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Questions and Answers
What is a cardiac drug that blocks sympathetic activity?
Which drug increases intracellular sodium and enhances vagal tone?
Digoxin
What type of drugs are used occasionally in the treatment of atrial fibrillation by blocking sodium channels?
Class I arrhythmia drugs (Flecainide)
What condition is characterized by a wide and fixed splitting of the second heart sound?
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What cardiac condition is frequently seen in Marfan syndrome?
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What condition produces an opening snap heard in early diastole?
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What heart sound is considered normal in young, healthy people?
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What is a complication of aortic dissection?
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Fibromuscular dysplasia affects the ___ and ___ arteries.
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What condition is indicated by hypotension, tachycardia, and distended jugular veins?
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What condition is indicated by a greater than 20 mmHg systolic difference between arms?
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What should you give if a patient has an aortic dissection and their systolic blood pressure remains above 120?
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Why are beta blockers first line in aortic dissection until surgery can be performed?
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What symptoms are present in patients with hypertrophic cardiomyopathy?
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What medications should be avoided in patients with hypertrophic cardiomyopathy?
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What is used for patients with heart failure due to left ventricular systolic dysfunction?
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What happens to patients who have systolic congestive heart failure?
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Study Notes
Cardiac Pharmacology
- Beta blockers decrease sympathetic activity, slowing impulse generation at the AV node and increasing refractory period without widening QRS interval.
- Digoxin increases intracellular sodium, enhancing vagal tone and reducing AV node conduction.
Arrhythmias
- Class I antiarrhythmics, such as flecainide, block sodium channels and prolong QRS during elevated heart rates.
- Syncope during activity often points to aortic stenosis, characterized by a slow-rising, low-amplitude pulse (pulsus parvus et tardus).
Congenital and Structural Heart Defects
- Atrial septal defect (ASD) results in a fixed, wide splitting of the second heart sound.
- Mitral valve prolapse is common in Marfan syndrome, presenting with a mid to late systolic murmur.
Cardiovascular Sounds
- An opening snap during early diastole indicates mitral stenosis.
- A third heart sound is normal in young, healthy individuals, but abnormal in dilated ventricles.
Complications and Conditions
- Aortic dissection can lead to aortic regurgitation, detectable by an early diastolic murmur.
- Fibromuscular dysplasia predominantly affects women, causing hypertension via renal artery stenosis and symptoms like pulsatile tinnitus and recurrent headaches.
Heart Failure and Tamponade
- Cardiac tamponade is characterized by hypotension, tachycardia, distended jugular veins, and pulsus paradoxus.
- Congestive heart failure leads to RAAS activation, increasing glomerular filtration rate through efferent arteriolar vasoconstriction.
Hypertrophic Cardiomyopathy
- Symptoms include lightheadedness, chest pain, syncope with exertion, and a fourth heart sound in young patients.
- Negative inotropic agents like beta blockers and verapamil are used to manage symptoms.
Management Strategies
- In aortic dissection, beta blockers are first-line to lower heart rate, blood pressure, and left ventricular contractility until surgical intervention.
- Sodium nitroprusside is the second-line agent if systolic blood pressure exceeds 120 mmHg after beta blocker administration.
Contraindications in Cardiomyopathy
- Avoid vasodilators (nitrates, calcium channel blockers, ACE inhibitors, ARBs) in hypertrophic cardiomyopathy as they can worsen left ventricular outflow tract obstruction.
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Description
Test your knowledge of cardiology concepts with these flashcards designed for PANCE preparation. Each card focuses on important cardiac drugs and their mechanisms of action, helping you reinforce critical information. Perfect for anyone looking to excel in cardiology exams.
