myogenic) reflex acts on the:

Answer 3

afferent arterial

Question 4

B/L pelvoureteral obstruction is an example of what type of renal failure?

Answer 4

Post-renal failure

Question 5

Hypovolemia, decreased cardiac output, decreased effective circulating volume (CHF, liver failure), impaired renal autoregulation (NSAIDs, ACE-I/ARB, Cyclosporine) would all cause what type of renal failure?

Answer 5

Pre-renal failure

Question 6

What is NOT a risk factor for chronic kidney disease?

Answer 6

Dementia

Question 7

Causes of chronic kidney disease:

Answer 7

1. chronic glomerulonephritis
2. systemic lupus erythematosus
3. neoplasms
4. polycystic kidney disease
5. AIDs nephropathy
6. diabetic nephropathy

Question 8

Risk factors for chronic kidney disease include:

Answer 8

-age of greater than 60
-smoking
-obesity
-HTN (poorly controlled)
-diabetes
-nephrotoxins/drugs
-infections
-low birth weight
-chronic inflammation

Question 9

Results of RIGHT-sided heart failure:

Answer 9

1. pulmonary edema
2. coughing
3. peripheral edema (arms & legs mostly)

Question 10

Results of LEFT-sided heart failure:

Answer 10

1. affects all organ systems
2. decreased kidney function (leads to fluid retention)
3. pulmonary edema
4. coughing

Question 11

Which ventricle typically fails first in heart failure?

Answer 11

Left

Question 12

What does the EF fraction measure?

Answer 12

amount of blood pumped out / amount of blood in chamber

Question 13

What is a normal EF?

Answer 13

55-70%

Question 14

What is considered severely below normal in regard to EF?

Answer 14

Less than 35%

Question 15

Reduced left ventricular EF:

Answer 15

systolic failure

Question 16

Heart failure with normal left ventricular EF:

Answer 16

diastolic failure

Question 17

Signs of heart failure:

Answer 17

1. rapid, shallow breathing
2. inspiratory rales (crackles)
3. increased HR
4. distended jugular veins
5. peripheral edema
6. ascites
7. cyanosis
8. weight gain
9. clubbing of fingers

Question 18

Symptoms of heart failure:

Answer 18

1. fatigue & weakness
2. orthopnea- SOB in recumbent position
3. exercise intolerance
4. muscle fatigue
5. weight gain
6. GI distress (nausea, vomiting, constipation)

Question 19

Therapy for stage A heart failure:

Answer 19

ACE inhibitors for ARBs

Question 20

Therapy for stage B heart failure:

Answer 20

ACE inhibitors, ARBs, Beta-blocker

Question 21

Therapy for stage C heart failure:

Answer 21

ACE inhibitors, Beta-blockers, Diuretics for fluid retention

Question 22

LVAD is considered:

Answer 22

intermediate therapy

Question 23

Signs of valvular heart disease include:

Answer 23

1. murmurs
2. syncope
3. HF
4. SOB

Question 24

Symptoms of valvular heart disease include:

Answer 24

1. HF
2. exercise intolerance
3. SOB

Question 25

Procedures that do NOT require antibiotic prophylaxis in patient IE:

Answer 25

1. anesthetic injection 2. radiographic imaging 3. placement of removable prosthodontics prosthesis 4. placement of removable ortho appliances & brackets 5. exfoliation of primary dentition 6. bleeding of lip or oral mucosal trauma 7. simple impressions 8. optical scans

Question 26

What is the antibiotic of choice for infective Endocarditis if a patient is allergic to PCN:

Answer 26

Azithromycin (or clindamycin)

Question 27

What is NOT approved by the AHA for antibiotic prophylaxis:

Answer 27

Cephalexin

Question 28

What do you give patient allergic to penicillin to take orally?

Answer 28

Azithromycin (or clindamycin)

Question 29

Example of a true allergy:

Answer 29

Rash Itching Angioedema

Question 30

Chest pain at rest:

Answer 30

unstable angina

Question 31

The role of the macula densa:

Answer 31

glomerular BP

Question 32

What organ system is responsible for finger clubbing?

Answer 32

Cardiovascular

Question 33

Which of the following shoes immunity for hep B?

Answer 33

Anti-Hbs

Question 34

Endocrine etiology of secondary HTN:

Answer 34

Increased catecholamines

Question 35

What is produced in the adrenal cortex?

Answer 35

Cortisol, androgen, aldosterone

Question 36

Norepinephrine is produced in the:

Answer 36

adrenal medualla (catecholamines are produced in adrenal medulla)

Question 37

Hepatic encephalopathy is associated with:

Answer 37

Asterixis

Question 38

What causes the poor wound healing seen in diabetics?

Answer 38

Impaired angiogenesis & cytokines