Vessels UWorld 1 (All) Flashcards Preview

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V/Q studies show large perfusion defect, no ventilation defect.

Specific for pulmonary embolism

1

Expression of COX enzymes

COX-1 is constitutively expressed, but COX-2 is only seen where inflammatory cells are activated. Thus COX-2 is an inducible enzyme.

2

Colchicine

Binds to tubulin to inhibit microtubule formation, results in impaired neutrophil mitosis and decreased motility

3

Infliximab

Monoclonal antibody that irreversibly binds and inhibits TNF-a. Inhibits inflammatory response, used for autoimmune diseases (IBD, RA, psoriasis, ankylosing spondylitis)

4

First line tx of isolated systolic HTN

Thiazides and DHP CCBs

5

Doxazosin prazosin, terazosin: class, use, side effects

Alpha-1 blockers. Treat HTN and BPH. Cause first-dose effect, cause hypotension on initiation.

6

Eplerenone

Aldosterone antagonist

7

Aldosterone antagonist most common side effect

Gynecomastia

8

Homocysteine + methylcobalamin -->

Methionine

9

Temporal arteritis: therapy? Trying to prevent?

Steroids (prednisone) to prevent blindness

10

Embryologic origin of PDA

Pulmonary arteries and ductus arteriosus from the 6th aortic arch

11

What is used to close a PDA? Keep it open?

Close: indomethecin
Open: PGE2

12

What arteries are associated with embryonic aortic arches?

1) Maxillary 2) None 3) ICA 4) Arch of aorta, subclavian 5) none 6) Pulmonary arteries, ductus arteriosus

13

What cranial nerves are associated with the embryonic aortic arches?

1) Trigeminal (5) 2) Facial (7) 3) Glossopharyngeal (9) 4) Superior laryngeal of vagus (10) 5) none 6) Recurrent branch of laryngeal (10)

5-7-9-10-0-10

14

-sartan suffix

ARB = angiotensin receptor blocker

15

ARB mechanism, effects

Block effects of angiotensin II by blocking AT-1 receptors. Decrease aldosterone, reflex increase in renin, ATI, and ATII. No change on bradykinin.

16

ACE-I and ARB effects on bradykinin

Bradykinin is broken down by ACE, so ACE inhibitors increase levels of bradykinin, causing cough. ARBs do not have this effect.

17

How do metalloproteases affect atherosclerotic plaques?

involved in remodeling, instability and risk of rupture

18

Common side effects of statin therapy

Hepatotoxicity and myopathy. Myositis can lead to elevated serum creatinine kinase

19

Effect modification

occurs when the effect of a main exposure on an outcome is modified by another variale. E.g. likelihood that asbestos exposure will result in lung cancer impacted by smoking status

20

Transmural inflammation of arterial wall with fibrinoid necrosis

polyarteritis nodosa

21

Dopamine effects at low, med, high dose

Low = D1, increases GFR, vasodilation
Med = D1+B1 = also increases HR, contractility, SBP
High = D1+B1+a1 = generalized systemic vasoconstriction, decreased CO

22

Isolated systolic hypertension

After age 50, becomes common. Caused by decreased compliance in aorta

23

Causes of spontaneous intracranial hemorrhage in young adults

1) AVMs
2) Ruptured cerebral aneurysms
3) Drugs, such as cocaine

24

Adult-type coarctation of aorta

Aortic narrowing is post ductal (no need for PDA). Notching of ribs, hypertension of upper extremities, weak/delayed pulses in lower extremities.

25

What is adult coarctation of aorta associated with?

Other congenital cardiac abnormalities, Berry aneurysm. These patients die of HTN causes.

26

Lipoprotein lipase

hydrolyzes chylomicrons to triglycerides

27

Lipoprotein lipase deficiency

Results in increased concentrations of serum chylomicrons. Body cannot clear dietary lipid loads. Presents as hyperlipidemia and pancreatitis (abdominal pain)

28

How does heparin affect triglycerides?

Releases lipases from endothelium, increasing clearance of triglycerides from circulation

29

What does frothy foamy urine suggest?

Proteinuria or bile salts in urine