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Jason's Cardiovascular Block > Valves and Kidney Drugs > Flashcards

Valves and Kidney Drugs Flashcards

(70 cards)

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1
Q

In stenosis, pressure is higher in the chamber behind? or in front of the valve?

A

behind the valve

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2
Q

What kind of overload is in stenosis? which chamber?

A

Pressure overload in the chamber behind the valve.

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3
Q

How do you get volume overload?

A

valve incompetence/regurgitation

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4
Q

What is innocent flow murmurs?

A

benign turbulence caused by high flow in children, fever, preg

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5
Q

2 Main causes of Valvular Heart Disease?

A

degenerative
congenital
Rheumatic fever (past)

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6
Q

What are the symptoms for mild/moderate valve lesions?

A

asymptomatic

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7
Q

When symptoms develop for regurg valve disease, is it reversible?

A

usually poor prognosis, irreversible canoes to LV

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8
Q

If you have symptoms for aortic stenosis, is it reversible?

A

Yes, LV changes can regress

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9
Q

What’s most important besides history to diagnose valvular heart disease?

A

Echocardiography because can show changes before irreversible

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10
Q

Valvular heart disease interventions. 4 of them

A

Replacements: metal/plastic
repair
balloon valvotomy
stent valves

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11
Q

What is the normal pressure gradient across valves?

A

0mm Hg

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12
Q

What is normal valve area?

A

> 2.5cm2

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13
Q

What kind of aortic stenosis usually in elderly?

A

calcific

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14
Q

What causes aortic leaflet damage? 2 reasons

A
  1. Endocarditis

2. Rheumatic fever

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15
Q

What causes aortic root dilation? 4 reasons.

A

Marfan’s
Aortic dissection
collagen vascular disorder (AS)
syphillis (past)

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16
Q

When does aortic regurgitation occur?

A

during diastole

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17
Q

what’s a consequence of aortic regurgitation?

A

volume overload for LV
increase EDV, EF, SV
Normal ESV

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18
Q

in aortic regurgitation, what does the pulse feel like?

A

collapsing pulse

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19
Q

Are decompensation changes in aortic regurgitation reversible

A

No.

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20
Q

How to treat acute severe aortic regurgitation?

A

early surgery due to cardiogenic shock/acute pulmonary oedema.

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21
Q

what does cardiomyopathy do to mitral valve?

A

changes the ventricular shape as who heart is bigger, not al structures are proportional = mitral regurg

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22
Q

what happens to left atrium in mitral regurgitation?

A

increase LA volume and pressure

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23
Q

Are heart changes reversible in mitral regurgitation?

A

Nope. Not after decompensation.

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24
Q

Why would you get left atrial fib?

A

left atrial pressure and volume increase, atrium stretches

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25
Symptoms of Right heart failure?
pulmonary hypertension, congestion, oedema, hypoxia
26
When would the risk of a thrombus in the Left atrium be significant?
mitral regurgitation
27
When is the 'atrial kick' important? increases risk of what?
in Mitral Stenosis Thrombosis fibrillation
28
is left ventricular systolic function affected in Mitral Stenosis?
Nope. Aaaaalll Atria baby.
29
4 things kidney does
regulate water and salt endocrine excrete endogenous waste excret exogenous waste
30
Drug elimination has two things:
metabolism | excretion
31
Where is K+ secreted? 2 spots
Collecting ducts | Distal tubule
32
how do you treat aspirin overdose?
sodium bicarb
33
3 kinds of drugs act on the kidney:
1. diuretics 2. urine pH 3. alter secretion of organic molecules
34
Diuretics do what exactly?
Increase Na+ and Cl- excretion
35
4 types of diuretics are:
1. loop 2. thiazide 3. K+ sparing 4. osmotic
36
Which is the most powerful class of 'torrential' diuretics?
Loop excretes 15-20% in Na+ in filtrate!
37
T/F? loop diuretics work on descending limb of loop of Henle?
False. works on ascending limb
38
What does loop diuretics inhibit?
Na+/K+/2Cl- carriers from lumen into cell
39
How long do loop diuretics last?
3-6 hours
40
how long does it take for loop diuretics to onset?
1 hour
41
Where does loop diuretics act? on the inside of outside of the loop of Henle
outside
42
3 bad things about loop diuretics?
1. hypokalemia 2. hypovolemia (elderly) 3. metabolic alkalosis
43
4 scenarios you'd most likely use loop diuretics?
Heart failure acute pulmonary oedema ascites (liver cirrhosis) renal failure
44
Two kinds of thiazides
True | Thiazide like: indapamide
45
What diuretics are moderately powerful?
Thiazides
46
Where and how do Thiazides work?
distal convoluted tubule | knock out Na+/Cl- cotransporter
47
How long do Thiazides work for?
8-12 hours
48
What diuretic side effects include gout and hypokalaemia?
Thiazides
49
Adverse effects of Thiazides?
gout and hypokalaemia
50
Would you ever combine a loop diuretic and Thiazides?
yes in severe resistant oedema
51
Which drug has less adverse Thiazides effects?
The thiazide-like drugs: indapamide
52
example of a K+ sparing diuretics?
spironolactone
53
are K+ sparing diuretics any good?
by themselves. not really. used in combo with other K+ losing diuretics to counteract hypokalaemia.
54
What aldosterone receptor antagonist has a slow onset?
Spironolactone
55
How does spironolactone do its job?
Aldosterone receptor antagonist
56
Half life of Spironolactone? what lasts longer?
half life of 10 min. metabolite lasts 16 hours
57
Adverse effects of Spironolactone? 2 things:
hyper kalaemia | GI upset
58
how would you clinically use Spironolactone?
in combo with loop or thiazides
59
What diuretic class does triamterene and amiloride belong to? how do they work?
K+ sparing diuretics | block Na+ reabsorption
60
What's Mannitol used as pharmacologically?
Osmotic diuretics
61
3 places Osmotic diuretics effect?
proximal tubules descending limb collecting ducts
62
How do Osmotic diuretics work?
reduce passive water reaboroption
63
When would you use Osmotic diuretics? 2 things:
raised intra cranial/ocular pressure | prevent acute renal failure
64
3 compounds that are bad news for kidneys
1. heavy metals 2. antibiotics 3. cancer drugs
65
kidneys are susceptible to toxicity cause?
1. receives 25% of blood supply 2. concentration 3. reactive species could damage
66
how does mercury hurt the kidneys?
binds to thiol groups in proteins causes glomerulonephritis
67
Which antibiotic used to treat gram -ve infections could cause renal toxicity?
Gentamicin via proteinuria, affects apical membrane of proximal tubule, messes with Ca2+ levels which effs up mitochondria
68
who is more susceptible to gentamicin toxicity?
existing renal disease
69
Cisplatin treats what and what's bad about it?
Treats prostate cancer nephrotoxicity via blood urea increase proteinuria electrolyte imbalance
70
How does Cisplatin mess with the kidney?
activated in cells binds to thiols reactive species

Jason's Cardiovascular Block (15 decks)

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