CARDIO RECAP Flashcards by Shubham Agwan

Name 3 catecholamines

Dobutamine
Adrenaline
Noradrenaline

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What do catecholamines do

Increase HR and force of contraction
Increase O2 consumption of heart
Decrease cardiac efficiency

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How do beta blockers help restore sinus rhythm

By decreasing sympathetic drive

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What side effects can non-selective beta blockers cause

Hypoglycaemia

Cold Extremities

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When can digoxin be used in heart failure

If the patient also has AF

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What is the mechanism of constant Nitric Oxide release

Nitric Oxide Synthase (NOS) converts L-arginine to Nitric Oxide which diffuses into SM cells and increases production of cGMP hence causing relaxation

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How do ARB’s work

Angiotensin 1 receptor blockers (ARB’s) competitively block Angiotensin II binding to the AT 1 receptor

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How do CCB’s work

Block L-type Ca2+ channels

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What can thiazide diuretics be used for

Mild Heart Failure
Hypertension
Severe resistant Oedema (with loop agent)

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What can loop diuretics be used for

Chronic Heart Failure

Acute Pulmonary Oedema (IV)

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What are the two equations to work out MAP (Mean Arterial pressure)

(2D + S) / 3

D + 1/3(D - S)

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Where are the two sets of baroreceptors and which cranial nerves do they signal via

Aortic Arch- signal via CN X (Vagus)

Carotid Sinus- signal via CN IX (Glossopharyngeal)

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What two components make up total body fluid

Intracellular fluid (2/3) 
Extracellular fluid (1/3)

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What 2 components make up extracellular fluid

Interstitial fluid

Plasma fluid

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What 3 cells does the juxtaglomerular apparatus consist of

Granular cells (release renin)
Macula Densa
Extraglomerular mesangial cells

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Mixing of arterial and venous blood results in a decreased 02 saturation of arterial blood, what is this called?

Hypoxaemia

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What is the rounded indent in the right atrium called

Fossa Ovalis

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What is the fossa ovalis a remnant of

A fibrous sheet which covered the foramen ovale (the foramen ovale in the heart, not the skull)

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What is another name for the moderator band which carries the papillary muscles

Septomarginal Trabecula

What provides mechanical adhesion between myocytes

Desmosomes

How does calcium-induced calcium release result in the exposure of the myosin

Ca2+ binds with troponin, pulling troponin-tropomyosin complex aside to expose cross-bridge binding site

In cardiac muscle where is the intracellular calcium released from

The Sarcoplasmic Reticulum (SR)

Which branch of the autonomic nervous system doesn’t have much innervation of arterial smooth muscle (and what are the exceptions to this)

There is no significant PARASYMPATHETIC innervation of arterial smooth muscle except in the penis and clitoris

Which three humoral agents cause vasodilation (by arterial smooth muscle relaxation)

Nitric oxide
Histamine
Bradykinin

Which cells continuously release Nitric Oxide

Endothelial cells of arteries and arterioles

For a heart rate of 75bpm, what are the durations of systole and diastole

Systole - 0.3s | Diastole - 0.5s

What is the normal EDV in an adult

130ml

What causes the dicrotic notch in the aortic pressure curve

The vibration of the aortic valve closing

Why does arterial pressure not fall to 0mmHg during diastole

Due to the elastic walls of the arteries rebounding during diastole

What is the investigation for intermittent claudication and which range of values indicates severe claudication

ABPI (Ankle Brachial Pressure Index) | 0- 4.5 = severe

What drug is given to PVD patients

Cilostazol (anti-platelet)

Which type of brain tissue is particularly sensitive to hypoxia

Grey matter

Which arteries form the basilar artery

2 vertebral arteries

Which arteries anastomose to form the circle of Willis

Carotid arteries anastomose to form circle of Willis

What kinds of substances is the blood-brain barrier impermeable to (and give examples)

Hydrophilic | Proteins, Catecholamines, Ions)

What is the key phrase to describe an AAA

Pulsatile, expansile mass

What is the investigation for an AAA

Ultrasound

What diameter must an AAA reach in order to warrant surgery

>5.5cm

What are the 2 parts of a lipoprotein

``` Hydrophobic core Hydrophilic coat (contains apoprotein) ```

What is the rate limiting enzyme in de novo cholesterol synthesis

HMG-CoA reductase

Describe reverse cholesterol transport

HDL accepts cholesterol from the plasma membrane of macrophages via CETP (cholesterol ester transfer protein) and transports it back to liver

What are the 4 major lipoproteins

HDL particles (contain apoA1 and apoA2) - GOOD LDL particles (contain apoB-100) - BAD Very-low density lipoprotein (VLDL) (contain apoB-100) Chylomicrons (contain apoB-48)

What do you give to a patient with bradycardia

Atropine

What do you do if a patient who is bradycardic isn't responding to atropine

temporary pacing wire

How do you recognise a right axis deviation on ECG

- QRS on lead 1 | + QRS on aVF

How do you recognise a left axis deviation on ECG

+ QRS on lead 1 | - QRS on aVF

How do you recognise extreme axis deviation on ECG

- QRS on lead 1 | - QRS on aVF