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Heart Lung and Kidney > HLK Week 1 > Flashcards

HLK Week 1 Flashcards

1
Q

Both parasympathetic and sympathetic nervous systems affect heart activity. Where does parasympathetic action take place?

A

Sinoatrial (SA) node and in the right atrium

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2
Q

Where do chronotropic influences on the heart take place?

A

SA node

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3
Q

Where do dromotropic influences on the heart take place?

A

AV node and conduction fibers

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4
Q

Where do inotropic influences on the heart take place?

A

contractile fibers

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5
Q

Which type of muscarinic receptor is involved in heart activity?

A

M2

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6
Q

Describe the sources of epinephrine/norepinephrine:

A

Post-ganglionic sympathetic nerve fibers and the adrenal medulla.

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7
Q

What is the single biggest determinant of myocardial oxygen demand?

A

HR

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8
Q

Other determinants of myocardial oxygen demand:

A
  • Myocardial contractility
  • Ventricular wall stress
    ~ (LV pressure)(LV radius)/LV wall thickness
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9
Q

What are the three things B-blockers do that make them useful for treating angina?

A
  • lower HR
  • decrease BP
  • decrease contractility
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10
Q

What 3 forms of disease does the term ACS refer to?

A
  • Unstable angina
  • Non ST Elevation Myocardial Infarction (NSTEMI)
  • STEMI
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11
Q

What sort of patient would an ACE inhibitor be a good treatment for?

A

Patients with diabetes, kidney disease, proteinuria,

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12
Q

According to JNC 7, what is the target blood pressure treatment should aim for?

A
  • 140/90, or

- 130/80 in pts with CKD or DM

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13
Q

According to JNC 8, what is the target blood pressure treatment should aim for?

A
  • 150/90 in pts over 60

- 140/90 in all other pts 18 and older

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14
Q

What are the 4 basic categories of medicine used to treat HTN?

A
  • Diuretics
  • Calcium channel blocker
  • ACE inhibitor
  • Angiotensin II receptor blocker
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15
Q

According to JNC 8, what should initial treatment of HTN be for black populations?

A

Thiazide diuretic or CCB

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16
Q

According to JNC 8, what should initial treatment be in pts with CKD?

A

ACE inhibitor or ARB, regardless of race or DM status

17
Q

According to JNC 8, when should you add a second drug to a pt’s HTN treatment?

A

If treatment goal isn’t achieved within a month of initiating treatment.

18
Q

Common causes of 2-ary HTN:

A
  • Hyperaldosteronism
  • Renal disease/renal artery stenosis
  • Coarctation of the aorta
  • Pheochromocytoma
  • Drug induced
  • Thyroid/parathyroid disease
  • Pregnancy
  • Metabolic syndrome (Cushing’s syndrome)
19
Q

“End organs” that are damages as a result of chronic HTN:

A
  • Brain (stroke, TIA)
  • Heart (LVH, MI, CHF, angina)
  • Kidneys (CKD, proteinuria)
  • Eyes (retinopathy)
  • Peripheral artery disease (atherosclerosis)
20
Q

Non-traditional risk factors for CAD:

A
  • Lipoprotein a Lp(a)
  • Homocysteine
  • hs-CRP
  • Coronary artery calcium score
  • Intimal medial wall thickness (IMT)
21
Q

Clinical signs (stigmata) of hyperlipidemia:

A
  • Corneal arcus
  • Xanthomas
  • Xanthelasma
22
Q

USPSTF recommendations for screening for lipid disorders:

A
  • In men > 35, strongly recommended
  • In men between 20 and 35, recommended if increased risk for CHD
  • Not recommended in women at any age unless at risk for CHD
23
Q

Side effects of thiazide diuretics:

A
  • hypokalemia
  • hyperuricemia
  • hyperglycemia
24
Q

Side effects of B-blockers:

A
  • hypotension
  • bradycardia
  • fatigue
  • insomnia
  • hallucinations
  • sexual side effects
  • decreased HDL and increased TG
25
Q

Side effects of ace inhibitors:

A
  • dry cough
  • altered taste
  • rash
  • hypotension
  • hyperkalemia
26
Q

Side effects with calcium channel blockers:

A
  • dizziness
  • HA
  • fatigue
  • gingival enlargement
  • constipation
  • flushing
27
Q

Side effects of alpha blockers:

A
  • reflex tachycardia
  • postural hypotension
  • water retention
28
Q

Side effects of direct vasodilators:

A
  • HA
  • nausea
  • tachycardia
  • lupus-like syndrome
  • arrhythmia
29
Q

Side effects of centrally acting agonists:

A
  • sedation
  • dry mouth
  • constipation
  • salt/water retention

Heart Lung and Kidney (6 decks)

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