Cardio Week 5 Flashcards

(32 cards)

1
Q

Define ischaemia

A

Deficiency, real or relative, of blood in a tissue causing a shortage of oxygen and impaired aerobic respiration

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2
Q

Hypertension is a risk factor for which diseases?

A
  • MI, stroke, TIA
  • aneurysm
  • atherosclerosis
  • ischaemic heart disease
  • renal failure
  • death
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3
Q

Risk factors for hypertension are?

A
  • Obesity - Smoking - Diet - Stress
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4
Q

What is the difference between atherosclerosis and arteriosclerosis

A

Atherosclerosis is the stiffening of a vessel wall due specifically to an atheromatous plaque while arteriosclerosis is any stiffening of a vessel wall.

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5
Q

What are three causes of ischaemia?

A
  1. Increases demand for O2 that is not met 2. Narrowing or block in supplying vessel 3. Systematic reduction in tissue perfusion
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5
Q

What is a dissection?

A

Blood entering and flowing in the media of the a vessel.

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6
Q

Which body systems directly effect BP? How?

A

The heart - CO

The vessels - TPR

The kidney - blood volume

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6
Q

What do angiotensin system inhibitors target?

A

Angiotensin converting enzyme inhibitor (the “prils”)

  • decrease vascular tone
  • decrease aldosterone production
  • decrease cardiac hypertrophy

Angiotensin receptor inhibitors (AT1 and AT2)

  • decrease vasocontriction
  • decrease aldosterone
  • decease cardiac hypertrophy
  • decease sympathetic activity
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6
Q

What are three causes of hypoxia?

A
  1. Deficient blood supply to a tissue (ischaemia)
  2. Reduction in O2 carrying capacity of blood eg anaemia
  3. Impaired respiratory function
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7
Q

What was the advantage and disadvantage of methicillin?

A

Adv: acts on penicillin resistant staphlococci Disadvantage: quite toxic - Flucloxacillin and dicloxacillin are less toxic

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8
Q

How do thiazide diuretics act?

A

Inhibit Na+/Cl- cotransporters in distal convoluted tubule > decrease Na and Cl reabsorption in renal tubules > increase Na conc. excretion from kidney > reduce blood volume and blood pressure

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9
Q

What is a aneurysm?

A

Dilation of vessel wall due to weakening of the media.

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10
Q

What are the affects of calcium channel blockers?

A

Inhibit voltage-gated L-type Ca2+ channels in myocardium and vasculture - reduce cardiac/vascular contractility - reduce vascular resistance

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10
Q

What effect does aldosterone have?

A

Salt and water retention - Increase fluid volume

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11
Q

Define cardiac remodeling

A

A increase in relative wall thickness without an overall increase in LV mass, overall the heart gets smaller.

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12
Q

Define eccentric hypertrophy

A

Increase in LV mass with no relative increase in wall thickness (total heart volume increases). A response to volume overload - increase LVEDV and ejection fraction to maintain SV. More sacromeres in series.

14
Q

What pharmacological properties are altered in semi-synthetic drugs?

A

Pharmacokinetics Reduce toxicity Spectrum of action

14
Q

What are 4 causes of Oedema

A

Heart failure

Decrease in osmotic pressure due to reduced plasma proteins

Block lymphatics

Increased capillary permeability

16
Q

What is the vaso vasorum?

A

Small vessel which supply the adventitia in large blood vessels.

16
Q

How to identify LV hypertrophy?

A

Clinical Examination – Forceful/displaced apex beat, S4, S3

ECG – tall voltages, T wave inversion

Chest XR – large heart in eccentric LVH (may be normal size in concentric LVH

Echo/MRI/Cardiac CT

18
Q

Define hypoxia

A

Lack of O2 in tissue

19
Q

What are five targets of antibiotics?

A

Cell wall - eg beta lactams

Cell membrane - polyenes (best anti-fungal)

Nucleic acid

Folic acid

Ribosomes

20
Q

What the affects of beta-adrenoceptors antagonists? What are they called?

A

“the olols”

  • reduce cardiac output acutely
  • reduce HR and contractility
  • reduce renin release
  • reduce blood volume and TPR
21
Q

What are some causes of LV hypertrophy?

A

Pressure overload - hypertrophy, aortic valve stenosis (concentric)

Volume overload - mitral and aortic valve regurgitation

Obesity

Hypertension

Following MI

Diabetes

Renal Failure

Genetic - Fabry’s disease

22
What are the three layers that blood vessel walls are divided into?
Intima, media, adventitia
24
What is the mechanism of atherosclerosis?
Endothelial dysfunction initiated via a variety of risk factors • LDL entry and oxidation e.g. via ROS • Cytokine production • Recruitment of monocytes – Expression of leukocyte adhesion molecules on endothelium • Selectins • VCAM-1, ICAM-1 – Chemoattractant signals e.g. IL8, MCP-1 – Phagocytosis of lipids and formation of foam cells • Recruitment of lymphocytes • Recruitment of smooth muscle cells from the media and formation of extracellular matrix e.g. stimulated by PDGF and TGF beta • Degeneration of components of plaque by e.g. apoptosis and matrix metalloproteinases, forming lipid rich necrotic core • Initial remodelling of vessel wall preserves lumen diameter • Continued endothelial dysfunction: altered release of vasoactive substances, alteration of normal antithrombotic properties • Eventually variable combination of vessel stenosis, impaired vasodilation, plaques vulnerable to rupture, local prothrombotic environment
25
What is the advantage of ampicillin?
Spectrum of action includes gram -ve rods. Newer, very similar, version is called amoxycillin
27
What was the advantage of penicillin V?
Oral administration
28
Define concentric hypertrophy
Increase in LV mass and wall thickness relative to the lumen volume. Due to pressure overload - thicker wall decreases or normalises wall stress. More sarcomeres in parallel
29
What are the 5 classes of antihypertensive drugs?
Angiotensin system inhibitors Beta-adrenoceptor antagonists Calcium channel blockers Diuretics Other
31
What effect does angiotensin II have?
Acts on AT1 receptors to cause vasocontriction Cell growth and remodelling of the heart Positive feedback to renin production Aldosterone production ADH production in the post. pituitary
32
What is the advantage of carbenicillin?
It is affective against Pseudomonas aeruginosa