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Drugs and factors that prolong QT intervals?
- Defects in cardiac sodium or potassium channels
- Macrolides (erythromycin)
- Antimalarials (chloroquine, mephaquine)
- Protease inhibitors
- Antiarrythmics (class IA)
- K+ channel blockers
Treatment of Torsades de Pointes
What is the treatment for the syndrome that produces delta waves through the use of bundle of Kent?
- Wolff-Parkinson-White syndrome
- TX: Procainamide and Amiodarone
What microorganism leads to AV nodal block?
Borrelia burgdoferi = complete heart block
Stimulation and MOA of ANP
Increase in blood volume and atrial pressure = activation
- vascular relaxation
- constricts efferent arteriole and dilates afferent arteriole = increased diuresis.
Cushing triad and and how it is started?
- respiratory depression
INcreased ICP constricts arterioles -> cerebral ischemia -> sympathetic hypertension(restore blood flow to brain) -> reflex bradycardia -> increased pressure on brainstem -> depressed respirations
Heart defect associated with Turners syndrome
- Infantile type coarctation of the aorta.
What keeps the PDA open in the neonatal period?
PGE synthesis and low O2 tension
Congenital cardiac defect assoicated with congeital rubella
- Septal defects
- pulmonary artery stenosis
- Calicification in the media of the arteries, esp radial or ulnar.
- Benign, no blood flow obstruction, and intima not involved.
Untreated streptococcus pyogenes.
- Rheumatic fever
- Antigenic similaritiy between bacterial antigens and normal "self" antigens in the heart and CNS lead to anti-self antibodies.
- myocarditis -> mitral/aortic insufficiency
What occurs 5-10 days after an MI?
GROSS: Hyperemic border; central yellow brown softening
Risk for free wall rupture, tamponade, papillary muscle rupture, interventricular septal rupture; due to macrophages degrading important structural components.
Causes of Dilated cardiomyopathy
- wet beriberi
- Coxsackie B viure myocarditis
- chronic cocaine use
- Chagas disease
- peripartum cardiomyopathy
Difference between Osler's nodes and Janeway lesions
Osler's nodes- tender raised lesions on finger or toe pads
Janeway Lesions- small painless erythematous lesions on palm or sole
JONES in Rheumatic heart disease
- Joints (migratory polyarthtritis)
- O pancarditis
- Nodules subcutaneous
- Erythema marginatum
- Sydenham's Chorea
Treatment of disease that is characterized by focal necrotizing vasculitis, necrotizing granulomas in the lung and upper airway, and necrotizing glomerulonephritis
TX: Cyclophosphamide and corticosteroids
2 p-ANCA positive vasculitides
- Microscopic polyangiitis:
- ~ Wegeners without the granulomas
- Affects small vessels
- Churg-Strauss syndrome:
- granulomatous vasculitis with eosinophilia
- Present with asthma, sinusitis, skin lesions, and peripheral neuropathy
Acute, self limiting necrotizing vasculitis in infants/children. Associated with asian ethnicity.
changes in lips/oral mucosa, lymphadenitis, desquamative skin rash. May develop coronary aneurysms.
Benign capillary skin papules found in AIDS patients. Caused by Bartonella henselae infections.
Essential hypertension therapy
- ACE inhibitors
- angiotensin II receptor blockers
- calcium channel blockers
increase cGMP -> smooth mucle relaxation -> afterload reduction
- severe hypertension(also pregnancy with methyldopa)
- S/E: compensatory tachycardia
- increase renin release
Dopamine D1 receptor agonist
relaxes renal vascular smooth muscle
K+ channel opener
- Hyperpolarizes and relaxes vascular smooth muscle.
- Can cause hyperglycemia
Names of drugs in Dihydropyridine CCB
Partial B-agonists contraindicated in angina
- inhbits Na/K ATPase
- stimulates vagus nerve -> decreased conduction at AV node and depression of SA node
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