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Perfusion: patho
To remember
| Question | Answer |
|---|---|
| Identified cause for coagulation deficit? | Thrombocytopenia Vitamin K deficiency Liver disease inherited disorders/Hemophilia Von Willebrand [Factor (vWF)] Disease (many variants) |
| What cause Vitamin K deficiency ? | Lack of coagulation factor (II, VII, IX, X) & prothrombin |
| The drug of choice for Von Willebrand [Factor (vWF)] insufficiency?What is its mechanism of action? | Drug: Desmopressin (vasopressin, ADH) Action: stimulates vWF endothelial cell synthesis & secretion |
| Please discuss about hemophilia A disorder and how it causes bleeding ? | X-linked recessive disorder Factor VIII insufficiency => bleeding Tx: synthetic Factor VIII; plasma |
| Describe risk factors for thrombus formation with rational | Venous stasis tissue injury smoking DIC high estrogen others....... |
| Discuss the pathophysiology of atrial fibrillation | Disorganized atrial contractility => inadequate ventricular filling => low CO Atrial rate >300 bpm; Ventricular rate 80-180 bpm(please read text book for detials) Tx plan: Ablation procedure |
| What are the common feature of atrial fibrillation & how you mange it? | Features : dizziness, irregular pulse, pulse deficit treatment ER: cardioversion ASA; slow nodal conduction (beta blockers, Cardiac selective Calcium channel blockers); interrupt the impulse re-entry pathway: Ablation |
| What is the most common cause of hypercoagulation (eg. pulmonary embolism)? | Deep vein thrombosis; usually in the legs |
| What is the pharmacology treatment of DVT? | Tx: Heparin or LMWH |
| Pharmacology treatment for pulmonary embolism? | Tx ER: thrombolytics Tx: Heparin or LMWH, Coumadin (Warfarin) NB:cuation with using Warfarin anticoagulation pre/during/post sx (Heparin, LMWH) |
| What preventive measure should nurse provide to prevent pulmonary embolism? | Early mobilization post sx; compression stockings anticoagulation pre/during/post sx (Heparin, LMWH) |
| Factor v leiden mutation is an autosomal dominant disorder.Discuss the probability of affecting child | See your ppt |
| How factor v leiden mutation cause hypercoagulation and what is its treatment ? | Mutation present in Factor V Factor V – endogenous coagulation activator mutated Factor V = cannot be deactivated => hypercoagulation Tx: monitor; LMWH (Apixaban) |
| List at list three risk factor for pulmonary HTN | Chronic small pulmonary embolisms; COPD; idiopathic; heart failure |
| Pulmonary HTN can be treated with ? | Tx ER: Nipride (nitroprusside) Tx: decrease preload (diuretics); prevention of cor pulmonale (RHF) |
| Discuss about hypercholesterolemia | See your text book |
| Discuss acute and chronic coronary artery disease (CAD) | See your ppt |
| What is the treatment of acute coronary syndrome? | Vasodilation: organic nitrates, morphine 02 Tx obstruction: PTCA, CABG Tx clotting: ASA, Reopro Thrombolytics: < 6hrs from onset for best efficacy Optimize CO: beta blockers, ACE, ARBs Tx arrhythmias – Ventricular fibrillation |
| Discuss the Vtach/Vfib - algorithm clearly | See your ppt and book |
| Compare the different between right and left heart failure? | Right side receives blood from the venous system & pumps into the lungs, if does not pump: back up into Systemic circulation Capillary pressure builds => interstitial fluid shift Left side receives blood from the lungs & pumps into the body; if it can |
| What do you think the most common cause of heart failure? | Low output failure |
| The treatment goal of heart failure is ? | Decrease preload,afterload & improve contractility |
| Which drug group used to improve contractility | Cardiac Glycosides like Digoxin (Lanoxin), Digitoxin P Inhibitors like Milrinone; Amrinone; Viagra (sildenafil) Adrenergic Agonists like Dobutamine; Dopamine HCL NB:see its MOA and implications |
| What is the drug of choice to reduce preload and afterload in acute heart failure | preload: Loop Diuretics like Lasix afterload:Direct acting vasodilators like Nipride |
| What is the drug of choice to improve contractility in acute heart failure | B1 agonists: Dobutamine Read also Perfuse coronaries Organic Nitrates: Nitro |
| What about drugs for chronic HF ? | longer acting/less potent drugs: Combination diuretics Cardiac glycosides instead of B1 agonists ACE/ARBs instead of Direct acting Vasodilator ... |
Created by:
aynalem
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