[qwiz style=”width: auto !important; min-height: auto !important; border-width: 4px !important; border-color: #0099cc !important; ” align=”center”]

[h] Cardiovascular System Flashcards

[i] Master this session in just 5 minutes.

[q] ………….. are metabolized within vascular smooth muscle cells to nitric oxide, which activates guanylate cyclase and promotes the conversion of guanosine triphosphate (GTP) to cyclic guanosine monophosphate (cGMP) —> decreased intracellular calcium, resultant decreased activity of myosin light-chain kinase, and, finally, myosin light chain dephosphorylation and vascular smooth muscle relaxation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5pdHJhdGUu[Qq]

[q] ………. is the form of nitrate that has a low bioavailability due to extensive first-pass hepatic metabolism prior to release in systemic circulation leading to the need for much higher doses of oral formulations as compared to sublingual nitroglycerin.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElzb3NvcmJpZGUgZGluaXRyYXRlLg==[Qq]

[q] Using …………… together with phosphodiesterase (PDE) inhibitors (sildenafil) used for erectile dysfunction and pulmonary hypertension causes a profound systemic hypotension because they both increase intracellular cGMP which causes vascular smooth muscle relaxation. Their use together is absolutely contraindicated.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG5pdHJhdGVzLg==[Qq]

[q] Nitrate-free interval must be provided every day in patients that are using daily long acting nitrates to avoid ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRvbGVyYW5jZSB0byB0aGUgZHJ1Zy4=[Qq]

[q] ………… inhibits the late phase of sodium current thereby reducing diastolic wall tension and oxygen consumption without affection on the heart rate or contractility. Used for treatment of angina refractory to other medical therapies and cause constipation and nausea as side effects.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJhbm9sYXppbmUu[Qq]

[q] …………………….  have been proven beneficial in CHF (all drugs that have been shown to improve survival do so by inhibiting remodeling).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFDRUlzLCBBUkJzLCBiZXRhIGJsb2NrZXJzLCBhbmQgc3Bpcm9ub2xhY3RvbmUu[Qq]

[q] ……………. work as ionotropic by inhibition of cardiac Na-K ATPase –> results in decreased sodium efflux and ↑ intracellular Na –> ↓ Na/Ca exchange –> ↑ intracellular Ca –> ↑ Ca release from sarcoplasmic reticulum –> ↑ actin-myosin interaction –> ↑ contractile force. And works as antiarrythmic by inhibition of neuronal Na-K ATPase –> results in ↑ vagal activity –> Good for supraventricular arrhythmia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpZ294aW4u

[q] ………… is a positive inotropic agent and provides symptomatic relief in patients with acute decompensated heart failure due to left ventricular systolic dysfunction.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpZ294aW4u[Qq]

[q] ………… has an anti-adrenergic effect (via increased parasympathetic tone) with slowing of conduction through the atrioventricular node, which can help improve supraventricular tachycardias with rapid ventricular rate except Wolff-Parkinson-White syndrome.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpZ294aW4u[Qq]

[q] Factors predisposing to digoxin toxicity are ………………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

JiM4MjExOyBSZW5hbCBmYWlsdXJlICjihpMgZXhjcmV0aW9uKSwgaHlwb2thbGVtaWEgKHBlcm1pc3NpdmUgZm9yIGRpZ294aW4gYmluZGluZyBhdCBLLWJpbmRpbmcgc2l0ZSBvbiBOYS9LIEFUUGFzZSku

JiM4MjExOyBEcnVncyB0aGF0IGRpc3BsYWNlIGRpZ294aW4gZnJvbSB0aXNzdWUtYmluZGluZyBzaXRlcy4=

– ↓ clearance (verapamil, amiodarone, quinidine).

[q] The most common presentation of digoxin toxicity is ……………, but the most specific is …………… and the most serious complivation …………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG5vbnNwZWNpZmljIGdhc3Ryb2ludGVzdGluYWwgKGFub3JleGlhLCBuYXVzZWEsIHZvbWl0aW5nKSwgY2hhbmdlcyBpbiBjb2xvciB2aXNpb24gKEJsdXJyeSB5ZWxsb3cgdmlzaW9uKSwgcG90ZW50aWFsbHkgZmF0YWwgY2FyZGlhYyBhcnJoeXRobWlhcyBvZiB2aXJ0dWFsbHkgYW55IHR5cGUu[Qq]

[q] Management of Digoxin toxicity is ……………………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNsb3dseSBub3JtYWxpemUgSywgY2FyZGlhYyBwYWNlciwgYW50aS1kaWdveGluIEZhYiBmcmFnbWVudHMsIE1nLg==[Qq]

[q]………………. is a selective phosphodiesterase (PDE)-3 enzyme inhibitor that can be used in patients with refractory heart failure due to left ventricular systolic dysfunction. It cause vasodilation, a well-known side effect of phosphodiesterase inhibitors which can occasionally limit their use in hypotensive patients.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBob3NwaG9kaWVzdGVyYXNlIDMgaW5oaWJpdG9ycyAoSW5hbQ==cmlub25lIA==YW5kIG1pbA==cmlub25lKS4=

[q] …………. is a beta-adrenergic agonist with predominant activity on beta-1 receptors, weaker activity on beta-2 receptors, and minimal activity on alpha-1 receptors. It is used for management of refractory heart failure associated with severe left ventricular systolic dysfunction and cardiogenic shock.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]U3ltcGF0aG9taW1ldGljcyAoZG9idXRhbWluZSku

[q] ………… is a metalloprotease that cleaves and inactivates both ANP and BNP. Therefore, medications that inhibit it like ……….. lead to increased levels of ANP and BNP and promote beneficial effects in heart failure.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5lcHJpbHlzaW4sIHNhY3ViaXRyaWwu

[q] Because neprilysin is also responsible for inactivating angiotensin II, inhibition of neprilysin further stimulates deleterious vasoconstriction and fluid retention via increased angiotensin II levels. Therefore, in treating heart failure, neprilysin inhibitors are combined with ……………. to mitigate these negative effects.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFuIGFuZ2lvdGVuc2luIGxsLXJlY2VwdG9yIGJsb2NrZXIgKHNhY3ViaXRyaWwtdmFsc2FydGFuKS4=

[q] Long-term use of beta blockers like …………. has been shown to improve survival in patients with HF due to left ventricular systolic dysfunction.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNhcnZlZGlsb2wsIG1ldG9wcm9sb2wu

[x][restart]

[/qwiz]