PC 707 Module 4 (Cardiac) Exam 2024

PC 707 Module 4 (Cardiac) Exam 2024 Does conversion of Angiotensin I to Angiotensin II cause vasodilation or vasoconstriction? - Answer ️️ -Vasoconstriction (Increases PVR) If epinephrine is secreted, what happens? - Answer ️️ -Tachycardia and vasoconstriction (Increases PVR) Alpha-Blockers, Beta-Blockers, Calcium-Channel Blockers decrease resistance (decreasing PVR) causing what? - Answer ️️ -Vasodilation Na+ holds on to water increasing the PVR or CO? - Answer ️️ -Cardiac Output (CO) A 58 y.o man comes into the clinic and the nurses immediately takes his Bp. Bp 160/92. Should you start him on blood pressure medication immediately? If not, what should you do? - Answer ️️ -No. First let him sit for a couple of minutes, uncross his feet, back rested. Recheck Bp in 5-10 minutes. Should you take a Bp on a full bladder? - Answer ️️ -NO What Bp level is considered Hypertensive? - Answer ️️ -130/80 First management of HTN - Answer ️️ -Lifestyle modifications -Weight loss -DASH -Dietary sodium reduction (2.4 g of sodium or 6 g of sodium chloride) -Regular aerobic physical activity (e.g., brisk walking) at least 30 min per day, most days of the week -Modification of alcohol consumption (2/day for men, 1/day for women) The DASH diet can lower BP in as little as - Answer ️️ -1-2 months What should you consider when taking BP in elderly? - Answer ️️ -Postural HTN Should you maximize one drug in the elderly or start a second agent? - Answer ️️ -Start a second agent What should you teach elderly patient to do when standing up if they are taking antihypertensives? - Answer ️️ -Stand up slowly What is the MOA for thiazides? - Answer ️️ -Increase urinary excretion of sodium & chloride in equal amounts Inhibit sodium & chloride reabsorption in the distal tubule Deplete sodium and potassium & decrease excretion of calcium & uric acid Side effects of thiazide diuretics - Answer ️️ -Hypokalemia, Hyponatremia Hyperglycemia, hyperuricemia, hypertriglycermia and hypercholesteremia What kind of electrolyte problems can thiazide diuretics cause? - Answer ️️ -Hyponatremia and hypokalemia Would you use thiazides in people who have sulfa allergies, renal impairment, or hypokalemia? - Answer ️️ -NO (contraindication) Which diuretic can be useful for women with osteoporosis and HTN because of the calcium- sparing effects - Answer ️️ -Thiazide diuretics What is the MOA of ACE inhibitors? - Answer ️️ -Blocks conversion of angiotensin I to angiotensin II by inhibiting ACE Angiotensin II is a potent vasoconstrictor, so by inhibiting it, less constriction occurs Inhibits degradation of bradykinin and increases the synthesis of vasodilation of prostaglandins Sarah P. comes into clinic complaining of a dry hacky unproductive cough since starting a new HTN medication. Which medication causes this? - Answer ️️ -ACEI What causes ACEI cough? - Answer ️️ -Breakdown of bradykinin If the ACEI cough occurs, how long does it take to resolve? Do you prescribe another ACEI? - Answer ️️ -1-4 weeks NO (discontinue drug) Side Note: occurs more in women If a person is presenting with an ACEI cough, what other antihypertensive drug might you switch them to? - Answer ️️ -ARB Does ACEI cause hypokalemia or hyperkalemia? - Answer ️️ -Hyperkalemia ACEI causes _________ more in women and African Americans - Answer ️️ -Angioedema S/S of angioedema - Answer ️️ -Red welts that suddenly appear, especially near the eyes and lips, but also on the hands, feet, and the inside of the throat. Burning, painful, swollen, sometimes itchy areas. Discolored patches or rash on the hands, feet, face, or genitals. More rarely, hoarseness, a tight or swollen throat, or trouble breathing. ***Can involve the intestine (presenting with abdominal pain) Angioedema can develop over minutes to hours, and typically resolves in 1 to 2 days. Although usually self-limiting, it can be life-threatening Would you recommend an ARB as replacement tx? - Answer ️️ -NO (unless necessary) Should you use an ACEI and ARB together? - Answer ️️ -NO