Cardi Patho Flashcards

1
Q

Varicose veins:
what is is
signs and symptoms
cause

A

A vein in which blood has pooled

Distended, tortuous (painful), and palpable veins

Caused by trauma or gradual venous distention (lack of movement)

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2
Q

what causes Chronic venous insufficiency

due to what (2)

A

Inadequate venous return to the heart over a long period

Due to varicose veins or valvular incompetence

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3
Q

What causes Venous stasis ulcers

A

Venous hypertension, decreases circulation, and tissue hypoxia cause an inflammatory reaction in vessels and tissue leading to ulceration.

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4
Q

what is a thrombus

A

A blood clot that remains attached to the vessel wall.

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5
Q

what is a Thromboembolus:

A

clot become detached from the vessel wall due to increased pressure building up behind it and moving through the vessels (DVT develops into a PE)

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6
Q

what is a Thrombophlebitis:

A

Inflammation of vein wall around the clot (from starting an IV).

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7
Q

what is a Arterial thrombi:

A

Virchow’s triad, atherosclerosis plaques.
Travels not very far b/c arteries are getting smaller.
Brain- ischemic, CVA; heart- MI

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8
Q

what is a Venous thrombi:

A

Related to pooling blood
likely starts as a DVT leading to a PE.
Travels further b/c veins are getting larger closer to the heart and lung.

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9
Q

what is an Embolism:
examples
what can this cause

A

anytime there is a circulating bolus in the vascular system.

Dislodged thrombus, air bubble, amniotic fluid, aggregate of fat, bacteria, cancer cells (tumors), or a foreign substance

*Causes ischemia or narcosis/ infarction of tissue distal to obstruction

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10
Q

PE

A

pulmonary embolism

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11
Q

DVT

A

Deep Vein Thrombosis

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12
Q

what is an Aneurysm:
where is this most likely to occur?
what is the cause by?

A

Local dilation or out pouching of a vessel wall or cardiac chamber. Due to pressure.

Most common occurring in the aorta or brain from atherosclerosis and hypertension (more likely happening in the arteries)

Caused by weakening of the arterial wall making it vulnerable to high pressure
Weakening can be caused by hypertension, atherosclerosis, infection, trauma, congenital weakness, inflammation

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13
Q

Dissecting saccular

A

damage to tunica intima, but not the adventitia (outer layer) causing fluid to pool around the vessel and expand

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14
Q

Aortic aneurysms-

causes

A

75% of aneurysms
Causes: atherosclerosis eroding vessel wall
HTN, Collagen vascular disorders, infection of vessel wall

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15
Q

Primary Hypertension
what is it
who is more predisposed
prevalence

A

Essential or idiopathic (don’t know what is causing it) hypertension. May be genetic or diet
BP > 140/90 mm Hg

Genetic (African American) and environmental factors (diet, Na+ intake)

Affects 92% to 95% of individuals with hypertension

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16
Q

Secondary HTN to known causes/dz
what is it
prevalence
examples (3)

A

Caused by a systemic disease that raises peripheral vascular resistance or cardiac output
<5% of population

-Renal disease: most common (elimination of extra fluid is inhibited)
-Endocrine: Primary hyperaldosteronism, Cushing syndrome, pheochromocytoma, hyperthyroidism
DM
-Aortic malformations (congenital)

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17
Q

Complicated HTN

A

Long term/severe hypertension causing tissue damage in the vessels and tissues

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18
Q

Most common complications of HTN are target organ diseases occurring in the:
Heart

A

Cardiac remodeling - Hypertrophy: reduces the size of the chambers= eventually weakened and fail; imbalance in fuel need leading to ischemia= MI

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19
Q

Most common complications of HTN are target organ diseases occurring in the:
Brain

A

Cerebrovascular disease: hemorrhagic CVA, clot formation and ischemic CVA.

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20
Q

Most common complications of HTN are target organ diseases occurring in the:
Vasculature

A

Peripheral Vascular disease: peripheral obstruction

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21
Q

Most common complications of HTN are target organ diseases occurring in the:
Kidneys

A

Nephrosclerosis: Filter organ, BP decrease causes fluid to not be filtered. Renal failure

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22
Q

Most common complications of HTN are target organ diseases occurring in the:
Eyes

A

Retinopathies: prolonged pressure leading to blindness

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23
Q

EOD

what it is

A

END Organ Damage: the effect of high pressure damaging tissues
*HTN is often asymptomatic until damage to tissues/organs

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24
Q

Malignant Hypertension

A

Hypertensive Crisis

Rapidly progressive hypertension
Diastolic pressure is usually >140 mmHg
210/140 = MAP of 163!! (range 70-110)

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25
Q

HTN emergency vs HTN urgency

A

HTN emergency – evidence of EOD

HTN urgency – no evidence of EOD

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26
Q

Orthostatic

A

Decrease in both systolic and diastolic blood pressure upon standing

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27
Q

PVD

A

Peripheral Vascular Disease

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28
Q
Thromboangiitis Obliterans (Burger's)
what is it
Who does it occur most in
What do the thrombi do?
A

Inflammatory disease of peripheral arteries resulting in the formation of nonatherosclerotic lesions of clots made of immune/inflammatory cells

Mostly in young men, heavy cigarette smokers
Autoimmune activation

Thrombi permanently block and obliterate small and medium-sized arteries

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29
Q

PAD

caused by?

A

Peripheral Artery disease:
Arteriosclerosis/Atherosclerotic disease of the arteries

Plaques that are exclusive of: coronary (CAD), aortic (aneurysm), and of the brain (CVD)

30
Q

Arteriosclerosis:

caused by?

A

Abnormal thickening and hardening of the vessel walls (decrease lumen size): loss of elasticity (thus lose compliance) leading to PVD (can be due to age).
Increase smooth muscle cells and collagen fibers migrate to the tunica intima

31
Q

Atherosclerosis:
leads to?
caused by?

A

Thickening and hardening due to fatty plaque deposits leading to Arteriosclerosis
cholesterol- LDL deposited behind vessel walls

32
Q
CAD 
what is it
caused by?
Biggest concern?
How is this preventable?
A

Coronary Artery disease: Any vascular disorder that narrows or occludes the coronary arteries causing ischemia then infarction
Atherosclerosis is the most common cause
MI
Dyslipidemia (high LDL and Low HDL)

33
Q

CVD
caused by?
Biggest concern?

A

Cerebero (brain) vascular disease: Atherosclerosis causing decreased flow
CVAs

34
Q

Lack of normal blood pressure compensation in response to gravitational changes on the circulation

A

Orthostatic

35
Q

Raynaud Disease

Primary

A
unknown vasospasm disorder 
Recurrent vasospasm involving small arteries/arterioles of hands and feet
Women > Men
Triggered by cold and emotional distress
(PVD)
36
Q

Raynaud Disease

Secondary

A

Collagen vascular disease (scleroderma), smoking, pulmonary HTN, and environmental factors (vibrating machinery)
(PVD)

37
Q

Atherosclerosis Progression (7)

A

1) Endothelial damage/inflammation: caused by HTN, smoking, DM
2) LDL deposit in vessel wall oxidize causing them to be recognized as foreign
3) Monocyte activation/macrophage migration- ingestion of LDL, but cannot digest become a foam cell
4) Foam cell formation- send out cytokines causing tissue change that leads to smooth muscle moving into the lumen
5) Fatty streak- activation of fibroblasts creating collagen over the foam cells
6) Fibrous plaque= diagnosed Atherosclerosis
7) Complicated plaque- plaque with a clot on top of it. Plaque ruptures and the release of collagen causes a fast clot reaction creating a blockage (most concerning the brain and the heart)

38
Q

MI is caused by what?

what can be used to test if someone is about to have an MI

A

Prolonged ischemia causing irreversible damage and cell death
EKG

39
Q

Angina

A

chest pain, demand is greater than supply

40
Q

Stable angina vs Unstable angina

A
  • exercise, increased exertion.

- plaque became complicated, the blockage is more obstructive

41
Q

Prinzmetal angina:

A

vasospasm (idiopathic), not due to a blockage

42
Q

Silent ischemia:

A

No angina, higher in women

43
Q

Transient ischemia:

A

unstable angina

44
Q

Sustained ischemia:

A

Blockage is not going away, high chance of going into MI

45
Q

Angioplasty vs Stent

A

Angioplasty is a procedure to open narrowed or blocked artery.
A stent is a small, metal mesh tube that expands inside a coronary artery. A stent is often placed during or immediately after angioplasty

46
Q

CABG

A

Coronary Artery Bypass Graft

47
Q

Acute pericarditis

cause

A

pericarditis (inflamed pericardium)

viral (more common) or idiopathic

48
Q

Constrictive pericarditis:

A

fibrous/ scared- idiopathic

49
Q

Pericardial effusion

Tamponade:

A

build up between the pericardial layers

-when fluid starts to compress and push back on the heart

50
Q

Myocardium

A

cardiac muscle

51
Q

Myocardium: Cardiomyopathies (3)

A

Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy

52
Q

Dilated cardiomyopathy

A

(value issues, vascular)

Congestive cardiomyopathy: blood sits and pools in the heart chambers

53
Q

Hypertrophic cardiomyopathy

A

increased work load by the heart (eg: HTN)

54
Q

Restrictive cardiomyopathy:

A

more ridge, college genetic problems

55
Q

Pericardium

A

fibrous membrane enclosing the heart

56
Q

Endocardium

A

the innermost layer of tissue that lines the chambers of the heart.

57
Q

Endocardium: Valvular dysfunctions (4)

A

Valvular stenosis

Valvular regurgitation

Mitral valve prolapse syndrome (MVPS)

Acute Rheumatic Heart Disease

58
Q

Valvular stenosis -

A

Failure of the valve to open completely, workload behind valve increases. Blood buildup in the chamber.

59
Q

Valvular regurgitation

A

Inability of the valve to close, eventually causing heart failure. Not preventing blood back flow. Leading to MVPS

60
Q

MVPS

A

Mitral valve prolapse syndrome - Cusps billow upward into left atrium
Most common valve disorder b/c it is under the most pressure

61
Q

Acute Rheumatic Heart Disease

A

(autoimmune after untreated strep)
Secondary to pharyngeal infection of group A β-hemolytic streptococcus
Only 3% of those with untreated strep throat will get rheumatic (Rh) fever, and 10%of those get Rh Heart disease.

62
Q

Endocarditis

A

Inflammation and infection of the endocardium
Especially on valves

Usually bacterial

63
Q
Dysrhythmias:
Flutter
Fibrillation
PVCs
PACs
Asystole
A

Flutter: extra little contraction inside a regular contraction

Fibrillation: quivering, shaking

Premature ventricular contractions: early contraction (problem with conduction pathway)

Premature atrial contractions: early contraction (problem with conduction pathway)

Asystole: loss of regular contraction

64
Q

Left heart failure

A

CHF. Blood backs up in pulmonary circulation

65
Q

Left heart failure : Systolic heart failure

A

Inability to generate adequate cardiac output to perfuse tissues (HTN, MI)
Ventricular remodeling or loss of myocytes

66
Q

Left heart failure: Diastolic heart failure

A

Pulmonary congestion despite normal stroke volume and cardiac output (prolonged HTN). fluid into lungs
Ventricles can’t fill with blood because they won’t relax or are too thick

67
Q

Right heart failure

cause

A

Most commonly caused by a diffuse hypoxic pulmonary disease (COPD/ARDS)- vasoconstriction due to shunting

Also caused by left vent. failure
Can result from an increase in left ventricular filling pressure that is reflected back into the pulmonary circulation

68
Q

Heart Failure: High-output failure

common causes

A

not a problem w/ the heart, the problem is with the lack of supply!
Inability of the heart to supply the body with blood-borne nutrients, despite adequate blood volume and normal or elevated myocardial contractility

Common causes:
Severe anemia
Septicemia
Hyperthyroidism (exaggerated metabolic demand)

69
Q

Shock at the tissues

A

Cardiovascular system fails to perfuse the tissues adequately:
Impaired oxygen use
Impaired glucose use

70
Q
Types of shock:
Cardiogenic
Hypovolemic
Neurogenic
Anaphylactic
Septic
A

Cardiogenic: heart failure

Hypovolemic: not enough blood volume

Neurogenic: lack of neuro stimulation

Anaphylactic: widespread inflammatory response

Septic: Bacterial

71
Q

MOD

A

Multiple Organ 
Dysfunction Syndrome

72
Q

Multiple Organ 
Dysfunction Syndrome:
what is it
cause
manifestations

A

Progressive dysfunction of two or more organ systems resulting from an uncontrolled inflammatory response to severe illness or injury

Causes:
Most common = sepsis
Other - trauma, burns, major surgery

Manifestations: Respiratory, Hepatic, Renal, GI, Myocardial failure