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Hugh's Foundation and Cardiovascular > Cardio Week 5 > Flashcards

Cardio Week 5 Flashcards

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
Q

What are the three layers that blood vessel walls are divided into?

A

Intima, media, adventitia

24
Q

What is the mechanism of atherosclerosis?

A

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
Q

What is the advantage of ampicillin?

A

Spectrum of action includes gram -ve rods. Newer, very similar, version is called amoxycillin

27
Q

What was the advantage of penicillin V?

A

Oral administration

28
Q

Define concentric hypertrophy

A

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
Q

What are the 5 classes of antihypertensive drugs?

A

Angiotensin system inhibitors

Beta-adrenoceptor antagonists

Calcium channel blockers

Diuretics

Other

31
Q

What effect does angiotensin II have?

A

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
Q

What is the advantage of carbenicillin?

A

It is affective against Pseudomonas aeruginosa

Hugh's Foundation and Cardiovascular (7 decks)

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