Cardiology MCQ: Drug not useful for treatment of HOCM
Which of the following is not useful in the treatment of hypertrophic obstructive cardiomyopathy (HOCM)?
a) Verapamil
b) Metoprolol
c) Isoprenaline
d) Disopyramide
Correct answer: c) Isoprenaline
Isoprenaline is an inotropic agent which will increase the myocardial contractility and thereby the obstruction in hypertrophic obstructive cardiomyopathy.
The post Cardiology MCQ: Drug not useful for treatment of HOCM appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - May 13, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
I’m a stickler about words. And here’s why.
It’s metoprolol.
m-e-t-o-p-r-o-l-o-l
The nurse on the other end of the phone sighs as she tolerates my tirade regarding pronunciation. They all know that I am particular about such things. For metoprolol is neither metoclopramide or metolazone, and the difference could be life altering.
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Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 9, 2015 Category: Journals (General) Authors: Jordan Grumet, MD Tags: Physician Hospital Source Type: blogs
Beta blockers in heart failure – Cardiology MCQ
Beta blockers shown to be useful in heart failure include all except:
a) Carvedilol
b) Metoprolol
c) Bisoprolol
d) Atenolol
Correct answer: d) Atenolol
Atenolol is a hydrophilic beta blocker while the rest are lipophilic.
Trials showing efficacy in heart failure:
Carvedilol: COMET Trial [1]
Metoprolol: MERIT-HF Trial [2]
Bisoprolol: CIBIS Trial [3]
References
Poole-Wilson PA, Swedberg K, Cleland JG, Di Lenarda A, Hanrath P, Komajda M, Lubsen J, Lutiger B, Metra M, Remme WJ, Torp-Pedersen C, Scherhag A, Skene A; Carvedilol Or Metoprolol European Trial Investigators. Comparison of carvedilol and metoprolol on clinical ou...
Source: Cardiophile MD - May 8, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
I lost the wheat, but didn’t lose the weight: Updated version
Yes, it happens: Rid your life of all things wheat and you get relief from acid reflux, joint pain, and high blood sugars . . . but not weight loss.
While most people enjoy rapid and dramatic weight loss with wheat elimination due to the loss of the appetite-stimulating effect of gliadin-derived opiates, the loss of repetitive glucose-insulin provocation of amylopectin A, the reduction of inflammation from the combined effects of gliadin/wheat germ agglutinin/amylopectin A, and reversal of the leptin-blocking effect of wheat germ agglutinin, this doesn’t happen to everybody. Or you lose, say, 20 pounds, only to have...
Source: Wheat Belly Blog - May 7, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle carbohydrates gluten grains insulin low-carb Thyroid Weight Loss whey Source Type: blogs
Drug contraindicated in HOCM – Cardiology MCQ
Drug contraindicated in hypertrophic obstructive cardiomyopathy (HOCM):
a) Digoxin
b) Metoprolol
c) Disopyramide
d) All of the above
Correct answer: a) Digoxin
Digoxin should be avoided in HOCM because of its positive inotropic effect, which can exacerbate the left ventricular outflow tract obstruction. Metoprolol and disopyramide are useful in alleviating symptoms of HOCM due to their negative inotropic effect. Caution has to be exerted while using verapamil for its negative inotropic effect in this situation as its vasodilatory effect can sometimes be deleterious in those with dynamic left ventricular outflow tract obs...
Source: Cardiophile MD - April 30, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Words
It's metoprolol.m-e-t-o-p-r-o-l-o-lThe nurse on the other end of the phone sighs as she tolerates my tirade regarding pronunciation. They all know that I am particular about such things. For metoprolol is neither metoclopramide or metalazone, and the difference could be life altering. I live in a world of words. Trained in a language created to parse pertinent details. Dysarthria or dysphagia? Paroxysmal nocturnal dyspnea, dyspnea on exertion, or orthopnea? Each variant a spectrum of flavor. A morsel chewed, swallowed, and digested into its basic parts to be rattled off in staccato sente...
Source: In My Humble Opinion - April 26, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
MKSAP: 21-year-old male student is evaluated for a murmur
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 21-year-old male student is evaluated for a murmur heard during an athletic preparticipation physical examination. He is asymptomatic. His medical and family history is unremarkable and he takes no medications.
On physical examination, the patient is afebrile, blood pressure is 118/76 mm Hg, pulse rate is 68/min, and respiration rate is 14/min. BMI is 18. He wears corrective lenses for myopia. Mild thoracic scoliosis is noted. He has long, thin fingers and a mild pectus excavatum deformity. His height is 188 c...
Source: Kevin, M.D. - Medical Weblog - March 8, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Heart Source Type: blogs
AstraZeneca Pays $7.9 Million To Resolve Kickback Allegations Related to PBM Formulary Placement
AstraZenaca last week settled with the Department of Justice over allegedly offering kickbacks to Medco Health Solutions, a pharmacy benefits manager, in exchange for Medco maintaining AstraZeneca’s drug Nexium in favorable status on its formulary. AstraZeneca settled the allegations for $7.9 million.
A drug’s listing as “brand-preferred” on a pharmacy benefit manager’s formulary crucial to a brand. Pharmaceutical companies want to be on a formulary so that when a physician writes a prescription for Nexium, for example, the patient can get it covered under their insurance when they walk into a pharma...
Source: Policy and Medicine - February 18, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Drugs that block weight loss
Following the Wheat Belly lifestyle of wheat and grain elimination results in weight loss in the majority of people in short order.
But there are exceptions. The exceptions should not be interpreted to mean that this lifestyle does not work; it should initiate a search for why the weight loss effect of wheat and grain elimination is being blocked. Iodine deficiency, for example, is a common cause for failed weight loss, no matter how perfect your diet and how much you exercise.
Another common cause for failed weight loss are prescription drugs and a few over-the-counter drugs. Among the common drugs that will block your...
Source: Wheat Belly Blog - February 15, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle gluten grains prescription drugs Weight Loss Source Type: blogs
A Relatively Narrow Complex Tachycardia at a Rate of 180.
I received a text message with this image: "Cardioversion didn't work. Any thoughts?" What do you think? The heart rate is 180.I was viewing this on my phone, but I saw what I thought were P-waves. I could barely see them in lead II:There are probable P-waves at the arrows, but I wasn't certainI texted back: "Could be very fast sinus."There is also a wide QRS at 113 ms and a large R-wave in aVR, so sodium channel blockade is likely. Common culprits in this situation are tricyclic overdose and cocaine toxicity (remember cocaine not only increases dopamine in central synapses, but is also a...
Source: Dr. Smith's ECG Blog - February 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
ED Case of Catecholaminergic Polymorphic Ventricular Tachycardia
This article only comments on chronic management, not acute management. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - February 6, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Medications After a Heart Attack
From: www.secondscount.orgYour heart attack recovery will include medications. Taking these medications exactly as prescribed is one of the best tools at your disposal for avoiding death in the months following a heart attack. According to an article published in Circulation, the journal of the American Heart Association, heart attack patients who had not filled any of their prescriptions within 120 days of being discharged from the hospital had 80 percent greater odds of death than those who filled all of their prescriptions.Medications you are likely to be prescribed after a heart attack fall int...
Source: Dr Portnay - January 23, 2015 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Updates on a Crowdfunded Mouse Life Span Study
For all that I think it isn't an efficient path forward, one likely to produce meaningful results in moving the needle on human life spans, there is considerable interest in testing combinations of existing drugs and various dietary compounds in mice to see if healthy life is extended. I expect that as public interest grows in the prospects for aging research to move from being an investigative to an interventional field, wherein researchers are actively trying to treat aging, we'll only see more of this. There is certainly a sizable portion of the research community who think that the the best path ahead is in fact the ph...
Source: Fight Aging! - January 1, 2015 Category: Research Authors: Reason Tags: Healthy Life Extension Community Source Type: blogs
MKSAP: 76-year-old woman with a headache
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 76-year-old woman is evaluated for a 1-day history of headache, left eye pain, nausea and vomiting, seeing halos around lights, and decreased visual acuity of the left eye. She has type 2 diabetes mellitus, hypertension, and atrial fibrillation. Medications are metformin, digoxin, metoprolol, hydrochlorothiazide, and warfarin.
On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 148/88 mm Hg, pulse rate is 104/min, and respiration rate is 16/min. Visual acuity wearing glasses is 20/40...
Source: Kevin, M.D. - Medical Weblog - December 20, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Neurology Source Type: blogs
It is Far too Early for a Requiem for Unstable Angina
Dr. Braunwald declared that high sensitivity troponins will make Unstable Angina a thing of the past. That very well may be true, but in the United States we are not yet in the era of high sensitivity troponins. And we do not know what their effect will be.Here are many more cases of Unstable Angina.Unstable AnginaA male in his 50's with no past history presented with new intermittent burning left chest pain, lasting 10 minutes at a time, radiating to the left arm, for 24 hours. He had chest pain just prior to arrival in the ED, but it resolved prior to physician evaluation. He did use cocaine a few...
Source: Dr. Smith's ECG Blog - December 15, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs
