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preload
left ventricular end diastolic volume -- the amount of blood in the ventricle after diastole
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afterload
the force the LV must generate during systole to overcome aortic pressure to open the aortic valve
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basic role of ACE inhibitors and angiontesin II receptor blockers
decrease BP
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nitrates/nitroglycerin - roles
- decrease angina
- vasodilation
- decrease preload
- reduce myocardial O2 demand
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aspirin for heart problems does what
- reduces platelet aggregation
- may prevent MIs
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hypolipidemic agents - do what? names?
- reduce serum lipid levels
- cholestyramine, colestipol
- simvastatin, lovastatin
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heteroptic vs orthotopic heart transplant
- heteroptic: leaving the natural heart and piggybacking the donor heart
- orthotopic: removing and replacing
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S&S of LV failure - in the lungs
- dyspnea
- dry cough
- orthopnea
- paroxysmal nocturnal dyspnea
- pulmnary rales, wheezing
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extra heart sounds in L vs R ventricular failur
- L has S3 and possibly S4,
- R has just S3,
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LV vs RV failure, which gives cyanosis, ascites, hepatomegaly, and jugular vein distension?
RV failure
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LV vs RV failure, which gives hypotension, tachycardia, fatigue, poor exercise tolerance, enlarged heart?
LV
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Buerger's disease
- thromgboangiitis obliterans
- chronic inflammatory vascular occlusive disease of small arteries and veins
- distal to proximal in both UE and LE
- symptoms: pain, paeresthesia, cyanotic, cold, decreased temp sensation, fatigue, risk of ulceration and gangrene
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diabetic angiopathy
elevation of blood glucose and accelerated atheroscleorsis --> neuropathy, ulcers, gangrene, amputation
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Wells scale for predicting DVT
- it's a bunch of conditions, and you get points for each one
- score over 3 = high probability of DVT
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lymphadenopathy
elargement of nodes w/wo tenderness
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adenosine does what
increases HR
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dobutamine does what to heart
increases contractility
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persantine does what to heart
vasodilate
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mets at rest
3.5mL/kg/min
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beta blockers for a pt with peripheral arterial disease?
may decrease time to claudication and worsen symptoms
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how to walk a pt w claudication
walk briefly until they reach a 2 on the scale, rest until pain recedes, repeat, until total of 30-60 min amb
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4 drugs that may increase time to claudication in a pt with peripheral artery disease
- aspirin
- warfarin
- pntoxifylline
- dypiridamole
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sympathectomy for peripheral arterial disease?
results in permanent vasodilation, improving blood flow to skin
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how much elevation for a limb with venous disease?
>18 cm above heart
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types of compression therapy for venous disease
- bandages (elastic, tubular) applied w/i 20 min of rising
- past bandages (Unna boot)
- gauze w zinc oxide, gelatin, or glycerine (4-7 days according to the wound)
- compression stockings (Jobst) >30mmHg
- compression pump 1-2hrs 2x daily
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strenuous activities, jogging, ballistic mvmnts w lymphedema?
contraind - can exacerbate the lymphedema
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pressure for lymphedema compression?
no higher than 45 mmHg -- higher could cause lymphatic collapse
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