Case 1: Racing Heart

Question 1

What do diuretics do? (2)

Answer 1

increase renal fluid loss

decrease blood volume and swelling

Question 2

What does Fen-phen do? (2)

Answer 2

weight loss

releases serotonin which decreases appetite

Question 3

What does digoxin do? (2)

Answer 3

increase pumping of heart

prevents calcium from entering (contraction lasts longer)

Question 4

What does St John’s Wort do? (2)

Answer 4

alter BP

increase HR and make uneven

Question 5

What is Ventolin and what does it do?

Answer 5

beta-agonist

opens airways by mimicking adrenaline

Question 6

What do vasodilators do? (1)

Answer 6

block calcium from entering

Question 7

What does endothelin-1 do? What does it mimic and how?

Answer 7

vasoconstrictor

endothelin- by being the same shape (competitive inhibitor)

Question 8

What does bosentan do? (1)

Answer 8

blocks vascular signaling molecules like endothelin-1

Question 9

Where is cocaine derived from and what does it do?

Answer 9

leaves of shrub in South America

anaesthetic, blocks AP, serotonin acts longer

Question 10

What type of junction are intercalated discs?

Answer 10

gap junctions in heart

Question 11

What allows cardiac muscle to contract?

Answer 11

sarcomeres

Question 12

What are the four stages of the cyclic sequence of heart pumping?

Answer 12

relaxation to atria contraction to ventricle contract to relaxation

Question 13

What 3 things control heart contraction?

Answer 13

pacemaker (SA node), atrial ventricular node, purkinje

Question 14

What does in echocardiogram measure and how?

Answer 14

chamber size, valve function, volume of blood

reflects sound waves to create moving image of heart

Question 15

How does a electrocardiogram measure and what does right axis deviation mean?

Answer 15

“leads”- lines between electrode pairs

right ventricle hypertrophy

Question 16

What are the 4 stages of clot formation?

Answer 16

1. injury
2. vessel contracts
3. platelet plug
4. fibrin clot (coagulation factors in precise order)

Question 17

What does warfarin do?

Answer 17

interfere with production of clotting factors in cascade

Question 18

What is the therapeutic window?

Answer 18

range of doses that produce a therapeutic effect without significant adverse side effects

Question 19

What happens with asthma, what are the symptoms and treatment?

Answer 19

smooth muscle contracts to close airways
wheezing, SOB, history of wheeze, +’ve response to bronchodilator
Ventolin

Question 20

What happens with right ventricle hypertrophy and what are the symptoms?

Answer 20

walls of RV get thicker, low resistance of vasculature in lungs
RV becomes rigid, not enough oxygen, hypertension, failure, “pressure overload”

Question 21

What happens with athlete’s heart?

Answer 21

left ventricle hypertrophy

Question 22

What happens with peripheral oedema, what are the symptoms and treatment?

Answer 22

fluid accumulation in interstitial space (venous return dependent on skeletal muscle contraction)
swelling
catheter inserted vena cava through ventricle into pulmonary artery

Question 23

What happens with pulmonary hypertension and what are the treatments?

Answer 23

narrowing of arterioles, increased resistance, pressure overload, vessels stiff, RV thickens to compensate
bosentan (Tracleer), diuretics to increase fluid loss and reduce swelling, blood thinners, heart stimulants, vasodilators, lung transplant