Cardiovascular Flashcards
Which are the general causes of peripheral edema?
- Increased hydrostatic pressure:
—- Increase plasma volume (CHF, renal disease, arteriovenous fistulas)
—- Venous obstruction - Decreased oncotic pressure
- Increased permeability
- Impaired lymphatic drainage:
—- Primary/congenital
—- Secondary: obstruction/destruction (inflammatory, infectious, neoplasia, surgery, trauma)
Which is the cause of myxedema?
Increase capillary leakage of proteins + reduction in lymphatic uptake
Which are the main causes of peripheral edema?
Vasculitis (40%) > venous/lymphatic obstruction (20%) > hypoalbuminemia (18%) > CHF-r (5%)
Localized (70%) (obstruction > vasculitis) > generalized (30%) (hypoalbuminemia)
CHFr is more typical to produce abdominal/pleural/pericardial effusion
Which is the mechanism of a vasovagal syncope?
Sudden autonomic nervous system failure, with a withdrawal of sympathetic tone and abrupt increase in vagal tone –> hypotension due to bradicardia + vasodilation
What is Bezold Jarisch reflex?
When a patient has a structural disease such as aortic stenosis or obstrive HCM, it exacerbates high left ventricular pressures –> stimulate ventricular pressure receptors (perceived as hypertension) –> vasovagal reflex
Which is the best biochemistry marker to distinguish between syncope and TCC seizure?
Phosphorus (P <0.97 100% E but 50% S of TCC seizure)
What variables determine the turbulence of blood?
- Blood velocity: + velocity, + turbulent
- Vessel diameter: + diameter, + turbulent
- Viscosity: - viscosity, + turbulent
Which are main causes of D-hyperlactatemia?
- Bacterial overgrowth
- EPI
- Diabetes mellitus
- Propylenglicol intoxication
Which factors affect/no affect to lactate concentration?
- No affect: venous/arterial sample
- Affect: exercise, food, stress, seixures, age
Which electrolytic disorder can be a marker of furosemide resistance and refractory tt?
Hypochloremia
How is the Laplace law?
Tension = P x (r/2h)
- Eccentric hypertrophy: secondary to volume overload
- Concentric hypertrophy: secondary to pressure overload
Which are the objectives of spironolactone administration in CHF?
- Diuretic effect (but low)
- Block of aldosterone detrimental effects on the vasculature (vasoconstriction) and cardiac remodeling
Which are the reasons torasemide have a decreased likelihood of patients to become refractory?
Diuretic effect + antialdosterone effect
Which are the most frequent areas of arterial thromboembolism?
- Iliac bifurcation
- Right subclavian artery
Which are the most common causes of arterial thrombus in dogs?
PLN (30%) > neoplasia > corticosteroids > endocrine > inf
In contrast to cats:
**Chronic course
**No cardiac cases!
**25% don’t reach a definitive diagnosis
Which are the effects of antiplaquetar agents in a thromboembolism?
- To prevent platelet aggregation and increasing the thrombus
- Inhibit production of thromboxane and serotonine, both of wich act reducing blood flow –> increase blood flow and collaterals.
Which is the most difference between unfractionated heparin and low molecular weight heparin?
LMWH have the same mechanism of action, but a reduced factor II inhibition –> whereas heparin can be monitored with PTT and TEG, LMWH have to be monitored with antiXa factor.
What is a NET?
Neutrophil extracellular traps: DNA, histones and proteins from activated neutrophils that are liberated to the extracellular –> componnet of innate immune response + prothroombotic.
Blood NETs TAE > no TAE –> can be a marker of TAE risk (specially citH3 more than cfDNA)
Which are the most common congenital diseases in dogs and cats?
- Dogs: PDA > SAS and AS > PS
- Cats: VSD > PDA > TVD > MVD > AV septal defect > AS
Which breed is predisposed to trichuspid dysplasia?
Labrador Retriever
Which breed is predisposed to mitral dysplasia?
Bull Terrier
Which are the most common clinical signs associated to degenerative valvular disease?
- Mitral valve disease: respiratory signs (dyspnea +/- cough). As a compensatory mechanism there is a eccentric hypertrophy of the ventricle and an increase in contractibility –> stroke volume no reduced –> no weakness/exercise intolerance. However, in cases where the stroke volume is reduced (because with time, contractibility is reduced), also weakness and exercise intolerance.
- Tricuspid valve disease: in general there is not important signs, but if it goes together with pulmonary hypertension, more signs.
How is the progression of radiographic changes?
A heart chamber enlargement has a slow phase of steadily progressing MMVD until about 6-12 months before the onset of CHF, when the rate of change of enalrgement is fast.
Which new markers of CHF exist in dogs?
- TMAO, L carnitine and choline: increased in CHF
- Heart Fatty Acid Binding Protein: increased in CHF
- Lymphos subtypes: increased CD8 and reduced CD4
- NLR and MLR: increased in CHF
- Galectin 3: increased in CHF
- Cystatin C (renal marker): increased in patients with less survival