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USMLE Step 1 > Cardiovascular Questions > Flashcards

Cardiovascular Questions Flashcards

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USMLE® Step 1 flashcards
1
Q

CO equation

A

HR * SV

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2
Q

Ficks Principle of CO

A

CO= rate of consumption /
/arterial O2 content - venous O2 Content

“ROS” / (a O2)- (v O2)

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3
Q

MAP (mean arterial Pressure)

A

CO * TPR (total resistance)

2/3 diastolic pressure + 1/3 systolic pressure

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4
Q

Pulse pressure=

A

Systolic Pressure- Diastolic Pressure

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5
Q

PP (pulse pressure) proportional to:

A

SV

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6
Q

PP (pulse pressure) inversely proportional to:

A

Arterial Compliance

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7
Q

SV=

A

EDV - ESV

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8
Q

How is CO maintained during Early & Late stages of exercise?

A 
Early= ^HR, ^SV
Late= ^ HR only (SV plateaus)
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9
Q

What happens typically to Diastole with ^ HR

A

Shortened, less filling time –> decreased CO (e.g. ventricular tachycardia)

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10
Q

Increased PP

A
  1. Hyperthyroidism
  2. Aortic Regurgitation
  3. Aortic Stiffening (isolated systolic hypertension in elderly)
  4. Obstructive sleep apnea (^ sympathetic tone)
  5. Exercise (transient)
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11
Q

Decreased PP

A
  1. Aortic Stenosis
  2. Cardiogenic Shock
  3. Cardiac Temponade
  4. Advanced HF
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12
Q

SV affected by which 3 factors?

A

SV ( CAP)

  1. Contractility. ^
  2. Afterload (decrease)
  3. Preload ^
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13
Q

Catecholamine stimulation via B1 Receptors

  1. pathway
  2. affect of Contractility
A
  1. Ca2+ channels phosphorylated
  2. ^ Ca2+ entry, Ca2+ induced release of Ca2+
  3. ^ storage of Ca2+ in Sarcoplasmic Reticulum
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14
Q

Increase Intracellular Ca2+
Decrease Extracellular Na+ ( dec activity of Na+/Ca2+ exchanger)

effect on contractility?

A

Increase Contractility (SV)

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15
Q

Digitalis is used to treat:

A

congestive heart failure (CHF) and heart rhythm problems (atrial arrhythmias)

can increase blood flow throughout your body
reduce swelling in your hands and ankles

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16
Q

Digitalis

  1. pathway
  2. effect of Contractility
A
  1. blocks Na+/K+ pump
    ^ Intracellular Na+
    dec Na+/Ca2+ exchanger activity
    ^ intracellular Ca2+
  2. Increase Contractility
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17
Q

Acidosis affect on contractility

A

Decrease

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18
Q

HF w. Systolic dysfunction affect on contractility

A

Decrease

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19
Q

B1- Blockage (decrease cAMP) affect on contractility

A

Decrease

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20
Q

Hypoxia/ hypercapnia (dec Po2/ inc PCo2 affect on contractility

A

Decrease

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21
Q

Non-dihydropyridine Ca 2+ Channel Blockers affect on contractility

A

Decrease

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22
Q

myoCARDial o2 demand in increase by?

A

increased:
Contractility
Afterload (proportional to arterial pressure)
HR
Diameter of Ventricule (increased wall tension)

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23
Q

Wall Tension follows Laplace’s Law:

A

Wall tension= pressure x radius

Wall stress= (pr)/ (2wall thickness)

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24
Q

vEnous vasodilators (e.g. nitroglycerin) effect on Preload

A

decrease preload

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25
Q

Approximated by EDV

A

PRELOAD

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26
Q

Approximated by MAP

A

AFTERLOAD

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27
Q

Preload depends

A
  1. venous tone

2. circulating blood volume

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28
Q

Increased Afterload leads to?

A

Increased Pressure

Increased wall tension per Laplace’s law

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29
Q

LV compensates for increased after load by

A

thickening (Hypertrophy) in order to decrease wall tension

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30
Q

Arterial vasodilators (e.g. hydrAlAzine) effect on Afterload

A

Decrease afterload

31
Q

decrease both preload & afterload

A

ACE inhibitors ( inhibit angiotensin converting enzyme)
(Hypertension, CHF; decrease BP, bv)
ARBS (angiotensin II antagonists)

32
Q

Chronic Hypertension (increase MAP) results in

A

LV Hypertrophy

33
Q

Index of ventricular contractility

A

Left ventricular EF

34
Q

EF=

A

sv/edv

(edv-esv)/edv

35
Q

Preserved ejection fraction

A

EF normal HFpEF

36
Q

Systolic HF (EF?)

A

Decreased EF

37
Q

dilated cardiomyopathy affect on Contracility

A

Decrease contracility

38
Q

Catecholamines, Positive inotropes (digoxin) affect on contracility

A

Increase contracility

39
Q

? highest total cross sectional area

A

capillaries

40
Q

? lowest flow velocity

A

capillaries

41
Q

? accounts for TPR

A

Arterioles

42
Q

? provide most of blood storage capacity

A

Veins

43
Q

Viscosity depends mostly on

A

hematocrit

44
Q 
hyperproteinemic states (e.g. multiple myeloma) 
polycythemia affect on viscocity
A

Increase Viscosity

45
Q

Anemia affect of viscosity

A

decrease viscosity

46
Q

Preload 3 variables inc/dec

A
  1. volume
  2. heart rate (filling time)
  3. veins. constrict or dilate (storage)
47
Q

Other than Stress & Drugs

Contractility is stimulated by

A

SNS

  1. B1 receptors
  2. Release of Epinephrine/ Norepinephrine
48
Q

Heart Pressure > Resistance

leads to:

A

push blood out of Aortic Valve

49
Q

After load depends on:

A
  1. Blood Pressure (resistance)

2. Obstruction (stenosis; abnormal narrowing of Lumen)

50
Q

Average pressure in Aorta during Cardiac Cycle

A

MAP

51
Q

Increase CO ? blood concentration in aorta

A

Increase

52
Q

Vasoconstriction of Arterioles ? TPR

A

TPR

53
Q

How do you Maintain MAP

A

control Hormonal & Neural

54
Q

Short term regulation of MAP (seconds to minutes)

A

Baroreceptors & Chemoreptors (respect to respiration)

55
Q

Long term regulation of MAP (minutes to days)

A

Kidneys , which regulate Blood Volume

56
Q

Where are Baroreceptors located?

A

Carotid Sinuses

Aortic Arch

57
Q

Baroreceptors are ? type of Receptors?

A

Stretch Receptors

58
Q

Stretch Receptors (baroreceptors) are able to detect “stretch” and send

A

Action Potentials to the Medulla Oblangata

59
Q

Cardiovascular Control Center

A

Medulla Oblangata

60
Q

The “stretch” (baroreceptors detect) is altered by

A

Pressure

61
Q

Myosin- Actin proteins in the heart require

A

Ca2+

62
Q

Ca2+ binds to

A

Troponin C

63
Q

if you are “scared” which ion floods the cell from the SNS

A

Ca2+

64
Q

Myosin head binding can depend on :

A

correct polarity of Actin

65
Q

for any given Volume, pressure Increase

A

more vertical slope ESPVR

66
Q

“How many Myosin Heads are working, at End of Systole”

A

Contractility

67
Q

Contractility altered by:

A
  1. Ca 2+ (Sympathetic Nerves)
  2. pH
  3. Temperature
68
Q

End Diastolic Volume

A

Volume of Blood in VENTRICLES before Contraction

69
Q

Preload

A

End Diastolic Pressure, stretching walls of ventricles to greatest dimensions

70
Q

Volume of Blood Ejected from blood per Heart Beat

A

Stroke Volume

71
Q

SV directly proportional to:

A

Preload

72
Q

at a greater EDV

  • -> ? strength of contractility of ventricles
  • ->? SV
A

Increase Contractility of Ventricles

Increase SV

73
Q

Increase in Myocardium stretch

  • -> ? sacromere length
  • -> ? sensitivity to Ca2+
A

increase sarcomere length
increase sensitivity to Ca2+
Increase contractility

USMLE Step 1 (5 decks)

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