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Pathology > Cardiovascular Pathology: Circulatory Diseases > Flashcards

Cardiovascular Pathology: Circulatory Diseases Flashcards

1
Q

Essential hypertension and idiopathic hypertension refer to:

A

HBP not due to a known disease or secondary effect of another disease, eg. tumor.

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2
Q

Major risk factors for hypertension:

A

-Salt intake
-Obesity
-smoking
-consuming alcohol
-Inactivity
(usually a combination of those)

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3
Q

Control of blood pressure is done by:

A
  • an intricate system controlled by the arteries, which dilate and constrict to deliver more or less blood to certain regions of the body.
  • The nervous system (autonomic nervous system controls the vessels)
  • The heart, brain, adrenals (due to hormone release)
  • Kidney (involved in controlling the volume of blood and release hormones that alter the BP)
  • Diets (salt intake)
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4
Q

What happens in the vessels in hypertension?

A
  • Walls of the vessels are more thicken, making the lumen smaller and less blood can pass through.
  • More constriction within the vessel, narrowing the lumen.
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5
Q

vicious circle between hypertension and atherosclerosis:

A

Branch points of blood vessels are vulnerable to damage from hypertension, making them possible site for plaque buildup.

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6
Q

Complications of hypertension:

A
  • Cardiac hypertrophy
  • Structural change in arteries (arteriosclerosis= in the arteriole, hyperplasia and hypertrophy of smooth muscle, Charcot-Bouchard aneurysms in the brain, atheroma’s, fribrinous necrosis)
  • Atherosclerosis.
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7
Q

Hypertension syndrome refer to:

A

damage to multiple organ systems.

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8
Q

Hypertension syndrome sing/symptoms:

A
  • Decrease arterial compliance
  • Endothelial dysfunction
  • Abnormal glucose metabolism
  • Abnormal insulin metabolism
  • Abnormalities of neurohormonal function
  • Change in renal function
  • Changes in blood clotting mechanisms
  • Left ventricular hypertrophy and dysfunction
  • Accelerated atherogenesis
  • Abnormal lipid metabolism
  • Obesity and adiposity.
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9
Q

How does salt affect blood pressure?

A

-Salt increased volume load (salt makes us retain more fluid)
-Various cardiotonic steroids are released
-Sodium affects Na+/K+ exchange in the vascular smooth muscle and an effect on calcium (more contractile vessels)
-

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10
Q

Non-pharmacological control of BP: (in order of effectiveness, most to least)

A
  • Decrease weight
  • Lower alcohol consumption
  • Reduce sodium intake
  • Increase physical exercise
  • Increase potassium intake
  • Decrease saturated fat intake
  • Use relaxation techniques (for those under high stress)
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11
Q

Ischemic Heart Disease include

A
  • Angina pectoris

- Myocardial Infarctus

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12
Q

Main branches of the coronary arteries:

A
  • Left anterior descending
  • Right coronary artery
  • Left coronary artery
  • Circumflex
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13
Q

Main coronary arteries:

A
  • Right coronary artery
  • Left coronary artery
  • Left anterior descending
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14
Q

Coronary artery disease (CAD) is

A

atherosclerotic plaque that tends to form in the proximal regions of the main coronary arteries. (greater damage due to greater region cover)

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15
Q

Stenosis is

A

narrowing of the lumen

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16
Q

The workload of the heart is determined by:

A
  • Preload
  • Afterload
  • Rate and force of contraction
17
Q

Preload is

A

the volume of blood that return to the heart/unit of time.

18
Q

Preload is determined by:

A
  • Venous return

- Exercise

19
Q

Afterload is

A

the pressure the heart needs to push against.

20
Q

Afterload is determined by:

A
  • Hypertension

- Exercise

21
Q

Rate and force of contraction is

A

controlled by the autonomic nervous system (eg. sympathetic) and various hormones.

22
Q

Afterload is determined by:

A
  • Adrenaline, and various hormones

- Exercise

23
Q

Cardiac Myocyte properties:

A
  • High energy requirement: Electrical (require a lot of ATP for Na+/K+ pump) and Mechanical (Heart need to continually work)
  • Low energy reserve (need continual supply in O2 and nutrients)
24
Q

treatment of choice for coronary spasm?

A

Nitroglycerine

25
Q

Angina detection?

A

ECG treadmill test (person walk on the treadmill and surveillance of the ECG, ST depression and surveillance of pain.

26
Q

Nitroglycerine role in Angina?

A

Vasodilate the veins, decrease the preload.

27
Q

The veins are referring to as the “capacitance system” because

A

they hold most of the blood at any given time. (by dilating veins e.g., more blood will stays in the veins, less blood goes to the heart and can relieve the angina)

28
Q

Why is the nitroglycerin do not have a large effect on the resistance system in the arteries?

A

Because the plaque are commonly circumferential and typically contains fibrous tissue so it will not respond to nitroglycerin. BUT if the plaque is only in one side, it can dilate the smooth muscles, givin some relief.

29
Q

If the left anterior descending is blocked, the damage will be

A

the damage will be to the anterior side of the heart

30
Q

If the right coronary artery is blocked, the damage will be

A

the damage will be to the posterior side of the heart

31
Q

If the left coronary artery is blocked, the damage will be

A

the damage will be on the side of the heart in between the anterior and posterior area.

32
Q

ECG change when there is an Ischemia:

A

ST depression/or T wave inversion

33
Q

ECG change when there is an injury:

A

ST elevation

34
Q

ECG change when there is an infarction:

A

Pathologic Q wave

35
Q

Markers of acute myocardial infarct:

A 
Myoglobin (peak quickly after the infarct)
Total CK
CK-MB
Troponin 1
LDH
(may be elevated days after)
36
Q

Healing stages (3) after an infarct in the tissues:

A 
Early Wound Healing (Extracellular matrix + dead cell remove)
Granulation Phase-Early Remodeling
Late Remodeling (more Extracellular matrix + fibroblasts)
37
Q

Cardiac tamponade:

A

When there is an accumulation of blood in the pericardial sac which pushing against the heart from the outside, making difficult for the heart to move.

Pathology (23 decks)

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