Test 2

Question 0

Seconday HTN

Answer 0

Specific etiology
Less common (10%)

Question 1

Primary HTN

Answer 1

Nurture and nature
Idiopathic
Most common form (90%)

Question 2

First line treatment for HTN

Answer 2

Diuretics

Question 3

Number one use limiting side effect of ACE inhibitors

Answer 3

Intense dry cough

Question 4

Major side effect of alpha2 agonists

Answer 4

Sedation

Question 5

Common uses for diuretics

Answer 5

CHF
Hepatic Ascites
Nephrotic syndrome
HTN

Question 6

4 diuretic categories

Answer 6

Carbonic anhydrase inhibitors
Loop diuretics
Thiazides
Potassium sparing diuretics

Question 7

Carbonic anhydrase inhibitors affect on urine

Answer 7

Increased Na
Increased K
Increased Bicarb
Increased volume

Question 8

Most efficacious of all diuretics

Answer 8

Loop diuretics

Question 9

Loop diuretics affect on urine

Answer 9

Increase Na
Increase K
Increase Ca
Increase volume

Question 10

1 choice for emergency edema

Answer 10

Loop diuretics

Question 11

3 perfusion uses of loop diuretics

Answer 11

Get rid of extra fluid on bypass
Get rid of excess
Maintain urine production

Question 12

Affect of Thiazide diuretics on urine

Answer 12

Increased Na
Increased K
Decreased Ca
Increased volume

Question 13

Benefit of thiazides

Answer 13

Promote Ca reabsorption

Significant less decrease in bone density

Question 14

Affect of K sparing diuretics on urine

Answer 14

Increased Na
Decreased K
Increased volume

Question 15

Diuretic of choice for liver failure with edema

Answer 15

Spironolactone

Question 16

1 rule when giving mannitol

Answer 16

Check bag for precipitated crystals

Question 17

5 types of angina

Answer 17

Classic/stable/effort-induced
Unstable
Variant/rest/vasospastic/prinzmetal
Acute coronary syndrome
Mixed

Question 18

If patient doesn’t respond to methemoglobinemia treatment, they are lacking what enzyme?

Answer 18

Glucose 6 phosphate dehydrogenase

Question 19

Calcium channel blockers in order from most cardiac effects to least

Answer 19

Verapamil>Diltiazem>Nifedipine

Question 20

Utilized extensively to prevent radial artery spasm and maintain patency

Answer 20

Diltiazem

Question 21

Systolic heart failure

Answer 21

Decreased contractility and EF
Thin walls
“Younger” patients

Question 22

Diastolic heart failure

Answer 22

Decreased filling and cardiac output

Older patients

Question 23

5 main HF Causes

Answer 23

Ischemia (70%)
Idiopathic 
Viral
Immune-mediated
HTN

Question 24

6 classes of QALY improving drugs

Answer 24

``` Positive inotropes Diuretics Renin/angiotensin blockers Primary vasodilators Beta blockers Aldosterone antagonists ```

Question 25

3 positive inotropes

Answer 25

Cardiac glycosides Catecholamines Bipyridines

Question 26

Preferred drug for cardiac arrest

Answer 26

Epinephrine

Question 27

Standard of care to give after AMIs

Answer 27

ACE Inhibitor

Question 28

Vaughn Williams classification

Answer 28

1a-c: Na channel blockers 2: beta blockers 3: K channel blockers 4: Ca channel blockers

Question 29

Which class of drugs are membrane stabilizers

Answer 29

Class 1a Na channel blockers

Question 30

Side effects of Quinidine

Answer 30

Cinchonism | Tornadoes des Pointes

Question 31

DOC for ventricular arrhythmias (ESP post MI)

Answer 31

Lidocaine

Question 32

Most common beta blocker for cardiac arrhythmias

Answer 32

Metoprolol

Question 33

Class of drug that is reverse use dependent blockade

Answer 33

K channel blockers

Question 34

DOC for AFib

Answer 34

Amiodarone

Question 35

Major side effects of Amiodarone

Answer 35

``` Hypotension Bradycardia Pulmonary fibrosis Nausea Jaundice Blue skin Hypothyroidism ```

Question 36

Beta blocker with class III (K channel blocker) activity

Answer 36

Sotalol

Question 37

Class of antiarrhythmic most prone to cause arrhythmia

Answer 37

Class III

Question 38

DOC for abolishing SVT

Answer 38

Adenosine

Question 39

DOC for digoxin induced arrhythmias

Answer 39

Magnesium sulfate

Question 40

4 anemia therapies

Answer 40

Iron Erythropoietin B9 (Folic acid) B12 (Cyanocobalamin)

Question 41

Anemia caused by iron deficiency

Answer 41

Hypochromic, microcytic

Question 42

Anemia caused by Folic acid deficiency

Answer 42

Megaloblastic

Question 43

Cause of pernicious anemia

Answer 43

B12 deficiency

Question 44

MOA of Hydroxyurea (Hydrea, Droxia)

Answer 44

Causes sickle cell hemoglobin to get diluted out by the formation of fetal hemoglobin, particularly with epo-alpha

Question 45

Indirect anticoagulants

Answer 45

Warfarin (Coumadin) Heparin (Lovenox) Fondaparinux (Arixtra)

Question 46

Direct anticoagulants

Answer 46

Lepirudin (Refludon) Argatroban Bivalirudin (Angiomax)

Question 47

Single most important drug used as a perfusionist

Answer 47

Heparin

Question 48

Mg of heparin per unit

Answer 48

0.002

Question 49

Half life of Unfractionated Heparin vs LMWH

Answer 49

Unfractionated: 1-2hours LMWH: 3-7hours

Question 50

Major advantage of Fondaparinux

Answer 50

Eliminates risk of HIT typeII

Question 51

MOA of Warfarin

Answer 51

Inhibits vitamin K | Blocks enzyme vitamin K epoxide reductase

Question 52

The liver requires vitamin K to produce what factors?

Answer 52

2: Prothrombin 7: Proconvertin 9: Plasma thromboplastin component 10: Stuart-Prower Factor

Question 53

Test to monitor warfarin activity

Answer 53

PT | Measures extrinsic factors

Question 54

INR (international normalized ratio) equation

Answer 54

INR= critters PT/ laboratory normal PT mean

Question 55

Reversal agent for Lepirudin

Answer 55

NONE

Question 56

Removal of Bivalirudin

Answer 56

Hemoconcentrator

Question 57

Measurement test for Argatroban

Answer 57

aPPT

Question 58

Anticoagulant used for renal failure

Answer 58

Argatroban (because cleared by liver)

Question 59

Anticoagulant used for liver failure

Answer 59

Lepirudin or Bivalirudin | Both are cleared by kidneys

Question 60

Aspirin MOA

Answer 60

Irreversibly binds COX1 which modifies activity of COX2 COX2 now produces lipopoxins Prostaglandins now blocked

Question 61

4 major clinical applications for aspirin

Answer 61

Platelets Fever Pain Inflammation

Question 62

Dose of aspirin for complete platelet inactivation

Answer 62

160mg

Question 63

3 major side effects of aspirin

Answer 63

Bleeding GI ulcers Kidney damage

Question 64

Black box warnings for Ticlopidine

Answer 64

Aplastic anemia Neutropenia Thrombotic thrombocytopenia purpura

Question 65

Concerns/side effects for Dextrans

Answer 65

Intra of and Postop bleeding *volume overload, particularly in heart failure and auric renal failure patients Anaphylaxis

Question 66

Appropriate time to give thrombolytics on bypass

Answer 66

NEVER

Question 67

Urokinase plasminogen activator (uPA) inhibitor

Answer 67

Mesupron

Question 68

Affect of Protamine given by itself

Answer 68

Anticoagulant | Decreases thrombin generation by inhibiting Factor V activation

Question 69

Ways to minimize protamine reactions

Answer 69

Slow administration Intra-aortic administration Administration with steroids and antihistamines

Question 70

Factors present in FFP

Answer 70

1, 2, 5, 7, 9, 10, 11, 13 ATIII Protein C and S

Question 71

Use of cryoprecipitate

Answer 71

To replace factors I, VIII, and vWF