pharma test cardio 1.txt

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mhunger
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pharma test cardio 1.txt
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2012-07-07 17:36:59
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Pharma cardio questions 1-4
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  1. Myocarditis
    • Inflammation of the heart muscle
    • Causes; viral infection (most common), bacterial infection
  2. Diagnostic tests for myocarditis
    • ECG (provides evidence of cardiac conduction disturbances)
    • Echocardiography (shows enlargement or inflammation of heart muscle
    • Blood cultures (shows evidence of infection)
    • Cardiac enzymes (elevated levels indicative of myocardial cell damage)
  3. Treatment for myocarditis
    • Antibiotics (if infectious microorganism has been identified)
    • Anti-inflammatory medicines (to reduce swelling)
    • Diuretics (to remove excess water from the body)
    • Low-salt diet (to control fluid volume in the body)
    • Reduced activity (to reduce workload on the heart)
  4. Cardiomyopathy
    • Weakening of or structural changes in heart muscle leading to progressive decrease in cardiac output (CO=HRxSV)
    • Three types; dilated (most common), hypertropic, restrictive
  5. Dilated cardiomyopathy
    • Most common
    • Three characteristic features; dilation of the ventricles, contracile dysfunction of ventricular muscle, congestive heart failure
  6. Common causes of dilated cardiomyopathy
    Infection, myocarditis, toxic agents, metabolic disorders, genetic disorders, immune disorders
  7. Treatments for dilated cardiomyopathy
    Rest, medications (beta-adrenegic receptor antagonists), angiotensin coverting enzyme inhibitors (ACE inhibitors), heart transplant
  8. Hypertrophic cardiomyopathy
    • Due to excessive ventricular growth or thickening of heart muscle (forces heart to work harder)
    • Primarily affects young adults
    • Most common cause of sudden cardiac death in young - cause of sudden death in athletes (occurs during or just afte physical activity)
  9. Common causes of hypertropic cardiomyopathy
    Unknown, may have a genetic component
  10. Treatment of hypertropic cardiomyopathy
    • Medication (beta-adrenergic receptor agonists), Ca2+ channel blockers, antidysrhythmics
    • Implantable-cardioverter defibrillator
    • Surgery (to remove thickened part of ventricle)
    • Alcohol septal ablation (injection of alcohol into the artieries supplying the thickened part of the heart; essentially induces a controlled heart attack by killing the affected area of heart muscle)
  11. Restrictive cardiomyopathy
    • Disorder preventing the heart chambers to fill properly with blood because of stiffness in one or both ventricles
    • Heart is of normal size or only slightly enlarged
    • Endemic to thrrd world countries
  12. Causes of restrictive cardiomyopathy
    Most common cause is amyloidosis; due to abnormal deposition of protein (amyloid) in heart tissue impairing cardiac function
  13. Treatment of restrictive cardiomyopathy
    • Medications (anticoagulants, antidysrhythmics, diuretics)
    • Heart transplant
  14. Cardiac drugs
    • Used to treat heart failure
    • Cardiac glycosides; antidysrhythmics, antiagninals, vasodilators, others
  15. Cardiac glycosides
    • To improve ventricular contraction or cardiac output and ejection fraction
    • To decrease heart rate
    • To decrease conduction velocity
  16. Antidysrhythmics
    To restore normal cardiac rhythm
  17. Antianginals
    • To regulate blood flow to the heart muscle
    • To increase O2 delivery to and reduce O2 requirement of cardiac tissue
  18. Vasodilators
    • To reduce cardiac afterload (by decreasing resistance in arteries)
    • To reduce cardiac preload (by dilating renal arterioles to improve renal perfusion and increse fluid excretion and by improving cirulation to skeletal muscles)
  19. Other cardiac drugs
    Angiotensin converting enzyme inhibitors (ACE); diuretics, beta-adrenergic receptor antagonists (contraindicated in heart failure)
  20. Beta-adrenergic receptor antagonists
    Use is contraindicated in heart failure
  21. Valvular heart disease
    • In a non-diseased heart, closed valves prevent a backflow of blood; open valves permit blood to move forward
    • Normal left atrial pressure is 8-10mmHg
    • Two general disorders; stenosis and regurgitation
  22. Stenosis
    • Mitral valve stenosis
    • Aortic valve stenosis
  23. Mitral valve stenosis
    • Narrowed mitral valve fails to open properly
    • Affects valve between the left atrium and left ventricle; mitral valve narrowing causes resistance to blood flow between left atrium and left ventricle
    • Causes blood to back up into the left atrium, leading to increased left atrial pressure (>10-30 mmHg)
  24. Mitral valve stenosis- increased left atrial pressure leads to:
    Increased pulmonary vein pressure, which causes congestion in pulmonary veins, blood flow back into lungs, fluid accumulation or pulmonary edema, difficulty in breathing, congestive heart failure
  25. Treatment for mitral valve stenosis
    • Valvuloplasty (small balloon is inserted and inflated to stratch and open a stenosed heart valve)
    • Surgical replacement
  26. Aortic valve stenosis
    • Narrowed aortic valve fails to close properly; left ventricular pressure is much greater than aortic pressure during left ventricular ejection
    • Aortic valve cusps show evidence of calcified deposits, adherence of cusps and are warty in appearance
  27. Causes of aortic valve stenosis
    • Rheumatic fever
    • Congenital heart defect
    • Arteriosclerosis
  28. Aortic valve stenosis can lead to
    • Left ventricular hypertrophy
    • Congestive heart failure
    • Inadequate cerebral blood flow
  29. Treatment of aortic valve stenosis
    surgical replacement
  30. Regurgitation diseases
    Mitral valve regurgitation and aortic valve regurgitation
  31. Mitral valve regurgitation
    • Mitral valve fails to close completely, so blood flows back (or regurgitates) into the left atrium during ventricular systole
    • Two types: sclerosis and retraction of valve cusps (mitral valve calcification) and mitral valve prolapse (connective tissue disorder or papillary muscle dysfunction)
  32. Mitral valve regurgitation also:
    • Reduces net left ventricular stroke volume
    • Increased atrial blood volume enlarges left atrial chamber and raised left atrial pressure
    • Left artrium compensates by increasing its contractile force to enhance ventricular filling
    • Leads to pulmonary congestion and edema
  33. Aortic valve regurgitation
    • Aortic valve incompletely closes, causing a backflow of clood into the left ventricle from the aorta closing
    • Left ventricular dilation - cardiac muscle weakens and becomes exhausted and congestive heart failure
    • I kind of wish that he'd write these notes up in proper English, because figuring out what he's trying to say without punctuation is KILLING me
    • On the other hand, I appreciate the notes.
  34. Causes of aortic valve regurgitation
    • Inflammation within the heart
    • Endocarditis
    • Dilated aorta
  35. Treatment of aortic valve regurgitation
    • Medications: ACE inhibitors, diuretics
    • Surgery: repair or replace aortic valve, repair aorta

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