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patho test 2 > cardio > Flashcards

cardio Flashcards

0
Q

which ethnic group has the highest death rate of CV Disease?

A

AA

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1
Q

what is the leading cause of death in men and women?

A

heart disease

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2
Q

two main modifiable risk factors for CV disease?

A

weight, physical activity

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3
Q

nonmodifiable risks for CV disease

A

age, gender, family history

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4
Q

why are women at less risk to have CV disease?

A

bc estrogen is a protective factor

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5
Q

main risk factors for CAD

A

1) HTN
2) smoking
3) high cholesterol

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6
Q

what are the percentage breakdowns for HTN

A

31%- HBP
1/3 have pre hypertension
47% have HTN under control

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7
Q

where is the greatest prevalence of HTN located in the US?

A

Bible Belt

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8
Q

what is blood pressure?

A

how well our heart pumps and how elastic our vessels are

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9
Q

what percentage of HTN is essential?

A

90%

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10
Q

T/F. HTN is asymptomatic until it affects an organ and damages it

A

T

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11
Q

HTN risk factors

A

inactivity, BMI >30, high salt >2300 mg/day (tsp), race (40%AA), age (women after menopause)

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12
Q

what does cholesterol bind with?

A

proteins

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13
Q

why is some cholesterol important in our diet?

A

it binds with proteins which are important in our cell membranes and hormones

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14
Q

this cholesterol transports to cells

A

LDL

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15
Q

this cholesterol travels from body to liver

A

HDL (good cholesterol)

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16
Q

what is the recommended daily cholesterol intake?

A

<200 mg/dL

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17
Q

what is high risk considered for cholesterol?

A

> 239 mg/dL

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18
Q

what is borderline for high risk of cholesterol?

A

200-239 mg/dL

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19
Q

recommended HDL numbers

A

men >40

women >50

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20
Q

recommended LDL numbers

A

<70

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21
Q

number to keep triglycerides at

A

<150

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22
Q

how many deaths per year are attributed to smoking

A

443,000

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23
Q

top 3 things smoking causes people to die from

A

1) lung cancer
2) ischemic heart disease
3) COPD

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24
Q

how many chemicals are in tobacco? how many cause cancer?

A

7000, 70

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25
Q

nonnicotine brand prescriptions

A 
buproprion SR (zyban)
varenicline tartrate (chantix)
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26
Q

what race/ethnicity is smoking most seen in?

A

multiple race (2nd is American Indians/alaskan)

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27
Q

does education level and smoking play a role?

A

yes, those with GED diploma (41.9%)

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28
Q

what is pack year history?

A

cigs per day times #3 years smoked

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29
Q

why does smoking lead to hypoxia?

A

bc more CO is present, so it binds to the Hb more readily than O2 does. So there is more CO present. This inc risk of clots and inc workload on the heart

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30
Q

does CO increase or decrease lipid permeability?

A

increase

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31
Q

T/F. smoking cause vasodilation

A

F. it cause vasoconstriction bc smooth muscle moves into the lumen. this therefore increases HTN bc of decreases coronary flow at rest

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32
Q

how many more times readily does CO bind to Hb than O2 does?

A

250 time

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33
Q

Smoking increases

A

fibrinogen, platelet aggregation, total cholesterol, risk of CAD and CVA when taken with oral contraceptives

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34
Q

within ____ months, lung function improves up to ____% with smoking cessation

A

2-3, 30

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35
Q

1 year after stopping smoking, heart disease risk drops by ___%

A

50

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36
Q

how many years after smoking cessation does risk of CVA become same as a nonsmoker?

A

5-15

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37
Q

DM has _____x increase risk of CAD

A

2-4

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38
Q

how does family history play a risk in CV disease

A

greater risk if relative <60 (female) had first coronary event

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39
Q

how does race play a role in CV disease?

A

AA higher bp and hd risk

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40
Q

how does age and gender play a role in hd?

A

men:women 4:1
before 40 8:1
after 70 1:1

41
Q

what is CAD patho??? what does it affect?

A

medium and large arteries (coronaries, aorta, popliteal, carotids)

42
Q

in atherogenesis, what layer is the permeability altered?

A

endothelium/intimal layer

43
Q

4 causes of altered permeability?

A

1) HTN –chronic mechanical stress
2) CO –smoking
3) catecholamines– stress and smoking
4) hyperlipdemia –diet, fam history, DM

44
Q

first sign of plaque is called __

A

Fatty streak

45
Q

what does plaque consist of?

A

lipids, conn tissue, smooth muscle cells, platelets

46
Q

T/F. some plaque is considered stable

A

T

47
Q

how is a plaque considered stable?

A

it calcifies

48
Q

what is the lipid hypothesis?

A

high LDLs–> smooth muscle hyperplasia–> cells migrate to intima–> subendothel exposed to blood at sites of tears and platelets aggregate

49
Q

what form of “compensation” occurs to the vasculature around areas of occlusion and chronic ischemia?

A

collateral vasculature

50
Q

what is a myocardial ischemia?

A

when the oxygen supply doesnt match the oxygen demand

51
Q

angina is considered ___% or more of artery occlusion

A

70

52
Q

impulse travels in _____ ______ nerves to thoracic ganglia through _____ ______, to the __________ tract of thalamus and ending in the cortex

A

sympathic unmyelinated, dorsal horn, spinothalamic

53
Q

which type of fibers also travel through the same path in angina, which causes it to travel to cutaneous portions

A

afferent

54
Q

which part of spinal cord does angina tract run through

A

C7-T5

55
Q

T/F. every person has a unique angina pattern

A

T

56
Q

common time for angina attack

A

1-5 min, 20 max

57
Q

three types of angina

A

Stable (resolved with end of activity)
Unstable (not resolved with ending of activity)
Prinzmetal

58
Q

zone of hypoxic injury has three areas, what are they

A

z. infarct, z. hypoxic, z. ischemia

59
Q

z infarct

A

never regains contractility (6-8 weeks)

60
Q

z. hypoxia

A

cells didnt die but hypoxic. pumping function may not ever be normal again (2-3 weeks)

61
Q

z ischemia

A

hypoxic but not to the same degree

62
Q

main methods of diagnosing MI and/or CHD

A

ECG, cardiac cath, exercise stress test

63
Q

speed and incline help diagnose CHD and MI in which test

A

exercise stress test

64
Q

pharmacological agents are used to

A

increase supply or decrease demand

65
Q

a stent is used in conjunction with _____ to open up an artery

A

PTCA (balloon tipped catheter)

66
Q

LVAD is a mechanical pump from ____ to ____ with external component

A

LV, aorta

67
Q

pulmonary HTN is seen in L or R sided heart failure

A

R

68
Q

MI is in R or L sided heart failure

A

R

69
Q

which type of edema does R sided heart failure cause?

A

systemic edema

70
Q

which type of forces are found in CHF

A

starling

71
Q

in left sided heart failure, when the pumping is malfunctioned and theres dec CO and higher volume in LV

A

systolic dysfunction

72
Q

diastolic dysfunction is when CO is ____ and ____ pressure

A

low, higher

73
Q

pressure is transmitted to what veins in CHF

A

pulmonary

74
Q

what percent of VO2 is normal in exertional dyspnea

A

45-55%

75
Q

how much weight gain is seen in CHF

A

6-10 lbs in 1-2 days

76
Q

increase of sympathetic activity in heart failure increases ____

A

preload

77
Q

decrease in SV stimulates baroreceptors, SNS releases catecholamines, _____ of HR and contractility

A

increase

78
Q

what is the result of compensation in HF?

A

preservation of cardiac output

79
Q

drop in what volume stimulates renin-angiotensin-aldosterone system

A

stroke volume

80
Q

drop in SV increases ____

A

preload

81
Q

loss of type _ fibers in heart failure and peripheral muscles

A

Type 1 fibers

82
Q

you want an ______ in preload and a _____ in after load in heart failure (treatment)

A

increase, decrease

83
Q

which type of medications are used to increase contractility for heart failure treatment

A

inotropic

84
Q

how many babies are born with CHD

A

8/1000

85
Q

T/F. CHD occurs in-utero

A

T

86
Q

two types of CHD

A

1) cyanotic

2) acyanotic

87
Q

blood flow to the lungs is impaired and/or there is mixing of oxygenated and deoxygenated blood

A

cyanotic CHD

88
Q

shunting of blood from left to right side of the heart

A

acyanotic CHD

89
Q

patent ductus arteriosis is a _____ CHD

A

acyanotic

90
Q

10% of CHD is attributed to

A

genetic defect (downsyndrome)

91
Q

first - weeks of pregnancy are crucial for heart formation

A

8-10 weeks

92
Q

T/F. ductus arteriosis connects pulmonary artery to the aorta

A

T

93
Q

what type of heart failure when R side of heart gets more blood than it should

A

R

94
Q

T/F. CHD can be detected with prenatal screening, ultrasound or ECG

A

T

95
Q

most common sites of aneurysm

A

abdominal and thoracic

96
Q

aneurysm is a weakened ____ layer

A

media

97
Q

stenosis increases work of ____ chambers

A

upstream

98
Q

ABI numbers

A

0-.4 severe PAD
.41-.9 mild moderate PAD
.91-.99 borderline PAD
1-1.29 normal

99
Q

with DM what are the percentages with occlusive arterial disease over 5 years

A

4% limb loss
20% nofatal MI or CVA
30% death rate

patho test 2 (3 decks)

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