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MNT I- Cardiovascular Disease > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Cardiovascular Disease (CVD)

A

A group of interrelated diseases that include coronary heart disease (CHD), atherosclerosis, hypertension, ischemic heart disease, peripheral vascular disease, and heart failure (HF).

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2
Q

Coronary Heart Disease (CHD)

A

Disease that involves impeded blood flow to the network of blood vessels surrounding and serving the heart. Major cause is atherosclerosis; structural and compositional changes in the inner wall of the arteries. Manifested in clinical end points of myocardial infarction (MI) and sudden death.

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3
Q

Atherosclerotic Heart Disease (ASHD)

A

Involves narrowing and loss of elasticity in the blood vessel wall caused by accumulation of plaque.

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4
Q

Dyslipidemia

A

Blood lipid profile that increases the risk of developing atherosclerosis.

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5
Q

Apolipoproteins

A

Carry lipids in the blood and also control the metabolism of the lipoprotein molecule.

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6
Q

C-reactive Protein (CRP)

A

Synthesized in the liver as the acute-phase response to inflammation.

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7
Q

Systolic Blood Pressure (SBP)

A

The blood pressure during the contraction phase of the cardiac cycle.

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8
Q

Diastolic Blood Pressure (DBP)

A

The pressure during the relaxation phase of the cardiac cycle.

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9
Q

Essential Hypertension

A

Hypertension of unknown cause.

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10
Q

Secondary Hypertension

A

Hypertension that arises as the result of another disease, usually endocrine.

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11
Q

Heart Failure (HF)

A

The heart cannot provide adequate blood flow to the rest of the body, causing symptoms of fatigue, dyspnea, and fluid retention.

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12
Q

Pathophysiology of Atherosclerosis

A
  1. Vessel lining is injured
  2. Plaque is deposited to repair injured area
  3. plaque thickens, incorporating cholesterol, protein, muscle cells, and calcium
  4. Arteries harden and narrow as plaque builds, making them less elastic
  5. Increasing pressure causes further damage
  6. A clot or spasm closes the opening, causing a STEMI
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13
Q

Nitric Oxide

A

Produced by endothelial cells, controls the normal relaxation of smooth arteries, and regulates mechanisms important in the atherosclerotic process.

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14
Q

Atheroma

A

Also know as plaque. Lipid deposits and other materials (cellular waste products, calcium, fibrin) that build up in the intimal layer.

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15
Q

Myocardial Infarction (MI)

A

When blood supply to the heart is disrupted, the heart is damaged. This may cause the heart to beat irregularly or stop altogether.

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16
Q

Lipoproteins

A

Proteins that bind to lipids and transport them in the blood. They vary in composition, size, and density and consist of varying amounts of triglyceride, cholesterol, phospholipid, and protein. The ratio of protein to fat determines the density.

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17
Q

Chylomicron

A

Transport of dietary triglyceride. Transport dietary fat and cholesterol from the small intestine to the liver. Absent in fasting studies.

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18
Q

VLDL

A

Manufactured in the liver to transport endogenous triglyceride and cholesterol. Not routinely measured.

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19
Q

IDL

A

Formed with catabolism of VLDL and is a precursor of LDL. Rich in cholesterol and apo E. Not routinely measured.

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20
Q

LDL

A

Primary cholesterol carried in the blood, 95% of apolipoproteins in LDL are apo B-100. It is formed in VLDL catabolism and 60% is taken up by LDL receptors in the liver, adrenals, or other tissues.

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21
Q

HDL

A

Reverse cholesterol transport. “Good” cholesterol. Contain more protein than the other lipoproteins. Apo A-1 is involved in tissue cholesterol removal. High HDL is associated with low levels of chylomicrons, VLDL remnants, and small, dense LDL.

22
Q

Lipid Panel (lab)

A

Includes measurement of total cholesterol, LDL, HDL, and triglyceride levels after fasting.

23
Q

Total Cholesterol (lab)

A

Captures cholesterol contained in all lipoprotein fractions.
60-70% is carried on LDL
20-30% is carried on HDL
10-15% is carried on VLDL

24
Q

Total Triglycerides (lab)

A

Triglyceride-rich lipoproteins that include chylomicrons, VLDL, remnants, or intermediary products.

25
Q

ATP III Guidelines

A

Adult Treatment Panel for the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults convened by the National Heart, Lunch and Blood Institute of the NIH.

26
Q

Evaluating Total Cholesterol

A

Desirable: 240

27
Q

Evaluating Triglycerides

A

Normal: 500

28
Q

Evaluating LDL

A

Optimal: 190

29
Q

Evaluating HDL

A

Low: 60

30
Q

Saturated Fatty Acids

A

Elevate blood cholesterol in all lipoprotein fractions (LDL and HDL) when substituted for CHO or other FAs and are associated with CAD progression.

31
Q

HMGCoA Reductase Inhibitors (Statins)

A

Reduce major coronary events, CHD mortality, coronary procedures (PTCA/CABG), stroke, and total mortality. Drug names end in -statin.

32
Q

Bile Acid Sequestrants

A

Reduce major coronary events and CHD mortality. Cholestyramine, Colestipol, and Colesevelam.

33
Q

Nicotinic Acid

A

Reduces major coronary events and possible reduction in total mortality. Immediate, extended and sustained release.

34
Q

Fibric Acids

A

Reduce progression of coronary lesions and major coronary events. Gemfibrozil, Fenofibrate QD, and Clofibrate BID.

35
Q

Major Actions of HMGCoA Reductase Inhibitors

A
  • Reduce LDL 18-55%
  • Reduce TG 7-30%
  • Raise HDL 5-15%
36
Q

Major Side Effects of HMGCoA Reductase Inhibitors

A
  • Myopathy

- Increased liver enzymes

37
Q

Contraindications of HMGCoA Reductase Inhibitors

A
  • Absolute: liver disease

- Relative: use with certain drugs

38
Q

Major Actions of Bile Acid Sequestrants

A
  • Reduce LDL 15-30%
  • Raise HDL 3-5%
  • May increase TG
39
Q

Side Effects of Bile Acid Sequestrants

A
  • GI distress/constipation

- Decreased absorption of other drugs

40
Q

Contraindications of Bile Acid Sequestrants

A
  • Dysbetalipoproteinemia

- Raised TG (especially >400 mg/dL)

41
Q

Major Actions of Nicotinic Acid

A
  • Lowers LDL 5-25%
  • Lowers TG 20-50%
  • Raises HDL 15-35%
42
Q

Side Effects of Nicotinic Acid

A
  • Flushing
  • Hyperglycemia
  • Hyperuricemia
  • Upper GI distress
  • Hepatotoxicity
43
Q

Contraindications of Nicotinic Acid

A
  • Liver disease
  • Severe gout
  • Peptic ulcer
44
Q

Major Actions of Fibric Acids

A
  • Lower LDL 5-20% (with normal TG)
  • May raise LDL (with high TG)
  • Lower TG 20-50%
  • Raise HDL 10-20%
45
Q

Side Effects of Fibric Acids

A
  • Dyspepsia
  • Gallstones
  • Myopathy
46
Q

Contraindications of Fibric Acids

A

Severe renal or hepatic disease.

47
Q

Blood Pressure

A

A function of cardiac output multiplied by peripheral resistance and is affected by the diameter of the blood vessel.

48
Q

Congestive Heart Failure (CHF)

A

A clinical syndrome characterized by progressive deterioration of left ventricular function, inadequate tissue perfusion, fatigue, SOB, and congestion.

49
Q

Compensated CHF

A

Lack of oxygen to tissues causes increase in heart rate and enlargement of the heart.

50
Q

Decompensated CHF

A

Heart no longer adjusts.

MNT I- Cardiovascular Disease (1 decks)

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