cvr overview
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Questions and Answers

What adverse effect is commonly associated with ACE inhibitors?

  • Dehydration
  • Hyperkalemia (correct)
  • Hypoglycemia
  • Anemia

What is the definition of prehypertension?

  • Chronic blood pressure greater than 120/80 mmHg (correct)
  • Chronic blood pressure greater than 160/100 mmHg
  • Chronic blood pressure greater than 180/120 mmHg
  • Chronic blood pressure greater than 140/90 mmHg

Which class of drugs blocks angiotensin II type 1 (AT₁) receptors?

  • Beta-blockers
  • ACE inhibitors
  • Angiotensin receptor blockers (ARBs) (correct)
  • Calcium channel blockers

Which of the following medications is NOT categorized as a β-blocker?

<p>Ramipril (B)</p> Signup and view all the answers

Which of the following is considered severe hypertension?

<p>Blood pressure greater than 180/120 mmHg (C)</p> Signup and view all the answers

What is the primary effect of β1 receptor antagonism in treating hypertension?

<p>Decrease heart rate (A)</p> Signup and view all the answers

What is the most common cause of essential hypertension?

<p>No identifiable cause (A)</p> Signup and view all the answers

Which of the following is a risk associated with hypertension?

<p>Kidney failure (C)</p> Signup and view all the answers

Which drug is contraindicated in patients with hypertension who also have asthma?

<p>Bisoprolol (A)</p> Signup and view all the answers

What is a characteristic effect of thiazide diuretics?

<p>Inhibit sodium and chloride reabsorption (C)</p> Signup and view all the answers

What are the two main factors controlling blood pressure?

<p>Autonomic and hormonal feedback loops (C)</p> Signup and view all the answers

Which factor is responsible for the faster regulation of blood pressure?

<p>Autonomic feedback loop (A)</p> Signup and view all the answers

Which medication is an example of an aldosterone receptor antagonist?

<p>Spironolactone (A)</p> Signup and view all the answers

What is the effect of increasing cardiac output on blood pressure?

<p>Increases blood pressure (C)</p> Signup and view all the answers

What is a common side effect of non-dihydropyridine calcium channel blockers?

<p>Constipation (D)</p> Signup and view all the answers

What effect does angiotensin II have on blood pressure?

<p>Vasoconstricts blood vessels (C)</p> Signup and view all the answers

Which drug should be avoided during pregnancy due to teratogenic effects?

<p>Lisinopril (A), Spironolactone (D)</p> Signup and view all the answers

Which drug class is commonly employed in managing both hypertension and heart failure?

<p>ACE inhibitors (A)</p> Signup and view all the answers

What blood pressure reading is classified as severe hypertension?

<p>180/120 mmHg (A)</p> Signup and view all the answers

Which of the following is an adverse effect of ACE inhibitors?

<p>Hyperkalemia (A)</p> Signup and view all the answers

Which class of drugs are antagonists at angiotensin II type 1 (AT₁) receptors?

<p>Angiotensin receptor blockers (ARBs) (D)</p> Signup and view all the answers

What characterizes essential hypertension?

<p>No identifiable cause (C)</p> Signup and view all the answers

What is the primary consequence of β2 receptor antagonism in the context of hypertension?

<p>Vasoconstriction (A)</p> Signup and view all the answers

Which statement correctly describes secondary hypertension?

<p>It is usually caused by a known condition such as heart or kidney disease (A)</p> Signup and view all the answers

Which of the following drugs is NOT a β-blocker?

<p>Ramipril (C)</p> Signup and view all the answers

Which of the following is a potential risk associated with untreated hypertension?

<p>Kidney failure (B)</p> Signup and view all the answers

What are the primary regulators of blood pressure?

<p>Autonomic and hormonal feedback loops (C)</p> Signup and view all the answers

What is a primary effect of β1 receptor antagonism in hypertension treatment?

<p>Decrease heart rate (C)</p> Signup and view all the answers

Which condition is primarily linked to hypertensive retinopathy?

<p>Stroke (A)</p> Signup and view all the answers

Which factor provides the fastest regulation of blood pressure?

<p>Autonomic feedback loop (C)</p> Signup and view all the answers

What class of drug is beneficial for managing benign prostatic hyperplasia in conjunction with hypertension?

<p>Alpha-blockers (B)</p> Signup and view all the answers

Which drug is contraindicated in hypertensive individuals with asthma?

<p>Bisoprolol (D)</p> Signup and view all the answers

How does increasing cardiac output influence blood pressure?

<p>Increases blood pressure (D)</p> Signup and view all the answers

How does aldosterone primarily influence blood pressure regulation?

<p>Increases sodium reabsorption and fluid volume (A)</p> Signup and view all the answers

Which of the following is a characteristic of thiazide diuretics?

<p>They are often used as a first-line treatment in hypertensive patients (B)</p> Signup and view all the answers

What is the effect of reducing peripheral vascular resistance (PVR) on blood pressure?

<p>Decreases blood pressure (D)</p> Signup and view all the answers

What is the recommended strategy for managing stage 2 hypertension?

<p>Administer multiple antihypertensive agents (B)</p> Signup and view all the answers

Which drug is an example of an aldosterone receptor antagonist?

<p>Spironolactone (D)</p> Signup and view all the answers

What is the main function of the renin-angiotensin system in the context of hypertension?

<p>Increase blood volume (D)</p> Signup and view all the answers

What is a common side effect of calcium channel blockers (CCBs)?

<p>Constipation (A)</p> Signup and view all the answers

What is a common side effect associated with the use of alpha blockers?

<p>Flushing (B)</p> Signup and view all the answers

Which treatment is most suitable for managing a hypertensive crisis?

<p>Parenteral antihypertensive agents (B)</p> Signup and view all the answers

Which medication is generally avoided during pregnancy due to its teratogenic effects?

<p>Lisinopril (B)</p> Signup and view all the answers

Which class of drugs is primarily used in patients with both hypertension and heart failure?

<p>ACE inhibitors (A)</p> Signup and view all the answers

What is a primary consequence of β2 receptor antagonism in hypertension?

<p>Vasoconstriction (B)</p> Signup and view all the answers

Which statement accurately describes secondary hypertension?

<p>It is usually caused by a known condition (B)</p> Signup and view all the answers

Hypertensive retinopathy is commonly associated with which condition?

<p>Stroke (A)</p> Signup and view all the answers

Which of the following is NOT a common first-line treatment for hypertension?

<p>Beta-blockers (D)</p> Signup and view all the answers

What is the treatment for bacterial pharyngitis (strep throat)?

<p>Antibiotics such as penicillin (C)</p> Signup and view all the answers

Which CRB65 score indicates a condition that may require hospitalization?

<p>CRB65 score of 2 or higher (B)</p> Signup and view all the answers

What is the typical cause of bronchitis in most cases?

<p>Viral infection (B)</p> Signup and view all the answers

What is the hallmark symptom of infective endocarditis (IE)?

<p>Heart murmur (D)</p> Signup and view all the answers

Which of the following is typically NOT a symptom of bronchitis?

<p>Muscle aches (C)</p> Signup and view all the answers

Which of the following pathogens is commonly associated with lower respiratory tract infections such as bronchitis?

<p>Mycoplasma pneumoniae (D)</p> Signup and view all the answers

Which pathogen is primarily responsible for community-acquired pneumonia?

<p>Streptococcus pneumoniae (B)</p> Signup and view all the answers

Under which circumstance would antibiotics be prescribed for bronchitis?

<p>If there is an elevated C-reactive protein level &gt;100mg/mL (A)</p> Signup and view all the answers

What is the most common method used to diagnose pneumonia?

<p>Chest X-ray (A)</p> Signup and view all the answers

What does a CRB65 score of 1 suggest in pneumonia assessment?

<p>Need for outpatient treatment (D)</p> Signup and view all the answers

Which of the following pathogens is considered a secondary invader in respiratory tract infections?

<p>Streptococcus pneumoniae (D)</p> Signup and view all the answers

Which of the following factors is associated with increased severity in pneumonia assessment?

<p>Respiratory rate ≥ 30 breaths/min (A)</p> Signup and view all the answers

What is the most common pathogen for subacute infective endocarditis (IE)?

<p>Viridans streptococci (A)</p> Signup and view all the answers

What is a typical feature of atypical pneumonia?

<p>Dry cough that progresses to sputum (C)</p> Signup and view all the answers

Which cell type in the respiratory tract is responsible for secreting mucins?

<p>Goblet cells (C)</p> Signup and view all the answers

What is a key role of club cells in the respiratory tract?

<p>Detoxify harmful substances inhaled into the lungs (D)</p> Signup and view all the answers

Which virus is commonly associated with the common cold?

<p>Rhinovirus (D)</p> Signup and view all the answers

What is the primary function of club cells in the respiratory system?

<p>Detoxify harmful inhaled substances (C)</p> Signup and view all the answers

Which pathogen is often associated with viral pneumonia in immunocompromised individuals?

<p>Cytomegalovirus (A)</p> Signup and view all the answers

What is the most common cause of infective endocarditis (IE) on native heart valves?

<p>Viridans streptococci (B)</p> Signup and view all the answers

What is one of the most common complications of pneumonia?

<p>Pneumothorax (D)</p> Signup and view all the answers

What laboratory test is most important for diagnosing infective endocarditis (IE)?

<p>Blood culture (D)</p> Signup and view all the answers

Which virus is the cause of influenza?

<p>Orthomyxovirus (C)</p> Signup and view all the answers

What is a common symptom of Epstein-Barr Virus (EBV) infection?

<p>Lymphadenopathy and sore throat (B)</p> Signup and view all the answers

What pathogen is most commonly responsible for hospital-acquired pneumonia (HAP)?

<p>Pseudomonas aeruginosa (C)</p> Signup and view all the answers

Which organism is often implicated in secondary pneumonia following an influenza infection?

<p>Staphylococcus aureus (B)</p> Signup and view all the answers

Which pathogen is considered a common cause of acute bronchitis?

<p>Mycoplasma pneumoniae (B)</p> Signup and view all the answers

What is typically NOT a symptom of bronchitis?

<p>Muscle aches (D)</p> Signup and view all the answers

Under which circumstance would antibiotics likely be prescribed for bronchitis?

<p>If there is an elevated C-reactive protein level &gt;100mg/mL (C)</p> Signup and view all the answers

Which pathogen is recognized as a secondary invader in respiratory tract infections?

<p>Streptococcus pneumoniae (A)</p> Signup and view all the answers

What is the leading pathogen associated with subacute infective endocarditis?

<p>Viridans streptococci (C)</p> Signup and view all the answers

Which organism is least likely to be associated with lower respiratory tract infections?

<p>Escherichia coli (B)</p> Signup and view all the answers

Which cell type in the respiratory tract secretes mucins?

<p>Goblet cells (D)</p> Signup and view all the answers

Which virus is classified as a 'professional invader' in the respiratory tract?

<p>Influenza virus (C)</p> Signup and view all the answers

What are common symptoms associated with the common cold?

<p>Sore throat, runny nose, and fever (B)</p> Signup and view all the answers

Which pathogen is often linked to viral pneumonia in immunocompromised individuals?

<p>Cytomegalovirus (B)</p> Signup and view all the answers

What complication can arise as a result of pneumonia?

<p>Pneumothorax (C)</p> Signup and view all the answers

Which virus is the leading cause of the common cold?

<p>Rhinovirus (A)</p> Signup and view all the answers

Which pathogen is most commonly responsible for community-acquired pneumonia?

<p>Streptococcus pneumoniae (D)</p> Signup and view all the answers

What is the most common diagnostic method used to detect pneumonia?

<p>Chest X-ray (B)</p> Signup and view all the answers

What is the primary role of C-reactive protein (CRP) in the body?

<p>To indicate liver inflammation (C)</p> Signup and view all the answers

What does a CRB65 score of 1 indicate concerning pneumonia severity?

<p>Low severity pneumonia (B)</p> Signup and view all the answers

What is a common factor associated with increased severity in pneumonia assessment?

<p>Rapid heartbeat &gt;100 bpm (D)</p> Signup and view all the answers

Which characteristic feature distinguishes atypical pneumonia from typical pneumonia?

<p>Less severe symptoms compared to typical pneumonia (B)</p> Signup and view all the answers

Which diagnostic test is utilized to confirm pneumonia in critically ill patients?

<p>Bronchoscopy (A)</p> Signup and view all the answers

What is the primary role of blood urea measurement?

<p>To measure kidney function and hydration status (C)</p> Signup and view all the answers

What does an elevated serum urea level indicate?

<p>Kidney function alteration or dehydration (A)</p> Signup and view all the answers

What differentiates plasma from serum samples in blood tests?

<p>Serum is obtained after clotting and centrifugation, plasma is not (D)</p> Signup and view all the answers

Why are venous blood samples commonly used for measuring blood cell contents?

<p>They are commonly used for tests like glycosylated hemoglobin (A)</p> Signup and view all the answers

What does arterial blood gas analysis primarily assess?

<p>Oxygen, carbon dioxide, and pH levels in blood (D)</p> Signup and view all the answers

What role does sodium play in the body's electrolyte balance?

<p>It controls water balance across compartments (A)</p> Signup and view all the answers

Which test is specifically used to monitor kidney function through urea measurement?

<p>Blood urea nitrogen (BUN) test (D)</p> Signup and view all the answers

What method is specifically used to measure sodium and potassium levels in bodily fluids?

<p>Ion-selective electrodes (ISE) (D)</p> Signup and view all the answers

What physiological response is triggered to counteract metabolic acidosis?

<p>Hyperventilation (A)</p> Signup and view all the answers

What is the function of glutamate dehydrogenase (GLDH) in the context of urea measurement?

<p>It converts ammonia and oxoglutarate to glutamate. (C)</p> Signup and view all the answers

Which sample type is essential for accurately assessing arterial blood gas levels?

<p>Arterial blood (B)</p> Signup and view all the answers

A positive cardiac troponin result primarily indicates what condition?

<p>Myocardial infarction (heart attack) (A)</p> Signup and view all the answers

How is cardiac troponin detected using antibodies and magnetic beads?

<p>The beads interact with troponin, producing measurable light. (C)</p> Signup and view all the answers

Which electrolyte is NOT typically measured using ion-selective electrodes?

<p>Magnesium (B)</p> Signup and view all the answers

What compensatory mechanism helps to increase blood pH during metabolic acidosis?

<p>Hyperventilation (B)</p> Signup and view all the answers

What principle underlies the measurement of biomolecules in the laboratory?

<p>Molecules absorb light energy at a specific wavelength for that molecule. (A)</p> Signup and view all the answers

Which instrument is primarily used to measure the absorbance of biomolecules?

<p>Spectrophotometer (A)</p> Signup and view all the answers

What does the term 'optical density' (OD) refer to in spectrophotometry?

<p>The absorbance of light by the sample. (C)</p> Signup and view all the answers

What characterizes a colometric assay?

<p>It involves the formation of a color complex at a specific wavelength. (D)</p> Signup and view all the answers

What is the primary reason for the presence of anti-cTnl antibodies in cardiac troponin detection?

<p>They bind to the TnI epitope and generate light in a luminometer. (B)</p> Signup and view all the answers

Which of the following statements accurately reflects sodium's role in the body?

<p>Sodium helps regulate blood pressure via extracellular fluid balance. (C)</p> Signup and view all the answers

How are unknown concentrations of biomolecules typically determined in spectrophotometry?

<p>By comparing absorbance values to a standard curve. (B)</p> Signup and view all the answers

Why are plasma samples often preferred over serum for specific tests?

<p>Plasma preserves certain analytes by preventing cellular metabolism. (A)</p> Signup and view all the answers

Which statement is true about screening tests?

<p>They provide preliminary physiological data about general conditions. (C)</p> Signup and view all the answers

Which sample source is increasingly used for testing disease biomarkers?

<p>Saliva (D)</p> Signup and view all the answers

Which condition is likely to cause low serum urea levels?

<p>Chronic liver disease (B)</p> Signup and view all the answers

What type of blood sample is best for detecting arterial blood gas abnormalities?

<p>Arterial blood (B)</p> Signup and view all the answers

What does a spectrophotometer measure?

<p>The optical density of a sample. (D)</p> Signup and view all the answers

What is the main advantage of using cardiac troponin as a marker for myocardial infarction?

<p>It is highly specific for cardiac muscle damage. (C)</p> Signup and view all the answers

What role does insulin production play in the context of metabolic balance?

<p>It reduces ketone body production. (C)</p> Signup and view all the answers

In what way does sodium influence glucose homeostasis in the body?

<p>Sodium has no direct effect on glucose regulation. (C)</p> Signup and view all the answers

What is the primary role of glutamate dehydrogenase (GLDH) in the measurement of urea in clinical samples?

<p>To convert ammonia and oxoglutarate to glutamate (A)</p> Signup and view all the answers

In the measurement of urea, what does a decline in NADH concentration indicate?

<p>An increase in urea concentration (C)</p> Signup and view all the answers

Which condition is most likely to cause increased sodium levels due to an electrolyte imbalance?

<p>Acute dehydration from vomiting (D)</p> Signup and view all the answers

Why does hyperventilation occur in a patient with diabetic ketoacidosis?

<p>To compensate for metabolic acidosis by removing excess CO₂ (A)</p> Signup and view all the answers

What is the function of anti-cTnl antibodies in detecting cardiac troponin?

<p>They bind to the TnI epitope and generate light in a luminometer. (D)</p> Signup and view all the answers

What is the role of sodium in maintaining electrolyte balance in the body?

<p>Sodium is crucial for maintaining osmolarity in the extracellular fluid. (B)</p> Signup and view all the answers

What underlying mechanism leads to the detection of cardiac troponin in clinical diagnostics?

<p>The binding and detection by specific antibodies generating light. (A)</p> Signup and view all the answers

In the context of metabolic acidosis, what compensatory mechanism is triggered?

<p>Increased respiration to expel CO₂ (C)</p> Signup and view all the answers

What does a positive result for cardiac troponin (TnT, TnI) indicate in a patient?

<p>Myocardial infarction (heart attack) (C)</p> Signup and view all the answers

Which sample type is typically used for detecting arterial blood gas abnormalities?

<p>Arterial blood (D)</p> Signup and view all the answers

How is cardiac troponin detected using magnetic beads and antibodies?

<p>The beads interact with a specific epitope on TnT or TnI, producing light for measurement (D)</p> Signup and view all the answers

Which of the following would most likely be a cause of electrolyte imbalance leading to increased sodium levels?

<p>Acute dehydration from vomiting (B)</p> Signup and view all the answers

What is the role of glutamate dehydrogenase (GLDH) in the urea measurement test?

<p>It facilitates the breakdown of urea into CO₂ and ammonium (D)</p> Signup and view all the answers

In the case study of a woman with diabetic ketoacidosis, why does hyperventilation occur?

<p>To eliminate excess carbon dioxide (D)</p> Signup and view all the answers

What is the primary mechanism by which atropine increases heart rate in bradycardia?

<p>It blocks muscarinic receptors, reducing parasympathetic activity (B)</p> Signup and view all the answers

For what primary condition are calcium channel blockers like Diltiazem predominantly used?

<p>To control heart rate in atrial fibrillation and atrial flutter (B)</p> Signup and view all the answers

What key feature characterizes rate control in the treatment of atrial fibrillation?

<p>It involves drugs that slow the conduction through the AV node (B)</p> Signup and view all the answers

What is the main objective of rhythm control in the management of atrial fibrillation?

<p>To restore the heart's normal sinus rhythm (D)</p> Signup and view all the answers

Which drug is known for its use in both rate and rhythm control for atrial fibrillation?

<p>Amiodarone (C)</p> Signup and view all the answers

What is a critical feature of re-entry arrhythmias?

<p>A circulating impulse re-excites previously active tissue. (A)</p> Signup and view all the answers

What characteristic is typically seen in Wolfe-Parkinson-White (WPW) syndrome?

<p>Shortened PR interval due to retrograde conduction. (B)</p> Signup and view all the answers

Which arrhythmia is most commonly associated with early afterdepolarizations (EAD)?

<p>Torsades de Pointes (C)</p> Signup and view all the answers

What is the primary classification of Flecainide in the Vaughan-Williams system?

<p>Class 1c (C)</p> Signup and view all the answers

Which risk is associated with Class 1a antiarrhythmic drugs such as Quinidine?

<p>Torsades de Pointes (A)</p> Signup and view all the answers

How do Class 1b antiarrhythmic drugs like Lidocaine primarily act?

<p>They rapidly dissociate from sodium channels and are effective at fast heart rates. (C)</p> Signup and view all the answers

What action do Class 2 antiarrhythmic drugs (beta-blockers) perform on heart function?

<p>Decrease sympathetic activity by blocking beta receptors. (A)</p> Signup and view all the answers

What is the primary function of gap junctions in cardiac tissue?

<p>To enable synchronized contraction of cardiac cells (C)</p> Signup and view all the answers

Which ion is primarily involved in the rapid depolarization phase of the cardiac action potential?

<p>Sodium (Na⁺) (B)</p> Signup and view all the answers

During which phase of the cardiac myocyte action potential do calcium and potassium ions balance each other's effects?

<p>Phase 2 (plateau) (B)</p> Signup and view all the answers

What initiates the pacemaker depolarization in the cardiac nodal action potential?

<p>Slow leak of sodium and potassium ions (B)</p> Signup and view all the answers

What best defines an ectopic beat in cardiac physiology?

<p>An impulse generated by myocytes outside the usual conduction pathway (B)</p> Signup and view all the answers

What is a recognized cause of tachycardia associated with after-polarization?

<p>High intracellular calcium levels (C)</p> Signup and view all the answers

In the cardiac action potential, what happens during Phase 3?

<p>Rapid potassium efflux contributes to repolarization (A)</p> Signup and view all the answers

What adverse effect is commonly associated with beta-blockers in arrhythmia treatment?

<p>Hypotension and dizziness (C)</p> Signup and view all the answers

Which antiarrhythmic drug can also exhibit Class 1a and Class 2 activity?

<p>Amiodarone (D)</p> Signup and view all the answers

How do Class 3 antiarrhythmic drugs prevent arrhythmias?

<p>By prolonging the repolarization phase (B)</p> Signup and view all the answers

What is a significant risk when using Class 4 calcium channel blockers like Verapamil for arrhythmias?

<p>Severe bradycardia and heart block (B)</p> Signup and view all the answers

What is the primary action of digoxin on cardiac myocytes?

<p>It inhibits the Na+/K+ ATPase pump (A)</p> Signup and view all the answers

In which situation is adenosine primarily utilized?

<p>As a first-line treatment for supraventricular tachycardia (D)</p> Signup and view all the answers

Which drug is considered first-line for treating acute bradycardia?

<p>Atropine (C)</p> Signup and view all the answers

What is the purpose of using Class 3 antiarrhythmic drugs like Amiodarone?

<p>To prolong the action potential duration (D)</p> Signup and view all the answers

What is the primary function of gap junctions in the cardiac syncytium?

<p>To enable synchronized contraction of cardiac cells (D)</p> Signup and view all the answers

Which ion is mainly responsible for the rapid depolarisation during phase 0 of the cardiac myocyte action potential?

<p>Sodium (Na⁺) (C)</p> Signup and view all the answers

What occurs during phase 2 (plateau) of the cardiac myocyte action potential?

<p>Simultaneous entry of calcium and efflux of potassium (B)</p> Signup and view all the answers

Which of the following is primarily responsible for pacemaker depolarisation in the cardiac nodal action potential?

<p>Leak currents of sodium and potassium (A)</p> Signup and view all the answers

What is the main characteristic of an ectopic beat?

<p>It is initiated by myocytes outside the normal conduction pathway (D)</p> Signup and view all the answers

Which describes a common cause of tachycardia associated with after-polarisation?

<p>High [Ca²⁺]i triggers trains of action potentials (A)</p> Signup and view all the answers

What is the mechanism of re-entry in arrhythmias?

<p>A circulating impulse re-excites previously active tissue (B)</p> Signup and view all the answers

Which feature is associated with Wolfe-Parkinson-White (WPW) syndrome?

<p>Shortened PR interval due to retrograde conduction (B)</p> Signup and view all the answers

What is the main effect of digoxin on cardiac myocytes?

<p>It inhibits the Na+/K+ ATPase pump, leading to positive inotropy (A)</p> Signup and view all the answers

In what scenario is adenosine most commonly used?

<p>As a first-line treatment for supraventricular tachycardia (D)</p> Signup and view all the answers

Which drug is used as the first-line treatment for bradycardia?

<p>Atropine (C)</p> Signup and view all the answers

What is the effect of atropine in the treatment of bradycardia?

<p>It blocks muscarinic receptors, reducing parasympathetic activity (A)</p> Signup and view all the answers

What is the main therapeutic use of calcium channel blockers like Diltiazem?

<p>To control heart rate in atrial fibrillation and atrial flutter (D)</p> Signup and view all the answers

Which is a characteristic of atrial fibrillation treatment with rate control?

<p>It involves drugs that slow the conduction through the AV node (D)</p> Signup and view all the answers

What is the primary purpose of rhythm control in atrial fibrillation?

<p>To restore the heart's normal sinus rhythm (C)</p> Signup and view all the answers

Which drug is commonly used in both rate and rhythm control for atrial fibrillation?

<p>Amiodarone (C)</p> Signup and view all the answers

Which of the following drugs is primarily indicated for acute attacks of stable angina?

<p>Glyceryl Trinitrate (GTN) (A)</p> Signup and view all the answers

What effect does glyceryl trinitrate (GTN) primarily have in alleviating angina?

<p>Reduces preload and afterload (B)</p> Signup and view all the answers

What is the mechanism of action of nicorandil?

<p>It is a K/ATP channel agonist that causes hyperpolarization of vascular smooth muscle (B)</p> Signup and view all the answers

Which medication is known to cause tolerance upon continuous use?

<p>Glyceryl Trinitrate (GTN) (C)</p> Signup and view all the answers

Which of the following is an inotropic agent used in the treatment of septic shock?

<p>Dobutamine (A)</p> Signup and view all the answers

What is the primary benefit of beta-blockers in treating angina pectoris?

<p>Decrease oxygen demand by reducing heart rate (D)</p> Signup and view all the answers

What effect does dobutamine have on the heart?

<p>Positive inotropic effect by increasing calcium entry into cells (D)</p> Signup and view all the answers

Which adverse effect is commonly associated with propranolol?

<p>Bronchoconstriction (A)</p> Signup and view all the answers

Which β-adrenoreceptor antagonist is selective for β1 receptors only?

<p>Atenolol (B)</p> Signup and view all the answers

What is the mechanism of action of milrinone in heart failure treatment?

<p>Increases cAMP levels by inhibiting PDE3, leading to vasodilation and increased heart contractility (B)</p> Signup and view all the answers

What is the main role of amlodipine in treating angina?

<p>Reduce myocardial oxygen demand (D)</p> Signup and view all the answers

Which of the following drugs is a selective β1 blocker used in heart failure treatment?

<p>Bisoprolol (A)</p> Signup and view all the answers

What is the main advantage of using beta-blockers in chronic heart failure?

<p>They reduce sympathetic stimulation, decreasing oxygen demand and preventing arrhythmias (B)</p> Signup and view all the answers

Which type of angina is primarily caused by coronary artery vasospasm?

<p>Variant angina (D)</p> Signup and view all the answers

Which of the following best describes the inotropic effect of digoxin?

<p>It inhibits sodium-potassium ATPase, leading to increased intracellular calcium (D)</p> Signup and view all the answers

Which drug combination can exacerbate heart failure, particularly in patients with reduced ejection fraction?

<p>Calcium channel blockers and β-blockers (A)</p> Signup and view all the answers

What is the primary cause of variant angina?

<p>Coronary vasospasm (B)</p> Signup and view all the answers

Which medication is considered the most appropriate for managing heart failure with hypotension?

<p>Milrinone (A)</p> Signup and view all the answers

Which drug should be contraindicated for a patient with both heart block and angina?

<p>Verapamil (C)</p> Signup and view all the answers

Which of the following medications would NOT be suitable for a patient with reduced ejection fraction heart failure?

<p>Diltiazem (C)</p> Signup and view all the answers

What is the major cause of angina pectoris in 90% of cases?

<p>Coronary atheroma (D)</p> Signup and view all the answers

Which drug used in angina treatment has 100% bioavailability and is taken orally?

<p>Isosorbide mononitrate (A)</p> Signup and view all the answers

Which of the following is an adverse effect of beta-blockers on the respiratory system?

<p>Bronchoconstriction (A)</p> Signup and view all the answers

What is the role of α1-adrenoreceptor antagonism in carvedilol?

<p>Reduces peripheral vascular resistance by causing vasodilation (D)</p> Signup and view all the answers

Which of the following is a major effect of nitrates in the treatment of angina?

<p>Stimulates β1 receptors to increase heart rate (A)</p> Signup and view all the answers

Which drug combination should be used with caution in the presence of heart failure?

<p>Calcium channel blockers and β-blockers (B)</p> Signup and view all the answers

Which of the following is a characteristic of variant angina?

<p>Caused by coronary vasospasm (D)</p> Signup and view all the answers

What type of angina is characterized by coronary artery vasospasm?

<p>Variant angina (C)</p> Signup and view all the answers

Which of the following drugs would be contraindicated in a patient with heart block and angina?

<p>Propanolol (B), Verapamil (C)</p> Signup and view all the answers

Which calcium channel blocker is most effective in treating coronary vasospasm?

<p>Nifedipine (D)</p> Signup and view all the answers

What is the primary mechanism of action of nicorandil?

<p>Opens K/ATP channels causing vasodilation (B)</p> Signup and view all the answers

Which agent is considered an inotropic drug for treating septic shock?

<p>Dobutamine (C)</p> Signup and view all the answers

What effect does dobutamine specifically have on cardiac function?

<p>Positive inotropic effect by increasing calcium entry (D)</p> Signup and view all the answers

What action does milrinone facilitate in heart failure treatment?

<p>Inhibits PDE3, increasing cAMP levels (A)</p> Signup and view all the answers

Which drug is recognized as a selective β1 blocker for heart failure?

<p>Bisoprolol (B)</p> Signup and view all the answers

Which medication works by increasing cAMP levels to enhance heart contractility?

<p>Milrinone (D)</p> Signup and view all the answers

What adverse effect is associated with non-selective beta-blockers on the respiratory system?

<p>Bronchoconstriction (C)</p> Signup and view all the answers

What major effect do nitrates have in treating angina?

<p>Decrease preload and afterload, reducing myocardial oxygen demand (B)</p> Signup and view all the answers

What is the primary mechanism by which digoxin enhances cardiac contractility?

<p>Inhibition of the Na/K ATPase pump (B)</p> Signup and view all the answers

Flashcards

What is prehypertension?

Chronic blood pressure greater than 140/90 mmHg, but less than 180/120 mmHg.

What is severe hypertension?

Chronic blood pressure greater than 180/120 mmHg.

What is the most common cause of essential hypertension?

The exact cause is unknown.

What are some health risks associated with hypertension?

Kidney failure, stroke, heart attack, heart failure, and eye problems

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What are the two main factors controlling blood pressure?

Cardiac output and peripheral vascular resistance (PVR).

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Which factor is responsible for the faster regulation of blood pressure?

The autonomic nervous system, which regulates blood pressure quickly through nerve signals.

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What is the effect of increasing cardiac output on blood pressure?

Increases blood pressure, as more blood is pumped into the circulatory system.

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How does reducing peripheral vascular resistance (PVR) affect blood pressure?

Decreases blood pressure, as blood flows more easily through widened vessels.

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What is a potential side effect of ACE inhibitors?

ACE inhibitors can cause high potassium levels (hyperkalemia) by affecting aldosterone, a hormone that helps excrete potassium.

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What class of drugs blocks angiotensin II type 1 receptors?

Angiotensin receptor blockers (ARBs) prevent vasoconstriction and lower blood pressure by blocking the angiotensin II type 1 receptors.

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Which drug is NOT a beta blocker?

Ramipril is an ACE inhibitor, not a beta blocker.

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What is the primary effect of beta 1 receptor antagonism in hypertension treatment?

Beta 1 receptor antagonism (blocking beta 1 receptors) decreases heart rate and contractility, leading to reduced blood pressure.

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Which drug is contraindicated in hypertensive individuals with asthma?

Bisoprolol, a beta 1-selective blocker, can still affect beta 2 receptors in the lungs, potentially causing bronchoconstriction in asthma patients.

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What is considered severe hypertension?

Blood pressure greater than 180/120 mmHg, often requiring urgent treatment to prevent complications like stroke or heart attack.

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How do thiazide diuretics lower blood pressure?

Thiazide diuretics, like hydrochlorothiazide, work by inhibiting sodium and chloride reabsorption in the kidneys, reducing blood volume and lowering blood pressure.

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What is an example of an aldosterone receptor antagonist?

Spironolactone is an aldosterone receptor antagonist that blocks aldosterone's effects, leading to reduced sodium reabsorption and lowered blood pressure.

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What is a common side effect of calcium channel blockers (CCBs)?

Non-dihydropyridine calcium channel blockers (e.g., verapamil) are commonly associated with constipation.

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What is a risk associated with hypertension?

Chronic high blood pressure can damage the kidneys, potentially leading to kidney failure if untreated.

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Which factor regulates blood pressure faster, autonomic feedback or hormonal feedback?

The autonomic nervous system works quickly to adjust blood pressure by altering heart rate and blood vessel diameter.

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What is the primary function of the renin-angiotensin system in hypertension?

The renin-angiotensin system raises blood pressure by increasing blood volume (more blood) and constricting blood vessels (narrower vessels).

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What's a common adverse effect of alpha blockers?

Alpha blockers, like doxazosin, can widen blood vessels, leading to side effects like flushing, dizziness, and low blood pressure when standing up.

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How is hypertensive crisis treated?

Hypertensive crisis demands immediate action, often using intravenous medications to lower blood pressure rapidly.

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Are beta-blockers first-line treatment for hypertension?

Beta-blockers, while helpful for heart issues, aren't usually the first choice for just high blood pressure.

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What drug is unsafe during pregnancy?

Lisinopril, an ACE inhibitor, can harm a developing baby, so it's strictly forbidden during pregnancy.

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What drug class is used for both hypertension and heart failure?

ACE inhibitors help both the heart and high blood pressure, making them a common choice for patients with both.

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What does β2 receptor antagonism do to blood pressure?

β2 receptor antagonism causes blood vessels to constrict, ultimately raising blood pressure.

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What causes secondary hypertension?

Secondary hypertension, unlike primary, originates from another medical condition, like kidney or hormonal problems.

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What condition is linked to hypertensive retinopathy?

Hypertensive retinopathy, usually caused by long-term uncontrolled blood pressure, can raise the risk of stroke due to eye and brain vessel damage.

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Teratogenic effects

A specific group of drugs that are known to cause birth defects when taken during pregnancy. These drugs can disrupt fetal development and lead to serious health problems in the newborn.

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Beta-blockers

A class of drugs used to treat both high blood pressure and heart failure by blocking the effects of epinephrine and norepinephrine on the heart.

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Vasoconstriction

The narrowing of blood vessels due to smooth muscle contraction.

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Secondary hypertension

High blood pressure that is caused by an underlying medical condition, such as kidney disease or thyroid problems.

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Hypertensive retinopathy

Damage to the blood vessels in the eye caused by high blood pressure. This can lead to vision loss if left untreated.

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Alpha-blockers

A class of drugs that relax the smooth muscle in the prostate gland and blood vessels, making it easier to urinate and lowering blood pressure.

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Aldosterone

A hormone secreted by the adrenal glands that helps regulate blood pressure by increasing sodium and water reabsorption in the kidneys.

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Stage 2 hypertension

The strategy for managing high blood pressure that requires two or more medication classes.

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What is a common adverse effect of ACE inhibitors?

ACE inhibitors prevent the conversion of angiotensin I to angiotensin II, leading to vasodilation and decreased blood pressure. This effect can cause potassium levels in the blood to rise.

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Which class of drugs are antagonists at angiotensin II type 1 (AT₁) receptors?

Angiotensin receptor blockers (ARBs) directly block the action of angiotensin II at its receptor, preventing vasoconstriction and aldosterone release, which leads to a decrease in blood pressure.

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What is a primary effect of β1 receptor antagonism in hypertension treatment?

Beta-blockers primarily target beta-adrenergic receptors, which are located in the heart and blood vessels. Blocking these receptors reduces heart rate and force of contraction, resulting in lower blood pressure.

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What is a characteristic of thiazide diuretics?

Thiazide diuretics increase urine output by inhibiting sodium and chloride reabsorption in the distal convoluted tubule of the nephron, leading to a decrease in blood volume and blood pressure.

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Which of the following is an example of an aldosterone receptor antagonist?

Aldosterone receptor antagonists block the action of aldosterone, a hormone that promotes sodium retention and potassium excretion. This results in increased potassium levels and reduced blood pressure.

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What is the most appropriate treatment for hypertensive crisis?

Hypertensive crisis refers to a rapid and severe increase in blood pressure that requires immediate treatment. This is typically managed with parenteral antihypertensive agents, which are administered intravenously.

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Which of the following is NOT a common first-line treatment for hypertension?

First-line medications for hypertension include ACE inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers, beta-blockers, and diuretics. These agents are often chosen based on individual patient factors and preferences.

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What is the most common cause of bronchitis?

A viral infection is the most common cause of bronchitis, also known as an inflammation of the bronchial tubes.

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Which symptom is NOT typical of bronchitis?

A runny nose is not a typical symptom of bronchitis, which primarily affects the lower respiratory tract.

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What pathogen is linked to bronchitis?

Mycoplasma pneumoniae is a common pathogen associated with lower respiratory tract infections like bronchitis.

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When are antibiotics prescribed for bronchitis?

Antibiotics are generally not prescribed for bronchitis unless a bacterial infection is confirmed.

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Which pathogen can be a primary invader in respiratory infections?

Streptococcus pneumoniae, while often a secondary invader, can sometimes be the primary cause of respiratory tract infections.

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What is the most common cause of subacute infective endocarditis (IE)?

Viridans streptococci are the most common bacterial cause of subacute infective endocarditis (IE), a serious heart infection.

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What cell type produces mucins in the respiratory tract?

Goblet cells are responsible for secreting mucins, which are important for protecting the respiratory tract.

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What is the role of club cells in the respiratory tract?

Club cells are important for detoxifying harmful substances in the respiratory tract.

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What is the most common virus associated with the common cold?

Rhinovirus, also known as the common cold virus, is a highly contagious virus that primarily affects the upper respiratory tract, causing symptoms like runny nose, sneezing, and congestion.

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What is the primary function of club cells in the respiratory system?

Club cells, found in the bronchioles of the lungs, play a vital role in protecting the respiratory system from inhaled toxins and pollutants. They detoxify these harmful substances and contribute to maintaining the health of the airways.

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Which pathogen is often responsible for viral pneumonia in immunocompromised individuals?

Cytomegalovirus (CMV) is a common virus that can cause severe pneumonia in individuals with weakened immune systems, such as those with HIV/AIDS or undergoing chemotherapy.

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What is the most common cause of infective endocarditis (IE) on native heart valves?

Viridans streptococci are a common group of bacteria found in the mouth and throat. They are the most frequent cause of infective endocarditis (IE) in people with healthy heart valves.

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What is one of the most common complications of pneumonia?

Pneumothorax, a potentially serious complication of pneumonia, occurs when air leaks into the space between the lung and chest wall, causing the lung to collapse.

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What laboratory test is most important for diagnosing infective endocarditis (IE)?

Blood culture is a diagnostic test used to identify the presence of bacteria or other microorganisms in the bloodstream. This is crucial for diagnosing infective endocarditis (IE) as it helps determine the specific causative infection.

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Which virus is the cause of influenza?

Influenza, commonly known as the flu, is caused by influenza viruses belonging to the Orthomyxovirus family. These viruses are highly contagious and can cause severe respiratory illness.

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What is the characteristic symptom of pharyngitis?

Pharyngitis, also called a sore throat, is characterized by inflammation and pain in the throat, often accompanied by difficulty swallowing and swollen lymph nodes.

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What's the treatment for strep throat?

Penicillin, a type of antibiotic, is the go-to treatment for bacterial pharyngitis, also known as strep throat.

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What pneumonia severity requires hospitalization?

A CRB65 score of 2 or higher indicates a serious case of pneumonia needing hospitalization. This score uses factors like confusion, respiratory rate, blood pressure, and age to assess severity.

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What's the hallmark symptom of infective endocarditis?

A heart murmur, an unusual sound heard during a heart exam, is the key sign of infective endocarditis (IE). It happens when bacteria infect the heart's inner lining.

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What's the most common cause of community-acquired pneumonia?

Streptococcus pneumoniae is the biggest culprit behind most cases of community-acquired pneumonia (CAP), the kind we get outside of hospitals.

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How is pneumonia usually diagnosed?

A chest X-ray is the most common way to diagnose pneumonia, showing abnormalities in the lung tissue.

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What's CRP's role?

C-reactive protein (CRP) rises during inflammation, indicating an infection. It's a way for the body to fight off bacteria.

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What does a CRB65 score of 1 mean for pneumonia?

A CRB65 score of 1 suggests mild pneumonia, probably treatable at home. The score helps guide treatment decisions.

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What shows more severe pneumonia?

A rapid heart rate (over 100 beats per minute) indicates more severe pneumonia. It's your body working hard to fight off the infection.

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What is the hallmark sign of infective endocarditis?

A new or changed heart murmur is the most common sign of infective endocarditis, which means infection of heart valves.

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How is pneumonia most often diagnosed?

A chest X-ray is the primary diagnostic tool for pneumonia, revealing inflammation and consolidation (fluid buildup) in the lungs.

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What is the function of C-reactive protein in the body?

C-reactive protein (CRP) is a marker of inflammation produced by the liver. Elevated CRP often points to infections like pneumonia.

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What does a CRB65 score of 1 suggest?

A CRB65 score assesses pneumonia severity. Score 1 signifies lower risk and potential for outpatient management.

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Which factor points to a more severe case of pneumonia?

A rapid heartbeat (tachycardia) over 100 beats per minute may indicate serious pneumonia or respiratory distress requiring close monitoring.

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What's a typical characteristic of atypical pneumonia?

Atypical pneumonia often presents with less severe symptoms like a mild fever and dry cough compared to typical pneumonia, caused by different organisms.

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How is pneumonia diagnosed in critically ill patients?

Bronchoscopy allows for a closer look at the lungs to confirm pneumonia in critically ill patients, especially when other tests are inconclusive.

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What pathogen is often associated with hospital-acquired pneumonia (HAP)?

Pseudomonas aeruginosa is a common bacterial pathogen often responsible for hospital-acquired pneumonia (HAP). It thrives in moist environments and can infect those with weakened immune systems.

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Which bacteria often causes pneumonia after the flu?

Haemophilus influenzae is a common bacterial pathogen that can cause secondary pneumonia following an influenza infection. This means it often infects individuals who are already weakened by the flu.

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What bacterial infection can worsen after a cold or flu?

Streptococcus pneumoniae is a common bacterium that can cause secondary pneumonia after viral respiratory infections. It can exploit weakened immune systems and cause serious lung problems.

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Which bacteria is often associated with bronchitis?

Mycoplasma pneumoniae is a common cause of bronchitis, a type of respiratory infection. It often affects young adults and can cause a persistent cough and shortness of breath.

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Why might doctors prescribe antibiotics for bronchitis?

C-reactive protein (CRP) is a marker of inflammation in the body. When it's elevated above 100mg/mL, it can suggest a bacterial infection rather than a viral one. This is why doctors might prescribe antibiotics for bronchitis in such cases.

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What are the most common bacteria that cause subacute infective endocarditis (IE)?

Viridans streptococci are a group of bacteria commonly associated with subacute infective endocarditis (IE), a serious heart infection. Typically, they infect people who already have a weakened heart.

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What causes most cases of bronchitis?

A viral infection is the most common cause of acute bronchitis. This means that most cases are caused by a virus, such as influenza, rhinovirus, or others.

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What is not a typical symptom of bronchitis?

Muscle aches are not a typical symptom of bronchitis. It mainly affects the respiratory system, causing cough, shortness of breath, chills, and fever. Muscle aches are more common with systemic infections like the flu.

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What are goblet cells responsible for?

Specialized cells found in the respiratory epithelium that produce and secrete mucins, the key components of mucus.

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What is a key role of club cells?

They help detoxify inhaled harmful substances and contribute to repairing damaged respiratory epithelium.

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What is a 'professional invader' in the respiratory tract?

A type of microbe that actively infects and causes illness, often directly attacking host cells.

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What is the clinical presentation of the common cold?

Usually characterized by symptoms like a sore throat, runny nose, and mild fever.

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What virus is commonly associated with the common cold?

The primary cause of the common cold, responsible for a large proportion of cases.

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What is pneumonia?

A serious lung infection that can lead to inflammation and fluid buildup in the alveoli.

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What pathogen is linked to viral pneumonia in immunocompromised individuals?

A common cause of viral pneumonia in individuals with weakened immune systems, such as organ transplant recipients or people with HIV.

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What is the most common cause of infective endocarditis on native heart valves?

The most common bacterial cause of infective endocarditis, affecting native heart valves, particularly after dental procedures or in people with poor oral hygiene.

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What is the role of glutamate dehydrogenase (GLDH) in urea measurement?

GLDH converts ammonia and α-ketoglutarate (OG) into glutamate, a crucial step in the enzymatic reaction that indirectly measures urea concentration.

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What sample type is typically used for detecting arterial blood gas abnormalities?

Arterial blood is ideal for detecting blood gas abnormalities like those seen in diabetic ketoacidosis as it directly reflects oxygen and carbon dioxide levels in the blood.

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What does a positive result for cardiac troponin (TnT, TnI) indicate?

Positive cardiac troponin (TnT, TnI) levels are a strong indicator of myocardial infarction (heart attack) as these proteins are released from damaged heart muscle cells.

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How is cardiac troponin detected using magnetic beads and antibodies?

Magnetic beads coated with antibodies specific to TnT or TnI bind to these proteins in the sample. The presence of bound beads is detected by light emission, directly measuring the amount of troponin.

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What is the primary role of glutamate dehydrogenase (GLDH) in urea measurement?

GLDH plays a crucial role by converting ammonia and α-ketoglutarate (OG) into glutamate. This reaction is linked to the breakdown of urea into ammonium and CO₂.

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In the measurement of urea, what does the decline in NADH concentration indicate?

Decreased NADH concentration in the urea measurement test indicates an increased level of urea. This occurs because the enzymatic reaction consumes NADH as it converts ammonia to glutamate.

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Which of the following would most likely be a cause of increased sodium levels?

Acute dehydration from vomiting can lead to electrolyte imbalance and increased sodium levels. This is because vomiting causes fluid loss, leading to concentrated electrolytes.

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In a case of diabetic ketoacidosis, why does hyperventilation occur?

Hyperventilation in diabetic ketoacidosis is caused by the body's attempt to compensate for acidic blood. The increased breathing rate helps to expel carbon dioxide, reducing the acidity.

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How do anti-cTnl antibodies detect cardiac troponin?

Anti-cTnl antibodies bind to a specific part of the troponin I (TnI) protein, triggering a reaction that produces light, which is measured. This light production is proportional to the amount of troponin I in the sample, allowing for detection of cardiac damage.

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What is the primary function of sodium in electrolyte balance?

Sodium primarily exists outside cells in the body's fluids (extracellular fluid). It plays a crucial role in maintaining the correct balance of fluids and electrolytes, vital for cell function and overall health.

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Why is plasma often preferred over serum for specific tests?

Plasma, unlike serum, contains clotting factors that help prevent cellular metabolism and breakdown of analytes. This makes it ideal for tests requiring accurate measurement of specific analytes.

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What conditions cause low serum urea levels?

Low serum urea levels can indicate impaired kidney function, as the kidneys typically filter and excrete urea. Decreased processing of protein due to liver disease can also lead to lower urea levels.

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Which sample is best for detecting arterial blood gas abnormalities?

Arterial blood directly reflects the oxygen and carbon dioxide levels in the blood, making it the most accurate sample for assessing arterial blood gas abnormalities like pH.

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Why is cardiac troponin used as a marker for myocardial infarction?

Cardiac troponin (TnT and TnI) is found specifically in cardiac muscle. Its presence in the blood is a strong indicator of heart damage, making it a reliable marker for myocardial infarction.

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How does hyperventilation help compensate for metabolic acidosis?

Hyperventilation can help compensate for metabolic acidosis by blowing off excess carbon dioxide (CO₂), which is an acidic molecule, thereby raising the pH. This helps to restore a more balanced blood pH.

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Does hyperventilation stimulate insulin production?

Insulin stimulates the uptake of glucose into cells and promotes its storage as glycogen in the liver and muscles, thus lowering blood glucose levels. Hyperventilation, while important in acidosis, does not directly influence insulin production.

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What principle governs biomolecule measurement?

The principle that each molecule absorbs light at a specific wavelength, and the amount of light absorbed is directly proportional to the concentration of the molecules in the solution.

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What instrument is used for biomolecule absorbance measurement?

A spectrophotometer measures the absorbance (optical density) of light by a sample, which is used to calculate the concentration of biomolecules in the sample.

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What is a colometric assay?

It involves the formation of a color complex at a specific wavelength, which is then measured by spectrophotometry.

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How are unknown biomolecule concentrations determined using spectrophotometry?

A standard curve is created by measuring absorbance at known concentrations. The unknown concentration is then determined by comparing its absorbance to the curve.

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What is the purpose of screening tests?

Screening tests are used to give initial information on a person's general health or physiological state. They don't provide detailed insights into specific organ function but serve as a starting point for further tests.

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What is a commonly used sample source for disease biomarker testing?

Saliva is increasingly used for disease biomarker testing as it is non-invasive and can provide information for conditions such as drug use, oral infections, and certain diseases.

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What does 'optical density' (OD) refer to?

Optical density (OD) is a unit used to quantify how much light is absorbed by a sample, which correlates with the concentration of biomolecules.

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What is the relationship between light absorbance and biomolecule concentration?

Each biomolecule absorbs light at a particular wavelength, and the amount of light absorbed is directly proportional to the concentration of the molecules in the solution.

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What is the BUN test?

Blood urea nitrogen (BUN) is a laboratory test that measures the level of urea in the blood. Urea is a waste product produced by the liver and excreted by the kidneys. By measuring BUN levels, doctors can assess kidney function and hydration status.

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What does an elevated blood urea level indicate?

Elevated blood urea levels can indicate a problem with kidney function or dehydration. When the kidneys aren't working properly, they may not effectively filter urea from the blood, leading to elevated levels. Dehydration can also cause increased urea concentration in the blood.

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What is the difference between serum and plasma?

Serum is obtained after clotting and centrifugation, while plasma is obtained from anticoagulated blood. Serum is the liquid portion of blood that remains after it has clotted and the blood cells have been removed. Plasma is the liquid portion of blood that contains clotting factors. So, plasma is collected before clotting, while serum is collected afterward.

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Why are venous blood samples used for measuring blood cell content?

Venous blood commonly used for tests like glycosylated hemoglobin (HbA1c) that reflect long-term glucose control. Venous blood is obtained from veins and is typically used for numerous tests, including glycosylated hemoglobin, which monitors average blood sugar levels over a period of time.

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What does arterial blood gas analysis assess?

Arterial blood gas analysis primarily assesses oxygen, carbon dioxide, and pH levels in blood. It is a crucial test for evaluating respiratory function and acid-base balance. It helps determine how effectively the lungs are transferring oxygen into and carbon dioxide out of the blood, as well as measuring the acidity or alkalinity of the blood.

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What is sodium's role in electrolyte balance?

Sodium plays a key role in controlling water balance. It helps regulate the movement of water between intracellular and extracellular compartments. Sodium attracts water, and the movement of water follows the movement of sodium ions, ensuring proper fluid balance throughout the body.

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What does an elevated cardiac troponin level indicate?

Cardiac troponin is a protein released from damaged heart muscle cells, making it a sensitive and specific indicator of myocardial infarction (heart attack). It's a valuable biomarker for diagnosing heart attacks.

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What method is used to measure electrolyte concentrations?

Ion-selective electrodes (ISE) are used to measure the concentration of specific ions like sodium, potassium, and chloride in blood and other body fluids. These electrodes selectively allow the target ion to pass through, generating an electrical signal proportional to the ion's concentration.

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Why does hyperventilation occur in metabolic acidosis?

Hyperventilation is a compensatory mechanism in metabolic acidosis. It involves increased breathing rate and depth, expelling CO₂ from the body. This reduces H+ ions, raising blood pH and partially compensating for acidosis.

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What is the role of GLDH in urea measurement?

Glutamate dehydrogenase (GLDH) is an enzyme used in the urea measurement test. It converts ammonia and α-ketoglutarate (OG) into glutamate. This reaction is linked to the breakdown of urea into ammonium and CO₂.

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Which sample type is preferred for detecting arterial blood gas abnormalities?

Arterial blood is the preferred sample type for blood gas analysis, especially in cases like diabetic ketoacidosis, where oxygen, carbon dioxide, and pH need to be measured directly from the arterial source, reflecting the blood's oxygen-carrying capacity and acid-base balance.

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What does a positive result for cardiac troponin indicate?

Elevated cardiac troponin levels, particularly TnT and TnI, are specific markers for myocardial infarction (heart attack). These proteins are released from damaged heart muscle cells, indicating cardiac muscle damage.

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What does a decline in NADH concentration indicate in the urea measurement test?

A decline in NADH concentration in the urea measurement test indicates an increased level of urea. This occurs because the enzymatic reaction consumes NADH as it converts ammonia to glutamate.

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What does a decrease in NADH concentration mean in urea measurement?

A decrease in NADH concentration indicates increased urea levels during testing. This occurs because the enzyme that converts ammonia uses up NADH as it works.

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What causes increased sodium levels (hypernatremia)?

Vomiting leads to dehydration, which concentrates sodium in the blood, causing an electrolyte imbalance.

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Why does hyperventilation occur in diabetic ketoacidosis?

The body hyperventilates to expel excess CO₂ from the blood, reducing the acidity (H+ ions) because of diabetic ketoacidosis.

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How do anti-cTnl antibodies work to detect cardiac troponin?

Anti-cTnl antibodies recognize and bind to cardiac troponin I. This binding triggers a light-emitting reaction, measured by a luminometer, allowing for detection of heart damage.

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What is the main function of sodium in the body?

Sodium is primarily found outside cells in the body's fluids (extracellular fluid). It helps maintain the correct balance of fluids and electrolytes.

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What is the main effect of digoxin on cardiac myocytes?

Digoxin inhibits the Na+/K+ ATPase pump, causing an increase in intracellular calcium, which strengthens myocardial contractions. This leads to a positive inotropic effect, improving heart muscle contractility.

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In what scenario is adenosine most commonly used?

Adenosine is primarily used as a first-line treatment for supraventricular tachycardia (SVT), a type of rapid heartbeat originating above the ventricles. It quickly slows the heart rate by blocking electrical signals in the heart.

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What is the effect of atropine in the treatment of bradycardia?

Atropine is used to treat bradycardia, a slow heart rate, by blocking muscarinic receptors in the heart. This reduces parasympathetic activity, allowing the heart to beat faster and regulate its rhythm.

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What is the main therapeutic use of calcium channel blockers like Diltiazem?

Calcium channel blockers like Diltiazem are primarily used to control heart rate in atrial fibrillation and atrial flutter, two types of irregular heart rhythms. They slow the conduction of electrical impulses through the heart, reducing how fast the heart beats.

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What is a characteristic of atrial fibrillation treatment with rate control?

Rate control in atrial fibrillation focuses on slowing down the heart rate to a normal range, using drugs that slow the conduction through the AV node. This helps regulate the heart rhythm and minimize symptoms like fatigue and breathlessness.

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What is the primary purpose of rhythm control in atrial fibrillation?

The primary purpose of rhythm control in atrial fibrillation is to restore the heart's normal sinus rhythm, effectively returning it to its regular beating pattern. This involves using medications like amiodarone or digoxin to re-establish the normal heart rhythm.

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Which drug is commonly used in both rate and rhythm control for atrial fibrillation?

Amiodarone is a drug commonly used for both rate and rhythm control in atrial fibrillation. It can effectively slow the heart rate and also help restore the normal sinus rhythm, making it a versatile treatment option.

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What is the function of gap junctions in the cardiac syncytium?

Gap junctions are specialized channels between cardiac cells that allow electrical signals to pass quickly and directly, enabling synchronized contraction of the heart muscle.

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Which ion is responsible for the rapid depolarization in phase 0 of the cardiac myocyte action potential?

The rapid depolarization (shift to a more positive charge) in phase 0 of the cardiac myocyte action potential is primarily due to the rapid influx of sodium ions (Na⁺) through voltage-gated sodium channels.

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What occurs during the plateau phase of the cardiac myocyte action potential?

Phase 2 of the cardiac myocyte action potential is characterized by a plateau phase where there's a balance between calcium influx and potassium efflux. Both calcium and potassium channels are open, creating a stable electrical state.

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What is responsible for pacemaker depolarization in the cardiac nodal action potential?

Pacemaker depolarization in the cardiac nodal action potential is mainly driven by the slow influx of calcium ions (Ca²⁺) through specific calcium channels. These channels are responsible for the spontaneous depolarization of pacemaker cells, driving the heart's rhythm.

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What is the main characteristic of an ectopic beat?

An ectopic beat originates from a location outside the normal heart conduction pathway, meaning a different part of the heart initiates the contraction, often leading to an abnormal rhythm.

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What is a common cause of tachycardia associated with after-polarization?

Tachycardia with after-depolarization is commonly caused by an elevated intracellular calcium concentration (high [Ca²⁺]i). This elevated calcium can trigger repetitive action potentials, leading to a rapid heart rate (tachycardia).

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What is the mechanism of re-entry in arrhythmias?

Re-entry arrhythmias occur when an electrical impulse travels in a circular path, re-exciting tissue that was recently active. This sustained electrical activity can lead to rapid and potentially life-threatening heart rhythms.

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What is a feature of Wolfe-Parkinson-White (WPW) syndrome?

Wolfe-Parkinson-White (WPW) syndrome is characterized by a shortened PR interval on the electrocardiogram (ECG), indicating accelerated conduction through an accessory pathway. This bypasses the normal AV node and can lead to rapid heart rhythms.

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What is the risk associated with early afterdepolarisation (EAD)?

Early afterdepolarizations (EADs) are associated with prolonged repolarization and can lead to abnormal action potentials that trigger dangerous arrhythmias such as Torsades de Pointes.

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What is the Vaughan-Williams classification of Flecainide?

Flecainide blocks sodium channels and is used for treating atrial arrhythmias, a type of cardiac rhythm problem.

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What is a key characteristic of Class 1a antiarrhythmic drugs like Quinidine?

Class 1a antiarrhythmic drugs, such as Quinidine, prolong the action potential and have a risk of causing torsades de pointes, a type of arrhythmia.

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What is the primary action of Class 1b antiarrhythmic drugs like Lidocaine?

Class 1b drugs like Lidocaine block sodium channels, but they dissociate rapidly, making them particularly effective at controlling arrhythmias at fast heart rates.

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What is the main mechanism of action for Class 2 antiarrhythmic drugs (beta-blockers)?

Class 2 drugs (beta-blockers) block beta-adrenergic receptors, reducing sympathetic stimulation, which slows heart rate and reduces arrhythmia.

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What is the mechanism of beta blockers?

They block beta-adrenergic receptors, reducing sympathetic stimulation, which slows the heart rate and reduces arrhythmia.

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How does Atropine treat Bradycardia?

Atropine blocks muscarinic receptors, reducing the influence of the parasympathetic nervous system on the heart, which increases the heart rate.

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How do calcium channel blockers like Diltiazem help atrial fibrillation?

Calcium channel blockers like Diltiazem slow conduction through the AV node, reducing the heart rate effectively.

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What is the goal of rate control?

Rate control in atrial fibrillation uses medications to slow the conduction through the AV node, reducing the ventricular rate.

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What is rhythm control in atrial fibrillation?

Rhythm control aims to restore the heart's natural sinus rhythm, often through medication or electrical cardioversion.

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What drug is used for both rate and rhythm control?

Amiodarone, due to its broad antiarrhythmic effects, is often used for controlling both the rate and rhythm of the heart in atrial fibrillation

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What is the primary function of gap junctions in the cardiac syncytium?

Gap junctions are specialized channels that allow electrical signals to pass directly between cardiac muscle cells, ensuring synchronized contraction for efficient heart function.

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Which ion is primarily responsible for the rapid depolarization in phase 0 of the cardiac myocyte action potential?

The rapid depolarization of the cardiac myocyte action potential (phase 0) is primarily driven by the influx of sodium ions (Na⁺) through voltage-gated sodium channels.

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What occurs during phase 2 (plateau) of the cardiac myocyte action potential?

Phase 2 (plateau) of the cardiac action potential is characterized by a balance between calcium influx (Ca²⁺) and potassium efflux (K⁺), which maintains the prolonged depolarization.

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Which of the following drugs primarily prolongs repolarization (phase 3) of the cardiac action potential?

Amiodarone is a class III antiarrhythmic drug that primarily prolongs the repolarization phase (phase 3) of the cardiac action potential, effectively slowing down the heart rate.

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Which of the following antiarrhythmic drugs specifically blocks the fast sodium channels during the early depolarization phase?

Lidocaine is a class IB antiarrhythmic drug with a unique characteristic: It primarily affects the sodium channels during the early phase of depolarization, effectively blocking the fast sodium channels.

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What is a common adverse effect of beta-blockers used in arrhythmias?

Beta-blockers can decrease blood pressure, causing a drop in blood pressure or lightheadedness due to reduced heart rate and force of contraction.

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What Class 3 antiarrhythmic drug is used for acute and chronic arrhythmias?

Amiodarone is a Class 3 antiarrhythmic drug with additional Class 1a and 2 properties. It's used for both immediate and long-term rhythm problems due to its broad action.

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How do Class 3 antiarrhythmic drugs work?

Class 3 drugs like Amiodarone block potassium channels, extending the repolarization phase and preventing abnormal heart rhythms.

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What risk is associated with Class 4 calcium channel blockers like Verapamil?

Class 4 drugs like Verapamil can slow down the heart rate significantly, leading to dangerous bradycardia (slow heartbeat) or heart block in patients with ventricular tachycardia.

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In what situation is adenosine most commonly used?

Adenosine is a first-line treatment for supraventricular tachycardia as it slows down the electrical signals in the heart, stopping the abnormal rhythm.

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Which drug is used as the first-line treatment for bradycardia?

Atropine is the first-line treatment for acute bradycardia, as it blocks the effects of the vagus nerve, thus increasing the heart rate.

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How does atropine work to address bradycardia?

Atropine is commonly used to treat bradycardia (slow heart rate) by blocking the vagus nerve, which decreases heart rate.

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What is Variant angina?

A type of angina caused by coronary artery spasms, often triggered by cold or stress. This leads to a temporary blockage of blood flow to the heart, causing chest pain.

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How does Glyceryl Trinitrate (GTN) work?

A quick-acting medication that helps relieve angina symptoms by relaxing blood vessels, decreasing heart workload, and increasing blood flow to the heart.

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What are beta-blockers and how do they help with angina?

A group of drugs that block the effects of adrenaline and similar hormones on the heart. They help reduce heart rate, myocardial contractility, and ultimately lower oxygen demand, helping with angina.

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What are Calcium Channel Blockers?

A group of medications that work by relaxing blood vessels. They decrease blood pressure and improve blood flow to the heart, reducing angina symptoms.

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What is Stable angina?

A type of angina caused by a gradual narrowing of coronary arteries due to atherosclerosis. This can lead to reduced blood flow to the heart, particularly during physical exertion.

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What is Tolerance (to GTN)?

The tendency for a drug's effectiveness to decrease over time with continuous use, requiring higher doses for the same effect. This is a common occurrence with nitroglycerin.

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What is Preload Reduction?

The effect of reducing the amount of blood flowing back to the heart, which helps to reduce the heart's workload and lower oxygen demand.

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What is Afterload Reduction?

This occurs when nitroglycerin (GTN) widens blood vessels, reducing the resistance the heart has to pump against, reducing the heart's workload and improving blood flow to the heart muscle.

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What is the mechanism of action of nicorandil?

Nicorandil is a potassium channel opener that leads to relaxation of smooth muscle in blood vessels, particularly in the coronary arteries. This dilation helps improve blood flow to the heart.

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Which inotropic agent is used for septic shock?

Dobutamine, a synthetic catecholamine, is a positive inotrope that directly stimulates β1 adrenergic receptors in the heart, boosting contractility and increasing cardiac output.

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What effect does dobutamine have on the heart?

Dobutamine is a β1 agonist, increasing the heart's contractile force (positive inotropy). It also increases heart rate (positive chronotropy), but to a lesser extent than other β1 agonists.

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Mechanism of action of milrinone in heart failure?

Milrinone increases cAMP levels by inhibiting phosphodiesterase type 3 (PDE3). This results in vasodilation and increased contractility, beneficial in heart failure treatment.

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Which drug is a selective β1 blocker for heart failure treatment?

Bisoprolol, a selective β1 blocker, is used in heart failure to reduce the heart's workload by decreasing heart rate and contractility.

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Main advantage of beta-blockers in chronic heart failure?

β-blockers reduce sympathetic stimulation, which decreases oxygen demand on the heart and helps prevent arrhythmias, making them beneficial for chronic heart failure.

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Inotropic effect of digoxin?

Digoxin, a cardiac glycoside, is a positive inotrope that increases heart contractility by inhibiting the sodium-potassium ATPase pump, leading to increased intracellular calcium.

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Describe the inotropic effect of digoxin.

Digoxin increases the strength of the heart's contraction (positive inotrope) without significantly altering heart rate.

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What is the most common cause of angina pectoris?

Coronary artery atheroma, a buildup of plaque in the coronary arteries, is the major cause of angina pectoris in 90% of cases.

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Which angina drug has 100% oral bioavailability?

Glyceryl trinitrate (GTN) is a nitrate drug with 100% bioavailability when taken orally. It is rapidly absorbed and acts quickly to relieve angina by relaxing blood vessels.

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What is a respiratory side effect of beta-blockers?

Beta-blockers can cause bronchoconstriction (narrowing of airways), leading to breathing difficulties in patients with asthma or other respiratory conditions.

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How does α1-adrenoreceptor antagonism affect carvedilol?

Carvedilol, a beta-blocker, also blocks α1-adrenoreceptors, causing vasodilation (widening of blood vessels) and reducing peripheral vascular resistance. This helps lower blood pressure.

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What is the main action of nitrates in angina treatment?

Nitrates are effective for angina because they cause vasodilation (widening of blood vessels) in the coronary arteries, increasing oxygen supply to the heart muscle.

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Which drug combination is risky in heart failure?

Combining calcium channel blockers (CCBs) and beta-blockers can be dangerous in patients with heart failure. Both drugs can negatively impact heart function, potentially worsening heart failure.

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What causes variant angina?

Variant angina is triggered by coronary vasospasm (sudden narrowing of coronary arteries) rather than atheroma. It usually occurs at rest and is associated with chest pain without exertion.

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Which drug is most helpful in heart failure with hypotension?

Dobutamine is a powerful inotropic agent that increases heart contractility and cardiac output. It is often used in patients with heart failure and hypotension to improve blood circulation.

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Which drug combination should be used with caution in the presence of heart failure?

Calcium channel blockers, particularly non-dihydropyridines, combined with beta-blockers can worsen heart failure, especially in patients with a reduced ejection fraction.

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What is the cause of variant angina?

Variant angina, also known as Prinzmetal angina, is caused by spontaneous coronary artery vasospasm. It is distinct from stable angina, which is caused by atherosclerosis.

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Which drug would be most appropriate for heart failure with hypotension?

Milrinone is a phosphodiesterase inhibitor that increases cAMP levels. This action leads to both inotropic support, strengthening heart contractions, and vasodilation, widening blood vessels. This makes it particularly useful in patients with heart failure and hypotension.

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Which drug is contraindicated in a patient with a heart block and angina?

Verapamil, a calcium channel blocker, can worsen heart block by further inhibiting conduction through the AV node. Its use is contraindicated in patients with a heart block.

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Why is Verapamil contraindicated for patients with a heart block?

Verapamil, is a calcium channel blocker that can worsen heart block by further inhibiting conduction through the A-V node. It is contraindicated in patients with a heart block.

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Which calcium channel blocker is most effective in treating coronary vasospasm?

Nifedipine, a dihydropyridine calcium channel blocker, is particularly effective in treating coronary vasospasm. It's known for its potent vasodilating effects, helping to relax narrowed arteries.

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How does nicorandil work?

Nicorandil has a dual mechanism of action. It acts as a nitrate, producing nitric oxide to relax blood vessels, and also opens K/ATP channels. This dual action enhances vasodilation and improves blood flow.

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What is dobutamine used for?

Dobutamine is a β1-selective agonist that increases myocardial contractility. It strengthens the heart's pumping action, improving cardiac output, which is essential in treating septic shock.

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What is the effect of dobutamine on the heart?

Dobutamine increases calcium entry into cardiac muscle cells, leading to enhanced contractility (positive inotropic effect). This effect is crucial in treating heart failure.

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How does milrinone work in treating heart failure?

Milrinone inhibits phosphodiesterase 3 (PDE3), preventing the breakdown of cAMP. Increased cAMP levels enhance heart contractility and cause vasodilation, improving blood flow in heart failure.

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What is a selective β1 blocker used in heart failure treatment?

Bisoprolol is a β1-selective beta-blocker used in heart failure. By blocking β1 receptors, it reduces heart rate and contractility, improving cardiac function and reducing the risk of arrhythmias.

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What is the main advantage of using beta-blockers in chronic heart failure?

Beta-blockers reduce the activity of the sympathetic nervous system, which helps lower oxygen demand, decrease arrhythmias, and improve survival in patients with heart failure.

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What is the primary effect of digoxin on heart function?

Digoxin increases the strength of heart contractions by inhibiting the sodium-potassium pump, but it doesn't directly affect heart rate.

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What is the primary cause of angina pectoris?

Coronary atherosclerosis (hardening of the arteries) is the most common cause of angina pectoris, leading to reduced blood flow to the heart.

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Which drug used in angina treatment has 100% bioavailability and is taken orally?

Isosorbide mononitrate is a medication used for angina that is taken orally and has almost complete absorption into the bloodstream.

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What is a potential side effect of beta-blockers on the respiratory system?

Non-selective beta-blockers, like propranolol, can block β2 receptors in the lungs, potentially causing bronchoconstriction, which is a concern for asthma patients.

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What is the role of α1-adrenoreceptor antagonism in carvedilol?

Carvedilol, a beta-blocker, also blocks α1 receptors, leading to vasodilation (widening of blood vessels), which helps reduce peripheral vascular resistance.

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What is the primary effect of nitrates in the treatment of angina?

Nitrates, like GTN, reduce preload (venous dilation) and afterload (arterial dilation), ultimately reducing myocardial oxygen demand, which helps relieve angina.

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What is the key mechanism of carvedilol in reducing peripheral vascular resistance?

Carvedilol, a β-blocker with α1-adrenoreceptor antagonism, reduces peripheral vascular resistance by causing vasodilation.

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Study Notes

Prehypertension Definition

  • Chronic blood pressure greater than 120/80 mmHg but less than 140/90 mmHg

Severe Hypertension

  • Blood pressure greater than 180/120 mmHg

Essential Hypertension Cause

  • No identifiable cause

Hypertension Risk Factor

  • Kidney failure
  • Increased stroke risk
  • Decreased oxygenation of tissues

Blood Pressure Control Factors

  • Cardiac output and body weight
  • Renal function and blood volume
  • Autonomic and hormonal feedback loops
  • Salt intake and physical activity
  • Vasoconstriction and vasodilation

Faster Blood Pressure Regulation

  • Autonomic feedback loop

Cardiac Output Effect on Blood Pressure

  • Increase in cardiac output increases blood pressure

Peripheral Vascular Resistance (PVR) Effect on Blood Pressure

  • Reducing PVR decreases blood pressure

Renin-Angiotensin System Function in Hypertension

  • Increase blood volume

Angiotensin II Effect on Blood Pressure

  • Vasoconstricts blood vessels

ACE Inhibitors Adverse Effect

  • Hyperkalemia

Angiotensin II Receptor Antagonists

  • Angiotensin receptor blockers (ARBs)

Non-β-blocker

  • Ramipril

Effect of β1 Receptor Antagonism

  • Decrease heart rate

Drug Contraindicated in Hypertensive Individuals with Asthma

  • Bisoprolol

Thiazide Diuretics Characteristic

  • Inhibit sodium and chloride reabsorption in the nephron

Aldosterone Receptor Antagonist

  • Spironolactone

Calcium Channel Blockers Side Effect

  • Constipation

Preferred Calcium Channel Blocker for Hypertension

  • Dihydropyridines

Alpha Blocker Adverse Effect

  • Flushing

Hypertensive Crisis Treatment

  • Parenteral antihypertensive agents

Non-First-Line Hypertension Treatment

  • Beta-blockers

Teratogenic Drug in Pregnancy

  • Lisinopril

Drug Class for Hypertension and Heart Failure

  • ACE inhibitors

β2 Receptor Antagonism Effect

  • Vasoconstriction

Secondary Hypertension

  • Caused by a known condition (e.g., heart or kidney disease)
  • Accounts for a small percentage of hypertension cases

Hypertensive Retinopathy Associated Condition

  • Stroke

Drug Effective for Benign Prostatic Hyperplasia and Hypertension

  • Alpha-blockers

Aldosterone's Role in Blood Pressure Regulation

  • Increases sodium reabsorption and fluid volume
  • Increases fluid volume and elevates blood pressure

Stage 2 Hypertension Management Approach

  • Administer multiple antihypertensive agents

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Description

Test your knowledge on hypertension, including its definitions, causes, risk factors, and control mechanisms. This quiz covers essential concepts such as blood pressure regulation, the role of the renin-angiotensin system, and the effects of cardiac output on blood pressure.

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