cardio 4

Question 1

what is afterload

Answer 1

the resistance that the heart has to pump against

Question 2

what determines afterload

Answer 2

arteriolar pressure and peripheral resistance

Question 3

what is preload

Answer 3

stress on ventricular wall before systole

Question 4

what is equal to preload

Answer 4

left ventricle end-diastolic pressure

Question 5

what is the formula for cardiac output

Answer 5

Stroke volume x heart rate

Question 6

what should cardiac output ideally be equal to

Answer 6

venous return

Question 7

which is larger, venous capacitance or arterial capacitance

Answer 7

venous

Question 8

what is cardiac output proportional to

Answer 8

rate and force of contraction

Question 9

what are the two regulations of cardiac performance

Answer 9

intrinsic and extrinsic

Question 10

what relationship guides the intrinsic regulation of cardiac performance

Answer 10

frank starling

Question 11

what is the frank starling relationship

Answer 11

force of contraction is proportional to initial fiber length

Question 12

what is a good measure of initial fiber length

Answer 12

LVEDP

Question 13

the strength of heart pumping is dependent on

Answer 13

the amount of blood

Question 14

in heart failure, what is the issue

Answer 14

more blood in heart does not increase the force of contraction

Question 15

what is involved in the extrinsic regulation of the heart

Answer 15

sympathetic parasympathetic baroceptor reflex

Question 16

what occurs if BP increases

Answer 16

carotid sinus baroceptors, CNS, increased vagal flow, decrease HR

Question 17

what occurs if BP decreases

Answer 17

less carotid sinus baroceptor to CNS, decrease in vagal outflow, increase in sympathetic outflow, increase heart rate and vasoconstriction

Question 18

what are the 3 causes of heart failure

Answer 18

infarct, ischemia, increased pressure or volume load

Question 19

what are signs of heart failure

Answer 19

reflex tachycardia
enlarged heart
oedema
dyspnea
elevated venous pressure
swollen ankles
swollen neck veins

Question 20

how does failure to pump affect sympathetic outflow?
how does this effect glomerular filtration?

Answer 20

increased
decreased

Question 21

what does enhances sympathetic outflow lead to

Answer 21

circulatory congestion

Question 22

what causes enlarged neck veins

Answer 22

pooling of blood in venous side of circulation

Question 23

how does sympathetic outflow affect venous pressure

Answer 23

increased

Question 24

what does increased venous pressure result in

Answer 24

fluid expelled from blood = edema and dyspnea

Question 25

what is the term for an enlarged and inefficient heart

Answer 25

maladaptive hypertrophy

Question 26

what are the 3 key ways to treat heart failure

Answer 26

enhance contracitilty reduce fluid intake and increase fluid loss reduce cardiac workload

Question 27

what cardiac glycoside is useful in treating HF

Answer 27

digoxin

Question 28

what are the 3 benefits of using cardiac glycosides in chronic EF

Answer 28

positive inotropic negative chronotropic edema reduced

Question 29

is arterial BP preserved with the use of cardiac glycosides

Answer 29

yes

Question 30

where do cardiac glycosides have indirect effects

Answer 30

supraventricular tissue baroceptors vagal tone

Question 31

where do cardiac glycosides have direct effects

Answer 31

purkinje fibres ventricular myocardium

Question 32

where do cardiac gylcosides have effects

Answer 32

SA AV purkinje and ventricles

Question 33

how do cardiac glycosides effect vagal outflow

Answer 33

increased

Question 34

how do cardiac glycosides affect purkinje fibres

Answer 34

automaticity anf excitabilty

Question 35

how do cardiac glycosides affecrt ventricles

Answer 35

(+ ) INOTROPIC

Question 36

how can cardiac glycosides cause problems in the AV node

Answer 36

AV block

Question 37

what are catecholamine positive inotropic agents?

Answer 37

dopamine and dobutamine

Question 38

what receptor for dopamine and dobutamine act on

Answer 38

beta 1

Question 39

what effect do phosphodiesterase inhibitors

Answer 39

positive inotropic

Question 40

how do phosphodiesterase inhb=itors increase contracility

Answer 40

inhibit breakdown of cAMP, increased Ca through L, increased contractility

Question 41

what are the two phosphodiesterase inhibitors

Answer 41

amrinone and milrinone

Question 42

what is one more class of drug that has positive inotropic effects

Answer 42

changes to angiotensin II

Question 43

what is the SGLT2 inhibitor of interest

Answer 43

empagliflozin