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Patho: pulmonary; cardi; hemo; GI; Urinary > Cardi Patho > Flashcards

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
HTN emergency vs HTN urgency
HTN emergency – evidence of EOD | HTN urgency – no evidence of EOD
26
Orthostatic
Decrease in both systolic and diastolic blood pressure upon standing
27
PVD
Peripheral Vascular Disease
28
``` Thromboangiitis Obliterans (Burger's) what is it Who does it occur most in What do the thrombi do? ```
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
29
PAD | caused by?
Peripheral Artery disease: Arteriosclerosis/Atherosclerotic disease of the arteries Plaques that are exclusive of: coronary (CAD), aortic (aneurysm), and of the brain (CVD)
30
Arteriosclerosis: | caused by?
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
Atherosclerosis: leads to? caused by?
Thickening and hardening due to fatty plaque deposits leading to Arteriosclerosis cholesterol- LDL deposited behind vessel walls
32
``` CAD what is it caused by? Biggest concern? How is this preventable? ```
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
CVD caused by? Biggest concern?
Cerebero (brain) vascular disease: Atherosclerosis causing decreased flow CVAs
34
Lack of normal blood pressure compensation in response to gravitational changes on the circulation
Orthostatic
35
Raynaud Disease | Primary
``` unknown vasospasm disorder Recurrent vasospasm involving small arteries/arterioles of hands and feet Women > Men Triggered by cold and emotional distress (PVD) ```
36
Raynaud Disease | Secondary
Collagen vascular disease (scleroderma), smoking, pulmonary HTN, and environmental factors (vibrating machinery) (PVD)
37
Atherosclerosis Progression (7)
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
MI is caused by what? | what can be used to test if someone is about to have an MI
Prolonged ischemia causing irreversible damage and cell death EKG
39
Angina
chest pain, demand is greater than supply
40
Stable angina vs Unstable angina
- exercise, increased exertion. | - plaque became complicated, the blockage is more obstructive
41
Prinzmetal angina:
vasospasm (idiopathic), not due to a blockage
42
Silent ischemia:
No angina, higher in women
43
Transient ischemia:
unstable angina
44
Sustained ischemia:
Blockage is not going away, high chance of going into MI
45
Angioplasty vs Stent
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
CABG
Coronary Artery Bypass Graft
47
Acute pericarditis | cause
pericarditis (inflamed pericardium) | viral (more common) or idiopathic
48
Constrictive pericarditis:
fibrous/ scared- idiopathic
49
Pericardial effusion | Tamponade:
build up between the pericardial layers | -when fluid starts to compress and push back on the heart
50
Myocardium
cardiac muscle
51
Myocardium: Cardiomyopathies (3)
Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy
52
Dilated cardiomyopathy
(value issues, vascular) | Congestive cardiomyopathy: blood sits and pools in the heart chambers
53
Hypertrophic cardiomyopathy
increased work load by the heart (eg: HTN)
54
Restrictive cardiomyopathy:
more ridge, college genetic problems
55
Pericardium
fibrous membrane enclosing the heart
56
Endocardium
the innermost layer of tissue that lines the chambers of the heart.
57
Endocardium: Valvular dysfunctions (4)
Valvular stenosis Valvular regurgitation Mitral valve prolapse syndrome (MVPS) Acute Rheumatic Heart Disease
58
Valvular stenosis -
Failure of the valve to open completely, workload behind valve increases. Blood buildup in the chamber.
59
Valvular regurgitation
Inability of the valve to close, eventually causing heart failure. Not preventing blood back flow. Leading to MVPS
60
MVPS
Mitral valve prolapse syndrome - Cusps billow upward into left atrium Most common valve disorder b/c it is under the most pressure
61
Acute Rheumatic Heart Disease
(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
Endocarditis
Inflammation and infection of the endocardium Especially on valves Usually bacterial
63
``` Dysrhythmias: Flutter Fibrillation PVCs PACs Asystole ```
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
Left heart failure
CHF. Blood backs up in pulmonary circulation
65
Left heart failure : Systolic heart failure
Inability to generate adequate cardiac output to perfuse tissues (HTN, MI) Ventricular remodeling or loss of myocytes
66
Left heart failure: Diastolic heart failure
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
Right heart failure | cause
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
Heart Failure: High-output failure | common causes
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
Shock at the tissues
Cardiovascular system fails to perfuse the tissues adequately: Impaired oxygen use Impaired glucose use
70
``` Types of shock: Cardiogenic Hypovolemic Neurogenic Anaphylactic Septic ```
Cardiogenic: heart failure Hypovolemic: not enough blood volume Neurogenic: lack of neuro stimulation Anaphylactic: widespread inflammatory response Septic: Bacterial
71
MOD
Multiple Organ 
Dysfunction Syndrome
72
Multiple Organ 
Dysfunction Syndrome: what is it cause manifestations
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

Patho: pulmonary; cardi; hemo; GI; Urinary (10 decks)

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