Term
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Definition
"Early cyanosis"
TOF
Transposition of the great vessels
Tricuspid Atrestia
TAPVR |
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Term
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Definition
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Term
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Definition
Uncorrected VSD, ASD, or PDA causes compensatory pulmonary Pulmonary vascular hypertrophy
Leads to pulm hypertension
Shunt reverses to become R > L
*Late cyanosis, clubbing and polycythemia |
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Term
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Definition
*anterosuperior displacement of the infundibular septum
1. Pulm stenosis
2. RVH
3. Overriding aorta
4. VSD
*boot shaped heart, will squat to decreased cyanosis |
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Term
| Transposition of great vessels |
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Definition
Not compatible with life unless a shunt is present
Failure of the AP to spiral
Common in children of diabetic mothers |
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Term
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Definition
Infantile- proximal to the insertion of DA, assoc Turners
Adult- distal to ligamentum arteriosum, notching of ribs |
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Term
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Definition
In fetal period, shunt is right to left (normal)
"machine like" murmur
Maintained by PGE synthesis and low O2 tension
Closed with Indomethacin |
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Term
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Definition
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Term
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Definition
| ASD, VSD, AV septal defect (endocardial cushions) |
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Term
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Definition
| Septal defects, PDA, pulmonary artery stenosis |
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Term
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Definition
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Term
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Definition
| Aortic insufficiency and dissection |
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Term
| Infant of diabetic mother |
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Definition
| Transposition of great vessels |
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Term
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Definition
Atheromas- plaques in BV walls
Xanthomas- Plaques or nodules composed of lipid laden histiocytes in the skin (esp eyelids)
Tendon xanthomas- Lipid deposits in tendon, especially the achilles
Corneal arcus- Lipid deposit in cornea |
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Term
| Monckeberg Arteriosclerosis |
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Definition
Calcification in the media of the arteries, especially radial or ulnar
Usually benign "pipestem" arteries
*does not obstruct blood flow |
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Term
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Definition
Hylaline- thickening of small arteries, especially in HTN, DM
Hyperplastic- Onion skinning in malignany HTN |
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Term
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Definition
Disease of elastic arteries, and large/med muscular arteries
Inc risk in men and postmenopausal women
Location: Abdom Aorta, Coronary Aa, popliteal artery, carotid artery |
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Term
| Atherosclerotic plaque progression |
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Definition
Endothelial cell dysfunction
Macrophage and LDL accumulation
Foam cell formation
Fatty streak
Sm Mm cell migration (PDGF and FGF), proliferation and ECM deposition
FIbrous plaque |
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Term
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Definition
Associated with atherosclerosis
Occurs more in Hypertensive male smokers, >50 |
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Term
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Definition
| Assoc with HTN, cystic medial necrosis and tertiary syphilis |
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Term
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Definition
Longitdenal intraluminal tear forming a false lumen
Assoc HTN, bicuspid aortic valve, cystic medial necrosis, and inherited CT disorders
CXR shows mediastinal widening
Tx: B blocker to lower the BP |
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Term
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Definition
*ONLY if there is narrowing of CAD >75%
ST depression on ECG
Prinzmetal variant will show ST elevation |
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Term
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Definition
| Vasodilator may aggregate ischemia, shunting blood from area of critical stenosis to an area of higher perfusion |
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Term
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Definition
| Most often due to acute thrombosis of atherosclerotic plaque |
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Term
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Definition
Dark Mottling
Early coag necrosis, edema, hemorrhage, wavy fibers
Risk of arrhythmia |
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Term
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Definition
Dark mottling
Contraction bands from repercussion injury, release of necrotic cell content into blood, Neutrophil migration
Risk of Arrythmia |
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Term
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Definition
Hyperemia
Extensive coag necrosis, acute inflammation at borders, neutrophil migration
Risk of fibrinous pericarditis |
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Term
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Definition
Hyperemic border with yellow brown softening
Macrophage infiltration, followed by granulation tissue at margins
Risk of free wall rupture, leading to tamponade |
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Term
| MI 2 weeks to several months |
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Definition
Gray white scar
Contracted scar complete
Risk of dressers syndrome (pericarditis post MI) |
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Term
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Definition
Anterior wall (LAD): V1-V5
Anteroseptal (LAD): V1-V2
Anterolateral (LCX): V4-V6
Lateral Wall (LCX): I, aVL, V5, V6
Inferior Wall (RCA): II, III, aVF |
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Term
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Definition
Most common
Alcohol abuse, wet beri beri, coxsackie B, cocaine use, Chagas disease, Doxorubicin tox, hemochromotosis
S3, dilated heart on US
Tx: Na restriction, ACE inhib, diuretics, digoxin, heart tp |
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Term
| Hypertrophic cardiomyopathy |
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Definition
Hypertrophied interventricular septum, leads to outflow obstruction
Autosomal dominant, B myosin heavy chain mutation
Assoc with friederichs ataxia
S4, systolic murmur
Tx: B blockers, NDHP Ca Ch blockers (verapamil) |
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Term
| Restrictive/Obliterative cardiomyopathy |
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Definition
Sarcoidosis, amyloidosis, postradiation fibrosis, endocardial fibroelastosis, hemochromatosis
Lofflers syndrome: endomyocardial fibrosis with eosinophils |
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Term
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Definition
| ACE inhibitors, B blockers, ARBs, and spironolactone all reduce mortality |
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Term
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Definition
| Hemosiderin laden macrophages in the lungs |
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Term
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Definition
Fever, Roths spots (round white spot on retina), Osler nodes, Janeway lesions (small painless lesions on palms), splinter hemorrhages
*Mitral valve is most frequently involved
TC valce in drug abusers |
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Term
| Causes of Bacterial Endocarditis |
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Definition
Acute- S. aureus, large vegetations, rapid onset
Subacute- Viridans strep, smaller vegetations on diseased valves
Malignancy- secondary
Colon cancer- S bovis
Prosthesis- S. epidermidis
IV drug abuse- S aureus, pseudomonas, candida |
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Term
| Libman Sacks endocarditis |
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Definition
Vegetations on both sides of valves, sterile
Assoc with SLE |
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Term
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Definition
A consequence of pharyngeal infection with GAS, b hemolytic
strep
Early death due to mycoarditis, Late is Rheumatic HF
Mitral > Aortic >> TC valves effected
*Aschoff bodies (granuloma with giant cells), anitschkow's cells (activated histiocytes)
Ab to M protein are the cause of damage |
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Term
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Definition
Sharp pain aggravated by inspiration and relieved by sitting up and leaning forward
Friction rub, widespread ST segment elevation |
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Term
| Causes of acute pericarditis |
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Definition
Fibrinous- Dresslers, uremia, radiation
Serous - Viral, non infections inflammatory diseases
Suppurative- Bacterial (pneumococcus, streptococcus) |
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Term
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Definition
Compression of the heart by fluid in pericardium, leading to dec CO
Equilibration of diastolic pressures in all four chambers
Hypotension, distant heart sounds, Inc HR, Pulsus paradoxus |
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Term
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Definition
Tertiary syphilis disrupts the vasa vasorum of the aorta with consequent atrophy of the vessel wall and dilation of the aorta and valve ring
*tree bark appearance |
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Term
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Definition
Most common primary cardiac tumor in adults
90% occur in the atria, mostly LA
*multiple syncopal episodes |
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Term
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Definition
| Most frequent primary tumor in children, assoc with tuberous sclerosis (+angiomyolipoma and astrocytoma) |
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Term
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Definition
Inc JVP on inspiration instead of normal dec
Inspiration causes negative intrathoracic pressure not TM to the heart, impaired filling of the R ventricle, blood backs up into the VC
Seen with constrictive pericarditis, restrictive cadriomyopathies, RA or RV tumors |
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Term
| Temporal (giant cell) arteritis |
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Definition
Generally elderly females
Unilateral HA, jaw claudication
*can cause irreversible blindness due to artery occlusion
Assoc with Polymyalgia rheumatica
Focal granulomatous inflammation
Tx: high dose corticosteroids |
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Term
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Definition
Asian females < 40
*pulseless disease, fever night sweats, arthritis, myalgias, skin nodules, ocular disturbances
Granulomatous thickening of the aortic arch
Tx corticosteroids |
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Term
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Definition
Young adults
*False HepB seroposivity in 30%
Abdominal Pain, melena, HTN, neurologic dysfunction, cutaneous eruptions, renal damage
*renal and visceral vessels mostly, diff age lesions
**Immune complex mediated
Transmural inflammation with fibrinoid necrosis,
Tx: corticosteroids, cyclophosphamide |
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Term
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Definition
Asian children < 4
Conjunctival injection, strawberry tongue, hand-foot erythemia, desquamating rash
Can develop coronary aneurysms
Tx: IvIg, aspirin |
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Term
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Definition
Heavy smokers, Males, <40
Intermittent claudication leads to gangrene, autoamputation of digits, superficial nodular phlebitis
*Raynauds often present |
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Term
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Definition
Necrotizing vasculitis in lungs, kidney, and skin
*pauci immune glomerulonephritis and palpable purpura
*NO granulomas
p-ANCA pos
Tx: cyclophosphamide and corticsteroids |
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Term
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Definition
Perforation of the nasal septum, chronic sinusitis, otitis media, mastoiditis
Hemopytisis, cough, dyspnea
Hematuria, red cell casts
*Focal necrotizing vasculitis, necrotizing granulomas in lung, necrotizing glomerulonephritis
c-ANCA pos
Cyclophosphamide, corticosteroids |
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Term
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Definition
Asthma, sinusitis, palpable purpura, peripheral neuropathy
Pauci immune glomerulonephritis
Granulomas, necrotizing vasculitis with eosinophilia
p-ANCA |
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Term
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Definition
Most common childhood systemic vasculitis
Often follows URI
Triad: Purpura (butt and legs), arthralgia, abdominal pain, melena, multiple lesions of same age
Secondary to IgA deposition |
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Term
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Definition
| Benign capiallry hemangioma of elderly |
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Term
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Definition
Polyploid capillary hemangioma that can ulcerate and bleed
Assoc with pregnancy |
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Term
|
Definition
Cavernous lymphangioma of the neck
Assoc with Turners |
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Term
|
Definition
Benign papules in AIDS patients
*bartonella henselae
Often mistaken for Kaposi sarcoma |
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Term
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Definition
Rare blood vessel malignancy
Head neck and breast area
Assoc with radiation therapy
Very aggressive and difficult to resect |
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Term
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Definition
| Malignancy assoc with persistent lymphedema |
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Term
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Definition
Endothelial malignancy most commonly of skin, but also mouth, GI tract and resp tract.
HHV-8 and HIV |
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Term
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Definition
Affects capillary sized vessels
Port Wine stain on face, ipsilateral leptomeningeal angiomatosis, seizures and early onset glaucoma |
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Term
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Definition
Verapamil, Diltiazem (NDHP), Nifedipine, Amlodipine (DHP)
Blocks VG L-type Ca channels to reduce contractility
Heart is affected by the NDHP
Used for HTN, Angina, arrythmias, Prinzmetal, Raynauds
T- cardiac depression, AV block |
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Term
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Definition
Vasodilate arterioles via Inc cGMP, Sm mm relaxation
First line therapy for pregnant hypertension with methyldopa
T- reflex tachy, fluid retention, lupus like syndrome |
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Term
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Definition
Short acting inc cGMP via direct release of NO, can cause cyanide toxicity
For malignant HTN |
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Term
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Definition
D1 receptor angonist
Dec BP andinc natriuresis |
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Term
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Definition
Opens K channels, relaxes vascular smooth muscle
Used for severe HTN
Can cause hypertrichosis, hypotension, reflex tachy |
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Term
| Nitroglycerin, Isosorbide Dinitrate |
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Definition
Vasodilate by releasing NO in Sm mm, causing an increase in cGMP and Sm Mm relaxation
*primarily dilates veins, dec preload
T- monday dz, tolerance during the work week |
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Term
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Definition
HMG CoA reductase inhibitors
Large effect on LDL, minimal effect on HDL
T- Hepatotox, Rhabdomyolysis |
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Term
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Definition
Inhibits lipolysis in adipose tissue, reduces hepatic VLDL secretion
Small change in HDL and LDL
T- Red flushed face, Hyperglycemia (acanthosis nigricans) Hyperuricemia (gout) |
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Term
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Definition
Cholestyramine, colestipol, colesvelam
Small change on LDL
Prevents intestinal reabsorption of bile acids
T- GI discomfort, cholesterol gallstones |
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Term
|
Definition
Prevents cholesterol reabsorption at brush border
Dec LDL |
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Term
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Definition
Upregulate LPL to increase TG clearance
Large decrease in TGs
Can cause myositis, hepatoxicity, cholesterol gallstones |
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Term
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Definition
Digoxin
Direct inhibition of Na/K ATPase leads to indirect inhibition of Na/Ca exchanger > pos inotropy
Stimualtes the vagus nerve to dec HR
Tox: Blurry yellow vision, can lead to hyperkalemia
Quinidine can decrease dig clearance, inc toxicity |
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Term
| Class 1A Na Channel blockers |
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Definition
Disopyramide, Quinidine, Procainamide
"Double Quarter Pounder"
Increases AP duration, increases ERP, Inc QT interval
Affects both atrial and ventricular arrythmias
T- Q(cinchonism, tinnitus) P(SLE like syndrome) D(heart failure) |
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Term
| Class 1B Na Channel Blockers |
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Definition
Lidocaine, Tocainide, Mexiletine "Lettuce, tomato, mayo"
Dec AP duration
Affects ischemic or depolarized Purkinje and ventricular tissue
Useful in acute Ventricular arrythmias
T- CV depression |
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Term
| Class 1C Na Channel Blockers |
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Definition
Flecainide, Propafone "Fries, please"
*No affect on AP duration
Useful in ventricular tachycardia that progress to Vfib
T- proarrythmic |
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Term
|
Definition
Decreases SA and AV node activity by dec cAMP and Ca currents
Decreases slope of phase 4
Use- Vtach, SVT
T- may mask the signs of hypoglycemia |
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Term
| Class 3 K Channel Blockers |
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Definition
Amiodarone, Ibutilide, Dofetilide, Sotalol
Inc AP duration, Inc ERP, Inc QT interval
T- S (torsades de pointes), I (torsades), A (pulmonary fibrosis, hepatox, hypo/hyperthryoid, corneal deposits, photodermatitis)
Check PFTs, LFTs, TFTs |
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Term
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Definition
Verapamil, Diltiazem
Decrease slope of phase 0
Dec conduction velocity, Inc ERP, Inc PR interval
Used in prevention of nodal
T- constipation, flushing, edema, CV effects |
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Term
|
Definition
Increase the K out of cells > hyper polarization.
DOC diagnosing/abolishing SVT
Very short acting
Effects blocked by theophylline and caffeine |
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Term
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Definition
| Effective in Torsades de Pointes and Dig toxicity |
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