Week 8

Question 1

What are the highest carriers of rabies

Answer 1

Bats

Question 2

Describe the progression of Rabies

Answer 2

1) incubation (1-3 months)
2) prodromal phase (2-10 days, fever, malaise, paresthesia)
3) Acute neurological phase, encephalitic, hydrophobia, adgitation, flaccid paralysis)

Question 3

Post-exposure for rabies

Answer 3

1) Immune globulin (immediately neutralize rabies virus in wound, weight-based, one-time dose, infiltrate as much as possible around wound, inject IM at a site distant from wound)
2) Vaccine (4-injection series, days 0,3,7,14, and 28 if immunosuppressed).

Question 4

What percent of adults have HTN

Answer 4

50% in the USA

Question 5

Lowering SBP by 10 mm Hg decreases risk of CVD by how much

Answer 5

20-30%

Question 6

What medications to start with for stage 1 HTN

Answer 6

• Thiazide diuretic, Ca channel blocker, or ACE inhibitor/ARB
• Use 2 drugs if stage 2 HTN and BP of 20/10 above target

Question 7

What part of the BP equation do loop target

Answer 7

They lower stroke volume, which directly comes from them lowering the blood volume.

Question 8

Where does lasix work in the body

Answer 8

the ascending loop of henle

Question 9

Site of action for HCTZ

Answer 9

distal convoluted tubule

Question 10

ACEs and ARBs can cause what nutrient abnormality

Answer 10

Hyperkalemia

Question 11

If patients are on loop diuretics long term, what supplementation is necessary

Answer 11

Potassium (loop diuretics decrease potasium)

Question 12

Aldosterone antagonists cause what kind of common side effect

Answer 12

gynecomastia
Aldosterone antagonists: Spironolactone and eplieronone

Question 13

Thiazide diuretics can cause which side effect

Answer 13

photosensitivity

Question 14

Which HTN meds cause hyperuricemia

Answer 14

diuretics, especially loop (Lasix) and thiazide (HCTZ)

Question 15

Most commonly used CA inhibitor

Answer 15

Acetazolamide

Question 16

Which classes of antihypertensives is most likey to decrease serum potassium levels

Answer 16

Thiazide diuretics like cholorathiadone

Question 17

How do you treat a patient on HCTZ that has low potassium?

Answer 17

Switch to triamterene/ HCTZ

Question 18

What are the calcium channel blockers

Answer 18

Amlodipine, nifedipine, diltiazem (cardizem), and verapamil

Question 19

What are the 2 categories of Ca channel blocers (CCBs)

Answer 19

1. Dihydropyridines (-dipine)
2. Non-dihydroperidines

Question 20

Main effect of dihydropyridines

Answer 20

Relax smooth muscle, which causes vasodialation, which lowers BP by decreasing afterload

Question 21

Adverse effects of DHPs

Answer 21

• Peripheral Edema
• CAD exacerbation (have to give nifedibine as the extended release for these to decrease impact, do not give immediate release)

Question 22

Non-DHP adverse reactions

Answer 22

diltiazem, verapamil
- Bradycardia, hypotension, CHF exascerebation, gingeval hyperplasia

Question 23

What are the beta blockers

Answer 23

Atenolol, metoprolol (succinate and tartate), propranol

Question 24

What are the A1- blockers

Answer 24

prazosin

Question 25

What are the a2 agonists

Answer 25

clonidine

Question 26

What are the beta blockers with the a1 blocking effect

Answer 26

carvedilol

Question 27

Preferred agents for htn in pregnancy

Answer 27

Labetalol and nifedipine most common, then methyldopa, hydralazine

Question 28

Contraindicated in pregnancy

Answer 28

ACEs ARBs Aldosterone antagonists

Question 29

What are the primary htn meds for black/AA pts

Answer 29

Thiazide diuretics and Ca channel blockers (HCTZ and amlodipine and nifedipine, diltizem and verapamil)

Question 30

Which drug helps with postural hypotension

Answer 30

midodrine (PO) Pure alpha 1 agonist.