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Pathology Block 11 > Cardiovascular Path > Flashcards

Cardiovascular Path Flashcards

1
Q

What is the cardiovascular systems job

A

To maintain sufficient blood pressure to perfume the body

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2
Q

What is the lowest MAP pressure you can have

A

Normal is 70mmHg, 60 is the bottom end of the range the kidney can regulate itself
-below this is shock

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3
Q

What is MAP

A

COxTPR

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4
Q

Body will alter what’s variables to maintain MAP

A

CO and TPR

-mainly HR, to change CO

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5
Q

Blood volume maintained by

A

Sodium
Mineralocorticoids
ANP

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6
Q

What does ANP do

A

If you have too much blood volume, allows you to pee it out

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7
Q

Things that constrict

A 
Angiotensin II
Catecholamines 
Thromboxane 
Leukotrienes 
Endothelin
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8
Q

Things that dilate

A

Prostaglandins
Kinins
NO

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9
Q

Things that affect cardiac output

A

Blood volume
Heart rate (B1, M2)
Contractility

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10
Q

Which of the folllowing would increase BP?
A. Increasing arteriolar diameter
B.increasing venule diameter
C. Increasing HR
D. Increasing PNS stimulation to the heart

A

Increasing HR

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11
Q 
Which of the following would be an appropriate response to increased BP?
A. Increasing angII
B. Increasing renin
C. Increasing aldosterone 
D. Increasing ANP
A

ANP

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12
Q

Leading cause off disease and death in the US

A

Cardiovascular disease

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13
Q

Most common cardiovascular diseases

A

HTN, coronary artery disease

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14
Q

Cardiovascular disease risk factors

A

Age and lifestyle

  • males >45, females >55
  • DM, elevated cholesterol, smoking, HTN
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15
Q

Why do women get cardiovascular diseases later than men

A

Hormones protect them until menopause

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16
Q

What is considered high BP

A

140/90

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17
Q

Primary HTN

A

Just have HTN

Most common

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18
Q

Secondary HTN

A

Due to another disease/drug. Can resolve with cause

-least common

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19
Q

Prolonged HTN

A

Damages vessel walls

-arteriosclerosis, atherosclerosis, stroke, and CAD

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20
Q

Damaged vessels walls due to HTN cause risk of

A

Cardiac hypertrophy and failure, retinal exudates, and flame hemorrhage’s

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21
Q

Injury to the vessel wall leads to

A

Remodeling

  • endothelial damage neointima formation
  • normal process of aging
  • exaggerated in HTN, hyperlipidemic states, and dm
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22
Q

Excessive vessel remodeling

A

Can lead to arteriosclerosis or atherosclerosis

-hardening and occlusion of arteries

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23
Q

A patient presents to the clinic with a fever and complains of flu like symptoms. A full work up shows she has a BP of 145/95 and the flu. After several days, she has recovered from he flu and her BP is once again 119/79. This was an exmple of

A

Secondary HTN

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24
Q

Aginging process accerlated by HTN, usually in less severe HTN. Smooth muscles increase production of ECM, increased ECM narrows artery and reduced compliance

A

Hyaline arteriosclerosis

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25
Q

This is present in severe HTN, layers of ECM and new smooth muscle cells are produced, narrows vessel, reduces compliance, and causes vessel necrosis

A

Hyperplastic arteriosclerosis

26
Q

Which is present in bad HTN, hyaline arteriosclerosis or hyperplastic arteriosclerosis

A

Hyperplastic arteriosclerosis

27
Q

What’s the difference between hyaline arteriosclerosis and hyperplastic arteriosclerosis

A

Hyperplastic is with bad HTN and causes the development of new smooth muscle, it looks like an onion

28
Q

Atherosclerosis

A

Cholesterol deposits and angry macrophages, forms a weak, fibrous cap

  • weakens the vessels, if it ruptures, large clot can form
  • clot can break off and lodge elsewhere, pulmonary embolism, stroke, MI, retinal occlusion
29
Q

Critical stenosis

A

Seen in corotid stenosis

30
Q

Tx for vascular things like atherosclerosis and HTN

A

-lifestyle changes: exercise,
weight loss, low salt, underlying disease
-Cardiac: B blockers and Ca channel blockers
-vessels: CCB
-kidneys: diuretics
-RAAS system: ACEI and ARBs
-lipid metabolism: cholesterol lowering meds (statin)

31
Q

Heart diseases

A
  • Failure to pump (issue with the muscle contracting or relaxing)
  • Obstruction to flow (stenosis valve or systemic HTN increases workload)
  • Regurgitant flow (incompetent valves allow backward flow and increase volume)
  • Disorders of flow (rupture of vessels or shunted flow)
  • Disorders of conduction (arrhythmia)
32
Q

Occurs when heart cannot maintains cardiac output OR can only maintain it at altered fillingpressure

A

Pump failure-heart failure

33
Q

Systolic pump failure

A

Heart cannot generate enough force, due to ischemia or HTN

34
Q

Diastolic pump failure

A

Heart cannot properly relax due to HTN, fibrosis or pericarditis

35
Q

What can HTN cause

A

Pump failure

36
Q

Which of the following would most likely result from HTN?

A

Cardiac hypertrophy

37
Q

Lack of sufficient blood flow to the heart, can occur due to reduced blood flow to overworked muscle or a clot in the coronary circulation. Results in loss of heart muscle and production of non-contractile scar

A 
Myocardial infarction (MI) 
Heart attack
38
Q

What is MI usually preceded by

A

Periods of angina (chest pain), dyspnea, and confusion

-as heart muscle dies, biomarkers are released and can be examined

39
Q

Treatment for MI

A

Restore blood flow by stent or bypass

40
Q

Which of the folllowung would most likely happen during prolonged cardiac ischemia?

A

Cardiac necrosis

41
Q

Which is the best lab to look at to see if someone had a MI?

A

Troponin

42
Q

Left ventricle is cause of failure

A

Left sided heart failure

43
Q

What is left sided heart failure

A

Left side cant pump what right gives it, volume builds up in lungs

  • increased volume increases pressure and causes pulmonary edema
  • increases workload on right heart
44
Q

Right sided heart failure

A
  • right side cant pump what the left gives it, volume build up in periphery
  • edema in the liver and legs
  • increases workload on left side
45
Q

Where do you see edema in right sided heart failure

A

Liver and legs

46
Q

Treatments for right/left sided heart failure

A

Reduce workload of heart

  • reduce BP or blood volume
  • Bblockers CCB and diuretics

Increase contractility to increase CO and maintain function
-cardiac glycosides, B agonistis

Heart transplant is only cure
-pretty rare to get one unless genetic disorder caused HF

47
Q

A patient presents to the ER with a 100% blockage of their left anterior descending coronary artery. After bypass, blood flow is restored but significant heart tissue was lost. Which fo the following will occur first

A

Pulmonary edema

48
Q

Obstruction to flow

A
  • stenosis valves or HTN increase pressure required to move blood
  • lead to cardiac hypertrophy and fibrosis
49
Q

Regurgitant flow

A
  • valves do not close properly, increase volume moving backwards
  • leads to dilation of heart
50
Q

Disordered flow

A
  • vessels abnormalities reduce flow to periphery

- aneurysms, coarcted aorta, patent ductus arteriosus

51
Q

Treatments for flow abnormalities

A
  • fix reason for altered blood flow
  • usually surgery and replace old valves with mechanical or animal valves
  • generally have to be replaced every couple of decades
52
Q

A patient presents with a severely stenosis pulmonary valve. Which of the following would you expect on echocardiographic examination of the heart?

A

Right ventricular hypertrophy

53
Q

Conduction abnormalities

A

Arrhythmia
Most dangerous are ventricular fibrillation
Most common are atrial fib

54
Q

What si the most dangerous conduction abnormalities

A

Ventricular fibrillation

-need to shock to reset the heart

55
Q

What is the most common conduction abnormality

A

Atrial fib

  • atria no longer contract in a coordinated way
  • will just tremble
56
Q

Damage to the conducting system causes altered conduction pathways and irregular heart beats

A

Arrhythmia

57
Q

Non-contracting atria have what effect on CO

A

Little effect

-atria only matter at high heart rates or in late heart failure

58
Q

Lack of contraction in atria can cause what

A

Pooling of blood

  • clots can form on walls
  • can break off and embolism in coronary artery, brain, retina, etc
59
Q

What should all afib patients be on

A

Anti-coagulant

60
Q

While examining a 75yo patient he mentions the doctor has changed his medicine and added a “blood thinner”. He doesn’t like the sound of that and asks you if he should be taking it. You say yes because wit could help prevent

A

Pulmonary embolism
Retinal ischemia
Heart attack

Pathology Block 11 (8 decks)

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