Question Bank 2: Cardiovascular system

Primary hypertension is the most common type of hypertensive patients: true or false?

You can also find an underlying disease for secondary hypertension: true or false?

Secondary hypertension can be reversed by ________________________

malignant hypertension is manifested intense spasm of arteries: true or false?

What are the impacts of Malignant Hypertension on the eye, brain and kidney?

The clinical manifestations normally appear quite early in patients with hypertension: true or false?

Low stroke volume can be caused by what types of shock?

Shock due to vasodilation can be seen in conditions such as __________________________________

What are the clinical manifestations of non-progressive shock?

In patients with progressive shock, blood pressure can be maintained: true or false

In patients with irreversible shock, tachycardia may lead to cardiac arrest: true or false

Urine output is normally reduced in patients with shock: true or false?

Stenosis is the condition where the ________________________

Regurgitation is the condition that the _______________________________

What are the complications that may results from mitral (bicuspid) valve stenosis?

The heart murmour occurs after S2, is a typical characteristic of _____________________

Aortic valve stenosis can lead to a decrease in systolic pressures, and in the long-term angina, syncope, dyspnoea: true or false?

Aortic valve regurgitation can lead to:
a. Systemic oedema
b. Pulmonary oedema
c. Angina
d. Atrial fibrillation

An "artificial pacemaker" is commonly used in patients with tachycardia or bradycardia?

Atherosclerosis is a progressive disease characterised by __________ of arteries caused by formation of ______ that hardens with time, leading to narrowing of the blood vessel producing a _______ in blood flow

In the atherosclerotic necrotic core, the accumulation of cholesterol crystals in the macrophages form the _____ cells

Angina is chest pain due to ___________ due to _____________________

Heart attack is when __________ myocardial damage leads to _________

Conduction defects are problems in _____ that carry _____________ to the heart

Heart failure is the _______________________________________

What are factors that can lead to ischaemic injury?

Stable plaques can easily rupture or burst, leading to blood clotting inside the artery: true or false?

Stable plaques partially block vessels: true or false?

Stable angina is due to _______

Unstable angina can occur at _____ with sudden onset of pain

Silent myocardial ischaemia is a type of myocardial ischaemia ________

Variant/Prinzmetal angina is due to ______________________

Ischaemia is a restriction on blood supply to tissues, causing a shortage of ______ and ______ needed for cellular metabolism

Infarction is ________ due to _____________________

What's the typical pain pattern in a patient with MI? What's the typical ECG shape for such a patient?

What tests would provide biochemical evidence of myocardial necrosis?

Dilated cardioMYOPATHY is a condition in which the heart becomes _________________ without any obvious cause and hence cannot ___________________

What are the possible causes (CVS disorders) of dilated cardiomyopathies?

Hypertrophic cardiomyopathy is a __________________

RESTRICTIVE cardiomyopathy is due to abnormally _____ walls and ventricles lack the ________________ as they fill with blood

Heart failure denotes ______________________________

Heart failure is classified into 4 classes bases on level of patient activity:

What is Class I heart failure?

Heart failure is classified into 4 classes bases on level of patient activity:

What is Class II?

Heart failure is classified into 4 classes bases on level of patient activity:

What is Class III?

Heart failure is classified into 4 classes bases on level of patient activity:

What is Class IV?

In patients with Class I Heart failure, the physical activities are limited: True or false?

Usually the LEFT heart failure can cause pulmonary oedema: true or false?

Usually the RIGHT heart failure can cause systemic oedema: True or false?

Productive cough with pink frothy sputum is usually observed in patients with left or right heart failure

Low output heart failure is caused by disorders that impair pumping ability of the heart and characterised by _______ skin

High output failure is __________, with function of the heart supernormal but _______________________________

Urine output is normally _________ due to low cardiac output in patients with HF. This is normally due to ___________ ADH release from the posterior pituitary

Right heart failure usually occurs as a result of left heart failure: true or false?

Left heart failure is:

Right side heart failure is:

3 manifestations of left heart failure:

4 manifestations of right heart failure:

What are the mechanisms of organic nitrates?

What are common side effects of organic nitrates?

Aspirin inhibits _____ irreversibly and blocks conversion of ____________ to ______________

Clopidogrel blocks ____________ thus preventing ________________ and conformational change in __________________

Tirofiban blocks receptor for _____________ which forms bridges between platelets

Heparin inhibits _____________ to prevent activation of ________

Fibrinolytic drugs (e.g. Streptokinase) converts __________ to _______ which breaks fibrin threads, which is associated with the risk of bleeding

___________ are the first-line therapy option for patients with stable angina. If it is ineffective, it can be combined with __________ or ___________

Please describe the mechanisms of the treatment options for patients with acute coronary syndromes (MI)

Percutaneous coronary intervention is performed within _________ upon patient presentation

Which is the most commonly prescribed 'first line' therapy in younger (under 55y/o) patients with hypertension?

A stepped approach, in which new medication is added to current therapy until the target blood pressure is achieved, has the advantage of ____________

Describe the RAAS pathway

Which one of the following effect CANNOT be attributed to angiotensin II?
a. vasodilation
b. salt retension
c. stimulation of aldosterone release from the adrenal glands
d. hypertrophy
e. hyerplasia

Release of renin from the granular cells in the kidney in response to a fall in blood pressure results in?

What is the safest hypertensive drug to use in pregnancy?

What are the adverse effects of Calcium Channel Blockers?

ACE is present in the lungs: true or false

ACE is inhibited by captopril: true or false?

ACE is inhibited by losartan: true or false

ACE converts angiotensin I to angiotensin II: true or false?

ACE degrades bradykinin: true or false?

What would be the recommended treatment for a patient with BP of 185/115, low CV risk (<10%) and no evidence of end organ damage?

Can all the following induce/aggravate hypertension?
pseudoephedrine, MOA's, excessive salt intake, nifedipine, cocaine

An elderly pt (70y/o) was given a thiazide diuretic for the treatment of hypertension. After 6 weeks, the doctor decided a second drug was required to reduce her BP to a target level. Which drug would be the most likely to be used if there were no other complications?

Activation of the RAAS in heart failure can be reduced by which of the following drugs?
a. ACE inhibitors
b. angiotensin receptor blockers
c. aspirin
d. diuretics
e. both A or B

Digoxin inhibits the Na/K ATPase pump: true or false

Digoxin increases the force of contraction of the heart: true or false?

Digoxin is a cardiac glycoside: true or false

Digoxin increases intracellular calcium levels

Digoxin decreases cardiac output: true or false?

Which class of drugs is used in the treatment of angina and promotes redistribution of coronary blood flow towards ischaemic areas via collaterals?

What is stable angina?

What is unstable angina?

What is the Coronary Steal phenomenon?

Which drug produces the coronary steal phenomenon and thus can aggravate ischaemia?

Why are anti platelets important?

Which clotting factors are inhibited by unfractionated heparin?

Which clotting factors are inhibited by low-molecular weight heparin?

What clotting factors are inhibited by Warfarin?

Which vitamin cofactor is required by clotting factors?

What is the advantage of rTPA over streptokinase?

Differentiate antiplatelets, anticoagulants and fibrinolytic's

What are the goals in the treatment of stable angina?

What are the aims of treating acute coronary syndrome?

What are the available reperfussion strategies?

Tolerance develops with long-acting nitrates: true or false?

Organic nitrates increase cyclic AMP: true or false?

The anti platelet effect of aspirin is reversible: true or false?

Heparin requires antithrombin III to inhibit clotting factors: true or false?

Anti platelets prevent platelet adhesion, activation and aggregation: true or false?

Warfarin blocks the extrinsic pathway of coagulation: true or false?

Warfarin had an early onset of action and therefore does not require an overlap with IV heparin: true or false?

Fibrinolytic drugs inhibit conversion of plasminogen to plasmin: true or false?

Organic Nitrates:

Example
Action
Side Effects

Calcium channel blockers
Diltiazem, verapamil

Action
Side effects

Beta-adrenoceptor antagonists (bete-blockers)
atenolol, metoprolol

Action
Side effect

ACE inhibitors
"pril's"

Action
Side effects

Antiplatelet drugs:
Aspirin

Action
Side Effects

Anti platelet drugs:
Clopidogrel

Action:

Antiplatelet drugs:
Tirofiban

Actions

Antithrombin drugs:
Unfractionated heparin

Antithrombin drugs:
Low-molecular weight heparins
e.g. enoxaparin (Clexane)

Action

Antithrombin drugs:
Warfarin

Action

Fibrinolytic drugs (thrombolytics)
Streptokinase

Dissolve existing thrombi

Fibrinolytic drugs (thrombolytics)
Recombinan tissue plasminogen activators (tPAs)

(all plane's e.g. altePLASE)