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Patho 2 > Cardio - Exam 1 > Flashcards

Cardio - Exam 1 Flashcards

1
Q

atherosclerosis is defined as a ____ disease of med and large sized arteries fueled by ___

A

inflammatory disease of med and large sized arteries fueled by lipids

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2
Q

list some risk factors of atherosclerosis

A
  1. HTN
  2. smoking
  3. low HDL, high LDL
  4. DM
  5. autoimmune disease
  6. infarction
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3
Q

list the 5 steps of plaque development

A
  1. endothelial cell injury
  2. migration of circulating monocytes
  3. lipid accumulation
  4. smooth muscle cell proliferation
  5. platelet adhesion
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4
Q

monocytes attach to the endothelial cells via which 2 receptors

A

VCAM 1 and ICAM 1

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5
Q

during lipid accumulation macrophages become ___ and form a lipid pool

A

foam cells

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6
Q

platelets can form a ___ through the platelet cascade

A

thrombus

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7
Q

4 steps of platelet cascade

A
  1. adhesion
  2. activation
  3. aggregation
  4. thrombosis
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8
Q

list the three key mediators to plaque development

A
  1. endothelial dysfunction
  2. oxLDL
  3. inflammatory response
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9
Q

oxLDL is released by ___ and causes ____

A

macrophages and causes increased inflammation (more monocytes are attracted to the area)

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10
Q

characteristics of vulnerable plaque

A
  1. THIN fibrous cap
  2. LARGE, soft, lipid rich core
  3. LOW SMC
  4. inflammatory process still occurring
  5. can lead to rupture/thrombus
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11
Q

myocardial ischemia is

A

decreased blood flow to the heart that decreases O2 to myocytes

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12
Q

STABLE angina is AKA

A

classic/effort angina

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13
Q

stable angina pain

A

intermittent with predictable pattern

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14
Q

pain at rest is unusual with ___ angina

A

stable

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15
Q

pain increases with 02 demand with ____ angina

A

stable angina

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16
Q

ECG will show ___ with stable angina

A

st segment depression

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17
Q

nirtoglycerin relieves pain for ___ angina

A

stable

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18
Q

pain lasts ___ min with stable angina

A

5-15 min

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19
Q

stable angina plaque has a ___ lipid core and a ___ cap

A

small lipid core and thick cap

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20
Q

unstable angina is AKA

A

crescendo angina

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21
Q

with UA pain has no

A

predictable pattern

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22
Q

with UA pain is at

A

rest or exertion

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23
Q

with UA the ECG will show

A

ST seg depression and T wave inversion

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24
Q

pain with UA lasts

A

longer than 20-30 min

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25
Q

with UA the plaque has a ___ lipid core and a ___ cap

A

large lipid core, thing cap

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26
Q

prinzmetal angina is AKA

A

variant angina

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27
Q

prinzmetal angina is related to

A

coronary artery spasms due to calcium influx

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28
Q

with prinzmetal angina there can be pain at

A

rest

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29
Q

ECG for prinzmetal angina

A

ECG ST segment elevation

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30
Q

silent myocardial ischemia is AKA

A

angina equivalent

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31
Q

with silent myocardial ischemia there is ___ presentation

A

atypical (no CP)

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32
Q

silent myocardial ischemia occurs in these three pops commonly

A

elderly, women, diabetics

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33
Q

what s/sx is common in those that present atypically

A

confusion

34
Q

3 terms under ACS (acute coronary syndrome umbrella)

A

UA, NSTEMI, STEMI

35
Q

3 terms under chronic ischemic HD

A

VA, SA, silent myo. ischemia

36
Q

with myocardial infarction the pain is described as

A

vice like (vs radiating pain in angina)

37
Q

a ____ MI is transmural or full thickness

A

STEMI

38
Q

NSTEMI damage is limited to the

A

subendocardial layer

39
Q

with STEMI the ECG shows

A

ST seg elevation

40
Q

ECG with NSTEMI shows

A

ST seg elevation, can be ST depression or T wave inversion

41
Q

with MI you will have elevated ____

A

cardiac enzymes

42
Q

NSTEMIS have ____ EF than STEMI

A

higher

43
Q

ST segment elevation is a sign of ____ and an early sign of ____

A

sign of injury and an early sign of infarction

44
Q

ST segment depression or T wave inversion are a sign of

A

ischemia

45
Q

an abnormal q wave is a sign of

A

necrosis/infarction

46
Q

list two cardiac enzymes

A

troponin 1 and CKMB

47
Q

troponin is released___ hours post injury, and stays elevated for

A

3-6 hrs, stays elevated for 4-12 days

48
Q

CKMB is released ___ post MI

A

4-12 hours

49
Q

___ is an abnormality in cardiac function, an inability of the heart to pump at a rate commensurate with metabolic requirements

A

heart failure

50
Q

frank starlings law: __ volume of blood in the heart —> ___ force of contraction

A

INC volume of blood in the heart —> INC force of contraction

51
Q

la place’s law: ___ wall tension, ___ volume, ___ pressure, ___ wall thickness

A

INC wall tension, INC volume, INC pressure, DEC wall thickness

52
Q

___ is when the LV is SQUEEZING and pressure is INC

A

systole

53
Q

____ is when the LV is FILLINg and vol is INC

A

diastole

54
Q

list some common causes of HF

A
  1. CAD w myocardial ischemia (most reversible)
  2. HTN
  3. idiopathic dilated cardiomyopathy
  4. valvular HD
  5. drugs
  6. post partum
55
Q

2 changes with post MI remodeling

A
  1. myocyte/ventricular hypertrophy

2. ventricular dilation

56
Q

EF (ejection fraction) is the

A

volumetric fraction of blood ejected from a ventricle of the heart with each beat

57
Q

normal EF

A

60-70%

58
Q

systolic ventricular dysfunction is AKA

A

HFrEF

59
Q

HFrEF is

A

HF with reduced EF

60
Q

with systolic ventricular dysfunction (HFrEF) EF is

A

less than 40%

61
Q

with systolic ventricular dysfunction (HFrEF) the volume in the heart is ___ and the EF is ___

A

volume in the heart is maintained but the EF is reduced

62
Q

with systolic ventricular dysfunction (HFrEF) the ventricle is not strong enough to _____ due to ____

A

pump out all the blood due to INC AFTERLOAD

63
Q

diastolic ventricular dysfunction is AKA

A

HFpEF

64
Q

HFpEF is

A

HF with preserved EF

65
Q

with diastolic ventricular dysfunction (HFpEF) volume of blood in the heart is ___ but EF is ____

A

volume of blood in heart is reduced but EF is preserved

66
Q

with diastolic ventricular dysfunction (HFpEF) there is DEC ventricular ___

A

compliance (dec preload)

67
Q

diastolic ventricular dysfunction (HFpEF) is more common in __ _and __

A

women and elderly

68
Q

____ is equal to EDV

A

preload = EDV

69
Q

preload is the amount of

A

stretch in the cardiomycocytes before contraction

70
Q

INC EDV –> ___ preload —> __ contraction

A

INC EDV –> INC preload (stretch) —>INC contraction

71
Q

____ is the pressure against which the heart must work to eject blood during systole

A

afterload

72
Q

INC after load leads to INC

A

pressure the heart must generate to eject blood

73
Q

compliance is the ability of the heart to

A

stretch

74
Q

DEC compliance –> ___ EDV –> __ SV

A

DEC compliance –> DEC EDV –> DEC SV

75
Q

____ are diseases that affect the mycardium and lead to HF

A

cardiomyopathies

76
Q

dilated cardiomyopathy has ____ cardiac chambers and ___ wall thickness

A

DILATED cardiac chambers and NML wall thickness

77
Q

with dilated cardiomyopathy there is poor ___ fxn

A

systolic

78
Q

with hypertrophic obstructive cardiomyopathy there is ___ wall thickness and ___ chamber size

A

INC wall thickness and DEC chamber size

79
Q

with hypertrophic obstructive cardiomyopathy there is poor ___ fxn

A

diastolic

80
Q

with restrictive cardiomyopathy there is ____ LV cavity dimensions and ___ wall thickness

A

normal LV cavity dimensions and INC wall thickness (filling of ventricles DEC and CO DEC)

81
Q

cause of Takotsubo cardiomyopathy

A

unknown, possible catecholamine induced myocardial stunning following physiological/emotional stress

Patho 2 (6 decks)

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