Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology > Ch 24- Part 2 Alteration in Cardiovascular Function > Flashcards

Ch 24- Part 2 Alteration in Cardiovascular Function Flashcards

1
Q

Coronary Artery Disease is usually caused by ________ (1) (plaque that build up diminishing blood supply to cardiac muscle cells)

It results in myocardial ______ (2) and infarction deprives heart muscle of blood-borne O2 (______ (3)) and nutrients and impair heart pumping ability.

A
  1. Atherosclerosis
  2. ischemia
  3. hypoxic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Persistent ischemia causes what syndrome which include myocardial infarction?

A

Acute Coronary Sydrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T or F: Myocardial cells remain alive when the person has CAD and also functioning properly.

A

FALSE; Myocardial cells remain alive BUT are not FUNCTIONING PROPERLY.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Infarction potentially triggers ____ attack

A

heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is cardiac infarction?

A

obstruction of blood supply causing irreversible myocardial damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the link between ab lipoproteins levels and CAD?

A

dyslipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 2 types of lipoproteins?

A

High density lipoproteins (HDL)
Low density lipoproteins (LDL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

LDL is responsible for DELIVERY of cholesterol to _____ (1) while HDL is responsible for delivery of excess cholesterol back to the ______ (2).

A
  1. tissues
  2. liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T or F: High intake of cholesterol and saturated fats leads to decreased LDL.

A

FALSE; LEADS TO ELEVATED LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Excessive levels of LDL causes LDL migration into vessel wall which initiates _______ (reduced blood supply to myocardial cells)

A

atherosclerosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T or F: HDL plays a role in endothelial repair and increases thrombosis.

A

FALSE; DECREASES THROMBOSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T or F: Elevated levels of HDL has not proven to prevent cardiovascular diseases

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hypertension is responsible for __-___ fold increase in CAD risk

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the cause of hypertension that leads to CAD? (2 pts)

A

endothelial injury – atherosclerosis and myocardial hypertrophy (increase heart O2 demand)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is myocardial hypertrophy?

A

increases heart O2 demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cigarette smoking is a ___ ____ generation

A

free radical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When we are smoking , what chemical stimulates catecholamines (epi/nor-epi)?

A

nicotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Nicotine stimulates catecholamines which _____ (1) HR and vasoconstriction which increases _____ (2)

A

increases (1) & B.P (2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CAD risk _____(1) with heavy smoking & _____(2) when smoking stopped.

Smoking is associated with _____ (3) LDL and ______(4) HDL

A
  1. increases
  2. decreases
  3. increased
  4. decreased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Abdominal obesity = strongest risk of CAD/ related to ____ (1) and decreased (LDL or HDL)_____ (2)

A

inflammation (1) & HDL (2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

T or F: Sedentary lifestyle not only increases risk of obesity but on its own increases risk of CAD

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is atherogenic diet.

A

diet that promotes formation of fatty plagues in arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of diet is an atherogenic diet?

A

Western-style diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the recommended diet?

A

Mediterranean diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which blood test can detect very low levels of C-reactive protein (CRP)?

A

hs-CRP test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

T or F: Elevated serum hs-CRP is correlated to decreased CAD risk

A

FALSE; Correlated to increased CAD risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does hs-CRP test used for?

A

determine heart disease risk & stroke without know heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is CRP (C-reactive protein)?

A

protein sythesized in liver in response to increase in inflammation of body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the hs-CRP value for high risk?

A

greater than 3 mg/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the hs-CRP value for low risk?

A

less than 1 mg/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the hs-CRP value for average risk?

A

1-3 mg/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the 2 hormones produced from adipose cells?

A

leptin and adinopectin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What type of hormones are leptin and adinopectin?

A

Adipokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Obesity = increased ____(1; hormone) & decreased _____ (2; hormone)

A

leptin (1) & adinopectin (2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Adinopectin protects vascualr endothelium and is ____- ______

A

anti-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How does myocardial ischemia develop?

A

blood-borne O2 is insufficient to meet myocardial metabolic demands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the common cause of myocardial ischemia?

A

atherosclerosis in coronary circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Atherosclerosis in coronary circulation = ____(1) ruptures = ____(2) formation = occlusion = myocardial _____ (3)

A
  1. plaque
  2. thrombus
  3. ischemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How long do myocardial cells become ischemic when occlusion occurs?

A

within 10 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

During myocardial ischemia, there is a shift toward anaerobic, thus there is accumulation of _____ (1) acid – there is then a decreased rate of ____ (2) re-phoshorylation.

A
  1. lactic
  2. ATP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

If perfusion not restored, myocardial infarction occurs within _____ minutes.

A

20

41
Q

What is angina?

A

chest pain caused by myocardial ischemia

42
Q

Which type of myocardial ischemia occurs alone or with angina?

A

silent ischemia

43
Q

What are some atypical symptoms of silent ischemia? (2 pts)

A

fatigue, dyspnea (bad/breathing)

44
Q

T or F: Silent ischemia has an increased risk of cardiac event.

A

TRUE

45
Q

T or F: Angina increases with rest and nitrates.

A

FALSE; Angina decreases with rest and nitrates

46
Q

What type of myocardial ischemia is associated with gradual narrowing & hardening of arterial walls associated with inflammation and decreased endothelial vasodilators?

A

stable angina pectoris

47
Q

What is the caused of prinzmetal angina?

A

VASOSPASM of coronary arteries

48
Q

Which type of myocardial ischemia is associated with transient angina that occurs unpredictably and often at rest/sleep?

A

Prinzmetal’s angina

49
Q

What are the tx for myocardial ischemia?

A

diet and exercise

Surgery: coronary vessels dilated and placement of coronary stent.

50
Q

What are some evaluation for myocardial ischemia?

A

single-photon emission computed tomography or SPECT.

51
Q

______ (1) congestion indicates impaired ____ (2) ventricular function for myocardial ischemia

A
  1. pulmonary
  2. left
52
Q

When evaluating myocardial ischemia, the physical examination displays _____ (1) pulse and extra heart sounds.

A

rapid

53
Q

In unstable angina, _____(1) (announces ‘the coming of something’) of impending infarction.

A

Harbinger

54
Q

For unstable angina to occur, occlusion lasts no more than __-__ (1) minutes.

A

10-20

55
Q

T or F: Unstable angina is consists of deep erosion of plague that leads to transient ep of thrombotic occlusion and vasoconstriction.

A

FALSE; superficial erosion of plague

56
Q

What is the diagnosis for unstable angina?

A

ECG during attack & hs-cTnt

57
Q

What is the tx for unstable angina?

A

immediate hospitalization

58
Q

What to do look for ECG during unstable angina?

A

ST depression/ T wave inversion/ ST segment elevation

59
Q

What is hs-cTnt when diagnosing unstable angina?

A

high sensitivity cardiac TROPONIN T can identify tiny amounts of enzymes released from damaged myocytes

60
Q

Which acute coronary syndrome is categorized as non-STEMI or STEMI

A

Myocardial infarction

61
Q

What does myocardial infarction non-STEMI mean?

A

persistent occlusion leads to infarction of myocardium closest to endocardium

62
Q

What does myocardial infarction STEMI mean?

A

continued occlusion leads to infarction from endocardium to pericardium

63
Q

How long does it take for myocardial infarction to occur?

O2 depletion in ___(1) seconds. After, the affected myocardium becomes ____ (2) and COOLER.

A
  1. 10
  2. cyanotic
64
Q

The O2 deprivation during myocardial infarction is accompanied by?

A
  • electrolyte disturbances (loss of K+)
  • infiltration of immune cells
65
Q

During myocardial infarction, what does infiltration of immune cells leads to?

A

further tissue damage

66
Q

During the O2 deprivation that occurs during myocardial infarction, electrolyte disturbances leads to?

A

myocardial cells loss contractability.

67
Q

With myocardial infarction, cardiac cells can withstand ischemic conditions for ___(1) minutes before _____(2) damage

A

20 (1) & irreversible (2)

68
Q

What are the manifestations for myocardial infarction?

A

acute, sudden, severe chest pain

69
Q

What is the diagnosis for myocardial infarction?

A

hs-cTnT

70
Q

T or F: Most HF causes due to dysfunction of right ventricle.

A

FALSE; Due to dysfunction of left ventricle.

71
Q

What is a heart failure?

A

heart unable to generate adequate cardiac output

72
Q

What are the characteristics of heart failure?

A

inadequate perfusion of tissues (1), increased diastolic filling pressure of LV (2) or both (3) (if both, pulmonary capillary pressures are increased.)

73
Q

How many individuals are affected by heart failure? What is the age range?

A

10% of individuals older than 65 yrs old.

74
Q

T or F: Heart failure is the most common reason for hospital admission for people who are older than 65 yrs old.

A

TRUE

75
Q

Left Ventricular Failure with Reduced Ejection Factor definition:

Left ventricle ejection fraction less than ___% (1) normal which results in inability of heart to ______ (2) tissue.

A

40% (1) & perfuse (2)

76
Q

How to find CO? (hint: formula)

A

CO= SV x HR

77
Q

What are the determinants of SV? (3pts)

A

contractility, preload and afterload.

78
Q

What is ventricular remodelling?

A

disruption of normal myocardial function

79
Q

What is the cause of ventricular remodelling?

A

progressive myocyte contractile dysfunction

80
Q

In ventricular remodelling, the progressive myocyte contractile dysfunction leads to?

A

reduced SV & left ventricular end-diastolic volume (LVEDV) INCREASES

81
Q

In ventricular remodelling, the disruption of normal myocardial function results in?

A

dilation of LEFT ventricle

82
Q

What are the 3 main causes of myocardial dysfunction?

A
  1. Myocardial infarction
  2. Ischemic heart disease
  3. Hypertension
83
Q

In left ventricular failure with REDUCED ejection factor, ____ (1) CO & ____(2) systemic BP = reduced PERFUSION of tissues.

Results:
increased ____(3) activity
increased secretion of _____(4)
increased _____(5)

A
  1. decreased
  2. decreased
  3. sympathetic
  4. catecholamines
  5. vasoconstriction
84
Q

In left ventricular failure with REDUCED ejection factor, ______ (1) perfusion of kidneys

Result:
____-____(2) system activation = increased vasoconstriction and ____ ____ (3)

A
  1. decreased
    2 Renin-angiontensin
  2. blood volume
85
Q

What are the 4 major results of left ventricular failure with reduced ejection factor?

A
  • increased cardiac afterload
  • increased b.p.
  • increased HR
  • ventricular remodelling
86
Q

In left ventricular failure with reduced ejection factor, there is decreased _____(1) function which leads to decreased in contractility, resulting in increased _____(2)

A
  1. myocyte
  2. preload
87
Q

What is the difference between effect of increased PRELOAD & AFTERLOAD? (2 pts each)

A

Increased Preload:
- stretching of myocardium –> further dysfunction of myocardial function
- sarcomere dysfunction

Increased Afterload:
-systemic HYPERTENSION
- myocardial HYPERTROPHY

88
Q

T or F: Increased afterload is associated with myocardial hypertrophy.

A

TRUE

89
Q

What is hypertrophy in regards to increased afterload?

A

increased myocardial O2 demand

90
Q

What % of HF cases have previous hypertension?

A

75%

91
Q

T or F: Hypertrophic/hypertrophy is the decrease in size of cells.

A

FALSE; Increase in size of cells

92
Q

As CO decreases, ____(1) perfusion is reduced which result in further activation of ____(2) pathway - continue increase in vasoconstriction and blood vol. _______(3) continue to detect b.p which increased catecholamine release and increased _____(4).

Both results in continued increase in both ___(5) & ____(6)

A

renal (1)
RAAS (2)
Baroreceptors (3)
vasoconstriction (4)
preload (5)
afterload (6)

93
Q

Pharmacology is the inhibition of various aspects of ____(1) & ____ (2)

A

RAAS (1) & SNS (2)

94
Q

What manifestation of hear disease is defined as pulmonary congestion despite normal SV & CO?

A

Left ventricular failure with PRESERVED ejection factor

95
Q

What is the prevalence of LVFpEF in population?

A

between 1-5%

96
Q

What is the cause of LVFpEF?

A
  • ab diastolic relaxation (normal left-ventricle volume)
  • normal amount of blood returning to heart increased ventricle pressure
  • the pressure is reflected back into pulmonary circulation – results in PULMONARY EDEMA & RIGHT ventricular hypertrophy
97
Q

What are the diagnosis for LVFpEF? (3pts)

A

dyspnea on exertion, fatigue & evidence of pulmonary edema

98
Q

Right ventricular failure is referred to as ___ Pulmonale

A

Cor

99
Q

Right ventricular failure is the inability of right ventricle to provide inadequate blood flow into ______ circulation at a normal venous pressure.

A

pulmonary

100
Q

What are the cause of right ventricular failure?

A

systemic hypertension leads to peripheral edema (1) & left ventricular failure – pressure reflected back into right ventricle (2)

101
Q

Right ventricular failure serves a problem due to right ventricle POORLY PREPARED for increased afterload and will ___ (1) & fail. As a result, systemic hypertension = _____(2) edema.

A

dilate (1) & peripheral (2)

Pathophysiology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions