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DR. CARL E. BALITA REVIEW CENTER TEL. NO.

735-4098/410-0250 - 1 -
Cardiovascular
9 Decreased TP in heart Æ Ischemia
(Angina) {r necrosis (MI)
{irreversible}[pathologic Q
wave/permanent in the ECG]
9 Eating a heav meal! stren"o"s e#ercise!
se#! e#pos"re to cold Æ Decreased blood
$low %heart&Æ decreased TP %heart&Æ
decreased '( %heart&Æ anaerobic
respiration Æ prod"ction o$ lactic acid Æ
PAIN Æ management decreased '(
demand b rest and )**
9 Angina
o Pain relieved b rest and +TG
o +TG
ƒ ,asodilation Æ orthostatic hpotention
Æ move grad"all Æ -onitor .P
ƒ )tore in a dar/ and amber container
ƒ E$$ective Æ tingling sensation Æ no
need to noti$ phsician
ƒ -a#im"m o$ 0 tablets with 1 min"te
interval
9 MI
o Pain relieved b -orphine )'2
ƒ +arcotic analgesic
ƒ Can ca"se respirator depression Æ
monitor 33 and '( sat"ration
ƒ 4ntidote Æ narcan
9 Cardioversion Æ snchrono"s
9 Defibrillation Æ "nsnchrono"s
9 Buerger’s disease Æ C) Æ
vasoconstriction Æ stop C) Æ common in
men
9 Ranaud’s Æ stress and cold Æ
vasoconstriction Æ common in $emale
9 Congestive heart failure
o 5e$t sided Æ p"lmonar
ƒ Dspnea
ƒ Crac/les
ƒ Polcthemia Æ d"e to decrease '( to
the /idnes
ƒ Cl"bbing o$ the $ingers Æ d"e to prolonged h#ia ƒ 'rthopnea o 3ight sided Æ sstemic ƒ 6epatomegal ƒ Distended nec/ veins ƒ Edema
Philippians 4:6 - “…do not be anxious
about anything, but in everything by
prayer and supplication ith
than!sgiving let your re"uests be #ade
!non to $od%&
ƒ Portal hpertension
ƒ 4scites Æ weight gain
ƒ ,aricose veins
o Digo#in
ƒ Cardiac glcoside
ƒ Positive inotrophic e$$ect Æ increased
strength o$ mocardial contraction
ƒ +egative chronotrophic e$$ect Æ
decreased cardiac rate Æ monitor C3
Æ never give i$ C3 below 78 bpm
ƒ 4dverse e$$ect
• ! 9 omitting
• A 9 nore#ia
• N 9 a"sea
• D 9 iarrhea
• A 9 bdominal pain
• R"M"MB"R: earliest Æ G;< late
Æ halo vision
• Antidote Æ Digibind
9 Decreased RBC → Activit in tolerance#
$atigue# %rovide rest# Anemia
9 Decreased Platelets → Prone to bleeding#
avoid %arenteral in&ection# a%%l
%ressure on in&ection site# high ris' for
in&ur
9 Decreased (BC → %rone to infection#
reverse isolation
9 Increased (BC → %resence of infection
9 $irst Da)Ne*l diagnosed → +no*ledge
deficit
9 ,e%arin Æ anticoag"lant Æ prevent
$"rther enlargement o$ clot not dissolve
them Æ monitor 4PTT/PTT Æ antidote
protamine )'2
9 Coumadin Æ anticoag"lant Æ prevent
$"rther enlargement o$ clot not dissolve it
Æ monitor PT Æ vitamin = is the antidote
9 -ro'inase).tre%toase → dissolves the
clot
9 5idocaine with Epinephrine when combine has a ver low p6 and is! there$ore ver pain$"l when in>ected? 6owever! the pain can be minimi@ed b b"$$ering the sol"tion with sodi"m bicarbonate! and b giving the in>ection s"bdermall at a ver slow rate?
'()*+'$ ,-./* +' 0)+1,
.-)2+34-*.(5-) .3'2+/+3'*


DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250 - 2 -
9 Epinephrine is added to local
anesthesia to increase the d"ration?
6owever! epinephrine ca"ses
vasoconstriction and decreased
bleeding! which wea/ens tiss"e
de$enses and increases the incidence o$
wo"nd in$ection?
9 4c"te aortic dissection has a phsical
signs and smptoms s"ch as .P
di$$erences between arms and or legs!
cardiac tamponade! and aortic
ins"$$icienc m"rm"r
9 Common side e$$ect o$ beta bloc/ers is
$atig"e! which occ"rs earl in the
treatment and depression which occ"rs
later?
9 -ost common ca"se o$ death within the
$irst $ew ho"rs $ollowing an -; is
Cardiac 4rrhtmias generall
,entric"lar *ibrillaton?
A? Bhat tpe o$ abnormal cardiac rhthm
can be slowed thro"gh ,alsalva
mane"vers and/or carotid massageC
Æ )"praventric"lar rhthms
(? +ame some common ,alsalva mane"vers?
Æ6olding the breath! stim"lation o$ the gag
re$le#! ipecac! sD"atting! press"re on the
eeball! or immersing the $ace in ice
0? Bhat is the common side e$$ect o$ bE
bloc/ersC
Æ *atig"e! which occ"rs earl in treatment:
and depression! which occ"rs later?
2? Bhat is the most common ca"se o$ death
within the $irst $ew ho"rs $ollowing an
-;C
Æ Cardiac dsrhthmias! generall ,E$ib
1? Bhat are the ECG $indings on a patient
with hpo/alemiaC
Æ*lattened TEwaves! depressed )T segments!
prominent PEwaves! prominent FEwaves! and
prolonged QT and P3 intervals
7? Bhat are the ECG $indings on a patient with hper/alemiaC Æ Pea/ed TEwaves! prolonged QT and P3 intervals! diminished PEwaves! depressed TE waves! Q3) widening levels e#ceeding A8 mED/5! and a classic sine wave?
G? Bhat is the $irst ECG $inding $or a patient
with hper/alemiaC
Æ The development o$ tallEpea/ed TEwaves at
levels o$ 1?7E7?8 mED/5! which are best seen
in the precordial leads
H? D"ring the $irst ho"rs a$ter a mocardial
in$arction! wh is it important to monitor
the patientIs ECGC
Æ 4rrhthmias are the leading ca"se o$ death
$ollowing an in$arct
J? Bh sho"ld o" co"nt a patientIs apical
p"lse be$ore administering digitalisC
Æ 4 smptom o$ digitalis to#icit is a slow
p"lse?
+otes:
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KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK “/o believe in yoursel6 and to 6ollo your drea#s, to have goals in li6e and a drive to succeed, and to surround yoursel6 ith the things and the people that #a!e you happy - this is success7&