Thursday, September 5, 2013

1. Hypertrophic cardiomyopathy
-usu genetic, freidrich's ataxia, IDM - transient (insulin is a growth factor)
2. Dilated cardiomyopathy
-ABCCCD: alcohol, beriberi (wet), cocaine, cobalt, coxsackie, doxorubicin (+anthracycline)
-muscular dystrophy, mitochondrial dx
3. Restrictive cardiomyopathy
-infiltrative processes: amyloid, sarcoid, hemochromatosis, wilson's, pompe's disease.
4. Arrythomogenic cardiomyopathy
5. LV Non-compaction: 
-in embryonic state, ventricular tissue is spongy and has deep clefts; over time, it compresses down into a tight, efficient muscle. Failure of this process (poss due to mitochondrial defects and decreased ATP) leads to a non-compacted, poorly contractile heart. Can present in infancy or adulthood.
6. Treatment for LV non compaction: reduce need for cardiac output, increase CO
-afterload reducers: ACE/ARB, milrinone, nitrates, synthetic BNP (diuretic)
-sympatholytics: B-blockers
-digoxin (inotropic, not chronotropic-- to increase relative cardiac perfusion)
-ultimately, only treatment is transplant
7. Excessive time under bili lights can degrade water-soluble vitamins and can lead to B vitamin deficiency, so alternate time under lights with time out.
8. Zinc deficiency: intense read rash perineally and periorally, +diarrhea.
9. Suspect mec ileus: enema with water-soluble contrast.
10. Pyloric stenosis presents in a few weeks of life; continued pressure against pylorus further encourages hypertrophy.

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