Jonathan Shared "CV II Exam 2" - 41 Picmonics

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CV II Exam 2

Abdominal Aortic Aneurysm
Screening
Screen Males 65-75 Who've Ever Smoked
Diagnosis
Ultrasound
Treatment
Observation
Asymptomatic and < 5 cm in Size
Surgical Repair
> 5.5 cm in Abdomen
Emergent Surgery
Ruptured or Symptomatic
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Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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Bernard-Soulier Syndrome
Mechanism
Autosomal Recessive
Deficiency of Glycoprotein Ib (GpIb) Receptor
Symptoms
Mucosal Membrane Bleeding
Menorrhagia
Easy Bruising
Labs
Large Platelets
Increased Bleeding Time
No Platelet Agglutination with Ristocetin
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3 mins
Coagulation Cascade
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
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2 mins
Disseminated Intravascular Coagulation (DIC)
Pathophysiology
Bleeding state
Activation of clotting factors
Deficiency of clotting factors
Causes
Sepsis
Trauma
Obstetric complications
Acute Pancreatitis
Malignancy
Nephrotic Syndrome
Transfusion
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2 mins
Ezetimibe
Indications
Hyperlipidemia
Mechanism of Action
Cholesterol Absorption Blocker
Decreases LDL
Side Effects
Diarrhea
Increased LFT Values
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Factor V Leiden Thrombophilia
Pathophysiology
Most Common Genetic Clotting Disorder in Caucasians
Genetic Point Mutation
Glutamine Replaces Arginine
Mutant Factor V
Resistant to Degradation by Activated Protein C
Symptoms
Hypercoagulability
Recurrent DVT (Increased Risk of Thromboembolism)
Considerations
Avoid Oral Contraceptives
Caution During Pregnancy
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2 mins
Glanzmann Thrombasthenia
Pathophysiology
Autosomal Recessive or Acquired as an Autoimmune Disorder
Deficiency of Glycoprotein IIb/IIIa (Gp IIb/IIIa) Receptor
Defective Platelet-to-Platelet Aggregation
Symptoms
Mucous Membrane Bleeding (Gingival Bleeding)
Easy Bruising
Increased Bleeding Time
Normal Platelet Count
Considerations
Avoid NSAIDs
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2 mins
Hemolytic Uremic Syndrome (HUS)
Children
Pathophysiology
Preceded by Acute Diarrheal Illness
Endothelial Damage
Classic Triad of Symptoms
Microangiopathic Hemolytic Anemia (MAHA)
Thrombocytopenia
Renal Failure
Labs
Helmet cells
LDH
Treatment
Dialysis
Supportive
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2 mins
Heparin Induced Thrombocytopenia (HIT)
Pathophysiology
5-10 Days After Heparin Exposure
Heparin-Platelet Factor 4 Complex
Autoantibodies Form Against Complex
Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
Platelet Aggregation
Procoagulant Release
Symptoms
Thrombocytopenia
Diagnosis
Serotonin Release Assay (SRA)
Treatment
Stop Heparin, Start Direct Thrombin Inhibitor
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2 mins
Hypercholesterolemia Disease
Risk Factors
Diabetes
Smoking
Family History
Hypertension
HDL < 40
Men Older than 45 Years of Age
Women Older than 55 Years of Age
Signs and Symptoms
Atheromas
Plaques in Blood Vessel Walls
Tissue Ischemia
Xanthomas
Lipemia Retinalis
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2 mins
Hypercholesterolemia Treatment
Lifestyle Modifications (Diet, Exercise, Smoking Cessation)
Statins
Niacin
Ezetimibe
Fibrates
Bile Acid Resins
Screening
Men greater or equal to 35 Years Old (20-35 if at increased risk)
Women greater or equal to 45 Years Old (20-45 if at increased risk)
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2 mins
Marfan Syndrome
Mechanism
Fibrillin-1 Mutation
Symptoms
Autosomal Dominant
Tall
Arachnodactyly
Pectus Excavatum
Hypermobile Joints
Aortic Aneurysm And Dissection
Mitral Valve Prolapse (MVP)
Subluxation of Lens (Superior)
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Niacin Therapy (Vitamin B3)
Mechanism
Inhibits Lipolysis in Adipose Tissue
Reduces Hepatic VLDL Secretion
Indications
Decrease Triglycerides
Decrease LDL
Increase HDL
Side Effects
Flushing
Decreased by Aspirin
Hyperglycemia
Hyperuricemia
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2 mins
Polyarteritis Nodosa
Pathophysiology
Immune Complex-Mediated Transmural Vasculitis
Hepatitis B Association
Fibrinoid Necrosis
Signs and Symptoms
Black Stool (Melena)
Neurologic Dysfunction
Myalgia
Fever
Hypertension
Diagnosis
Vessels / Lesions in Different Stages
Renal Microaneurysms (On Arteriogram)
Spares Pulmonary Arteries (No Pulmonary Involvement)
Treatment
Corticosteroids
Cyclophosphamide
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2 mins
Primary Hypertension Risk Factors
Excessive Alcohol Consumption
High Sodium Diet
Dyslipidemia
Obesity
African American
Advanced Age
Vitamin D Deficiency
Reduced Nephron number
Diabetes
Lack of Physical Activity
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1 min
Statins
Rhabdomyolysis
Hepatotoxicity
HMG-CoA reductase inhibitors
Decrease LDL
Decrease Triglycerides
Increase HDL
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2 mins
Thrombotic Thrombocytopenic Purpura (TTP)
Inhibition or deficiency of ADAMTS 13
vWF Multimers are not degraded
Microthrombi (and Emboli)
Symptoms
FAT RN Pentad
Fever
Anemia
Thrombocytopenia
Renal Dysfunction
Neurologic Abnormalities (Altered Mental status)
Treatment
Plasmapheresis
Corticosteroids
Splenectomy
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2 mins
Von Willebrand Disease
Mixed platelet and coagulation disorder
Mechanism
Autosomal Dominant Condition Leading to Reduced vWF
Defect in platelet plug formation
Labs
Increased Bleeding Time
PTT increased
Factor VIII decreased
Normal platelet count
Treatment
DDAVP (synthetic vasopressin)
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1 min
Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
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2 mins

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