cardio Flashcards
0
Q
which ethnic group has the highest death rate of CV Disease?
A
AA
1
Q
what is the leading cause of death in men and women?
A
heart disease
2
Q
two main modifiable risk factors for CV disease?
A
weight, physical activity
3
Q
nonmodifiable risks for CV disease
A
age, gender, family history
4
Q
why are women at less risk to have CV disease?
A
bc estrogen is a protective factor
5
Q
main risk factors for CAD
A
1) HTN
2) smoking
3) high cholesterol
6
Q
what are the percentage breakdowns for HTN
A
31%- HBP
1/3 have pre hypertension
47% have HTN under control
7
Q
where is the greatest prevalence of HTN located in the US?
A
Bible Belt
8
Q
what is blood pressure?
A
how well our heart pumps and how elastic our vessels are
9
Q
what percentage of HTN is essential?
A
90%
10
Q
T/F. HTN is asymptomatic until it affects an organ and damages it
A
T
11
Q
HTN risk factors
A
inactivity, BMI >30, high salt >2300 mg/day (tsp), race (40%AA), age (women after menopause)
12
Q
what does cholesterol bind with?
A
proteins
13
Q
why is some cholesterol important in our diet?
A
it binds with proteins which are important in our cell membranes and hormones
14
Q
this cholesterol transports to cells
A
LDL
15
Q
this cholesterol travels from body to liver
A
HDL (good cholesterol)
16
Q
what is the recommended daily cholesterol intake?
A
<200 mg/dL
17
Q
what is high risk considered for cholesterol?
A
> 239 mg/dL
18
Q
what is borderline for high risk of cholesterol?
A
200-239 mg/dL
19
Q
recommended HDL numbers
A
men >40
women >50
20
Q
recommended LDL numbers
A
<70
21
Q
number to keep triglycerides at
A
<150
22
Q
how many deaths per year are attributed to smoking
A
443,000
23
Q
top 3 things smoking causes people to die from
A
1) lung cancer
2) ischemic heart disease
3) COPD
24
how many chemicals are in tobacco? how many cause cancer?
7000, 70
25
nonnicotine brand prescriptions
```
buproprion SR (zyban)
varenicline tartrate (chantix)
```
26
what race/ethnicity is smoking most seen in?
multiple race (2nd is American Indians/alaskan)
27
does education level and smoking play a role?
yes, those with GED diploma (41.9%)
28
what is pack year history?
cigs per day times #3 years smoked
29
why does smoking lead to hypoxia?
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
30
does CO increase or decrease lipid permeability?
increase
31
T/F. smoking cause vasodilation
F. it cause vasoconstriction bc smooth muscle moves into the lumen. this therefore increases HTN bc of decreases coronary flow at rest
32
how many more times readily does CO bind to Hb than O2 does?
250 time
33
Smoking increases
fibrinogen, platelet aggregation, total cholesterol, risk of CAD and CVA when taken with oral contraceptives
34
within ____ months, lung function improves up to ____% with smoking cessation
2-3, 30
35
1 year after stopping smoking, heart disease risk drops by ___%
50
36
how many years after smoking cessation does risk of CVA become same as a nonsmoker?
5-15
37
DM has _____x increase risk of CAD
2-4
38
how does family history play a risk in CV disease
greater risk if relative <60 (female) had first coronary event
39
how does race play a role in CV disease?
AA higher bp and hd risk
40
how does age and gender play a role in hd?
men:women 4:1
before 40 8:1
after 70 1:1
41
what is CAD patho??? what does it affect?
medium and large arteries (coronaries, aorta, popliteal, carotids)
42
in atherogenesis, what layer is the permeability altered?
endothelium/intimal layer
43
4 causes of altered permeability?
1) HTN --chronic mechanical stress
2) CO --smoking
3) catecholamines-- stress and smoking
4) hyperlipdemia --diet, fam history, DM
44
first sign of plaque is called __
Fatty streak
45
what does plaque consist of?
lipids, conn tissue, smooth muscle cells, platelets
46
T/F. some plaque is considered stable
T
47
how is a plaque considered stable?
it calcifies
48
what is the lipid hypothesis?
high LDLs--> smooth muscle hyperplasia--> cells migrate to intima--> subendothel exposed to blood at sites of tears and platelets aggregate
49
what form of "compensation" occurs to the vasculature around areas of occlusion and chronic ischemia?
collateral vasculature
50
what is a myocardial ischemia?
when the oxygen supply doesnt match the oxygen demand
51
angina is considered ___% or more of artery occlusion
70
52
impulse travels in _____ ______ nerves to thoracic ganglia through _____ ______, to the __________ tract of thalamus and ending in the cortex
sympathic unmyelinated, dorsal horn, spinothalamic
53
which type of fibers also travel through the same path in angina, which causes it to travel to cutaneous portions
afferent
54
which part of spinal cord does angina tract run through
C7-T5
55
T/F. every person has a unique angina pattern
T
56
common time for angina attack
1-5 min, 20 max
57
three types of angina
Stable (resolved with end of activity)
Unstable (not resolved with ending of activity)
Prinzmetal
58
zone of hypoxic injury has three areas, what are they
z. infarct, z. hypoxic, z. ischemia
59
z infarct
never regains contractility (6-8 weeks)
60
z. hypoxia
cells didnt die but hypoxic. pumping function may not ever be normal again (2-3 weeks)
61
z ischemia
hypoxic but not to the same degree
62
main methods of diagnosing MI and/or CHD
ECG, cardiac cath, exercise stress test
63
speed and incline help diagnose CHD and MI in which test
exercise stress test
64
pharmacological agents are used to
increase supply or decrease demand
65
a stent is used in conjunction with _____ to open up an artery
PTCA (balloon tipped catheter)
66
LVAD is a mechanical pump from ____ to ____ with external component
LV, aorta
67
pulmonary HTN is seen in L or R sided heart failure
R
68
MI is in R or L sided heart failure
R
69
which type of edema does R sided heart failure cause?
systemic edema
70
which type of forces are found in CHF
starling
71
in left sided heart failure, when the pumping is malfunctioned and theres dec CO and higher volume in LV
systolic dysfunction
72
diastolic dysfunction is when CO is ____ and ____ pressure
low, higher
73
pressure is transmitted to what veins in CHF
pulmonary
74
what percent of VO2 is normal in exertional dyspnea
45-55%
75
how much weight gain is seen in CHF
6-10 lbs in 1-2 days
76
increase of sympathetic activity in heart failure increases ____
preload
77
decrease in SV stimulates baroreceptors, SNS releases catecholamines, _____ of HR and contractility
increase
78
what is the result of compensation in HF?
preservation of cardiac output
79
drop in what volume stimulates renin-angiotensin-aldosterone system
stroke volume
80
drop in SV increases ____
preload
81
loss of type _ fibers in heart failure and peripheral muscles
Type 1 fibers
82
you want an ______ in preload and a _____ in after load in heart failure (treatment)
increase, decrease
83
which type of medications are used to increase contractility for heart failure treatment
inotropic
84
how many babies are born with CHD
8/1000
85
T/F. CHD occurs in-utero
T
86
two types of CHD
1) cyanotic
| 2) acyanotic
87
blood flow to the lungs is impaired and/or there is mixing of oxygenated and deoxygenated blood
cyanotic CHD
88
shunting of blood from left to right side of the heart
acyanotic CHD
89
patent ductus arteriosis is a _____ CHD
acyanotic
90
10% of CHD is attributed to
genetic defect (downsyndrome)
91
first _-_ weeks of pregnancy are crucial for heart formation
8-10 weeks
92
T/F. ductus arteriosis connects pulmonary artery to the aorta
T
93
what type of heart failure when R side of heart gets more blood than it should
R
94
T/F. CHD can be detected with prenatal screening, ultrasound or ECG
T
95
most common sites of aneurysm
abdominal and thoracic
96
aneurysm is a weakened ____ layer
media
97
stenosis increases work of ____ chambers
upstream
98
ABI numbers
0-.4 severe PAD
.41-.9 mild moderate PAD
.91-.99 borderline PAD
1-1.29 normal
99
with DM what are the percentages with occlusive arterial disease over 5 years
4% limb loss
20% nofatal MI or CVA
30% death rate
