Brainscape's Knowledge GenomeTM

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


See full index

Pass Program > Chapter 16 Vascular Physiology > Flashcards

Chapter 16 Vascular Physiology Flashcards

1
Q

What surround veins and drain interstitial fluid?

A

lymphatic ducts

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

What drain into thoracic duct?

A

lower extremities and left thorax

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

What drain into right lymphatic duct?

A

head, neck, right thorax

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

What is the presentation of SVC Superior Venous Cava Syndrome?

A

swollen head and neck

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

unilateral ankle swelling?

A

DVT until ruled otherwise

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

bilateral ankle swelling?

A

right-sided heart failure

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

What lab value goes up with clots in body?

A

D-dimer

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

What radiographic test done for DVT?

A

Doppler ultrasound

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

What is Virchow’s triad?

A

cause of clotting: hypercoagulability, stasis, endothelial injury

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

Tx for DVT?

A

heparin

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

1 Cause venous clots?

A

stasis

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

1 cause arterial clots?

A

endothelial injury

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

Tx arterial clots

A

aspirin

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

Homan’s sign

A

calf pain upon dorsiflexion

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

How do veins constrict before arteries?

A

vessel constriction via norepinephrine (main neurotransmitter of ANS); NE has more affinity for alpha 1 receptors; veins have more alpha 1 receptors

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

When body loses volume, which is first to constrict, veins or arteries?

A

veins! always first before arteries

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

Poor perfusion of skin signs

A
  1. poor capillary refill
  2. cool extremities
  3. mottled appearance (lentigo reticularis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which vessels have greatest surface area and greatest diffusion?

A

capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain Fick’s equation

A

In capillaries there is hydrostatic pressure pushing out of vessel and oncotic pressure pulling water and proteins into the capillary while the interstitium surrounding the capillary has hydrostatic pressure pushing fluids into capillaries and oncotic pressure pulling fluids out of the capillaries. There is usually a balance, but if the balance is interrupted (i.e. low albumin in the blood), the oncotic pressure inside will be less than the oncotic pressure in intersitium and proteins and fluid will be pulled more into the interstitium ; that is edema.

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

Which second messengers work in the veins?

A

veins, alpha 1 receptors, 2nd messenger IP3/DAG, causing constriction

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

Which second messengers work in the arteries?

A

beta 2, cAMP, causing dilation

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

plasma proteins usually don’t leak out of vessels, why not?

A

heparan sulfate provides a negative charge in the BM that repel negatively charged plasma proteins

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

What is transudate?

A

transudate is effusion that is mostly water; due to CHF, renal failure or hypothyroidism

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

What is exudate?

A

exudate is effusion that is mostly protein ( greater than 0.5 protein or LDH greater than 0.6 ) caused by purulent, granulomatous, caseous infections; always pathological

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

The epithelium of aorta is lined by which cells?

A

stratified squamous

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

What is the blood supply of the aorta?

A

vaso vasorum

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

Monckeberg’s Arteriosclerosis cause

A

As we get older, vaso vasorum undergoes atherosclerosis, calcifies and dies. The aorta does not have much blood supply and cannot maintain its stratified squamous epithelium. Calcifcations can be seen in the walls of the aorta (not the lumen); physiological response to aging. Loss of epithelial layers will expose underlying smooth muscle to RBC and cause aneurysms and dissections.

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

causes of aneurysms early in life

A

syphilis, takayasu, collagen dis., basement membrane dis.

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

aortic aneurysm Type A

A

ascending aorta dissection usually from collagen dis. like Marfan’s

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

aortic aneurysm Type B

A

descending usually caused by HTN ; usually no surgery, can be controlled with BB, lower BP

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

Which organs have resistance in series (have to filtrate)

A

Liver, Kidney, spleen, lung, placenta

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

If you take out one of the organs that have parallel (with heart), what will happen to blood pressure?

A

BP will go up (that’s why have to control BP after eclampsia when the placenta is removed)

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

when does the heart receive blood from coronary arteries?

A

in diastole

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

What happens to coronary artery flow if the heart rate is high?

A

time in diastole is very short and not enough blood can get to the heart; could result in MI

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

What is the difference between oxygen in artery and its vein

A

A-V O2 difference

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

Which organ always has lowest A-V O2 difference?

A

kidney

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

Which one has the greatest A-V O2 difference after eating?

A

GI system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which organ has the greatest A-V O2 difference after exercise?

A

skeletal muscle

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

What does it mean if AV O2 difference increases?

A

less O2 on venous side, tissue more metabolically active or there was less blood flow into the tissue, forcing it to extract more

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

What does it mean if AVO2 difference decreases?

A

more O2 on venous side, tissue less metabolically active; or more blood flow into the tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does it mean if AVO2 difference very low?

A

blood never reached tissue (shunting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

normal AVO2 difference?

A

25-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

example of iatrogenic AV shunt?

A

guide-wire pokes through vein to artery; dialysis fistula; Blalock-Taussig shunt (descending aorta to pulmonary artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

example of congenital AVM shunt?

A

PDA; AVM; Osler-Weber-Rendu (multiple AVMs); Von-Hippel-Lindau multiple AVM in abdomen and brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

example of traumatic AV Shunt

A

stab wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

If you cut a vessels radius in half, what happens to resistance?

A

It goes up r to the 4 times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

If you increase length of vessel, what happens to flow?

A

decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What does our body regulate first, resistance or pressure?

A

resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

If you want to increase flow in the brain, what should you do?

A

increase PCO2, decrease PO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

If you want to increase flow in the lungs, what shouldyou do?

A

increase pO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

If you want to increase flow in the kidneys, what shouldyou do?

A

increase PGE2, increase dopamine, increase ANP (secubitril)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What does adenosine do?

A

opens up coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What happens to your brain vessels in high altitudes?

A

pO2 decreases, cerebral vessels dilate, ICP rises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

mechanism of migraines

A

vasoconstriction causes localized hypoxia; aura then rapid severe vasodilation causing increased contractility of hear, nausea and vomiting due to ICP increase; increased flow to eyes causing photosensitivity; increased flow to ears causing noise sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

tx migraine

A

O2, sleep, sumatriptan (acute); propranolol (preventive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

definition of chronic migraine

A

more than 14 days in one month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What does it mean if CN X is inhibitory?

A

Increased firing of vagus nerve will lower HR.
lowering firing of vagus nerve will increase HR

58
Q

Which autonomic center in brain controls NE and maintaining HR and BP when we stand?

A

nucleus tractus solitarius

59
Q

What is it called when an elderly persons HR doesn’t go up when he stands?

A

Sick Sinus Syndrome

60
Q

What can you give before nitrates to prevent excessive increase in HR after giving nitrates?

A

beta blocker

61
Q

What is the normal physiologic response to hypovolemia?

A

increase HR

62
Q

definition of orthostatic hypotension

A

systolic drops by more than 20; diastolic drops by more than 10; HR increases by more than 10

63
Q

after 20 minutes of decreased blood flow, which part of body takes over in regulation of blood pressure?

A

JG apparatus releases renin–angiotensinogen–AT1, AT2, aldosterone

64
Q

actions of AT2

A
  1. constricts efferent arteriole more than afferent arteriole; creates backup pressure in glomerulus and increases GFR
  2. Increases TPR (vasoconstricts arterioles)
  3. Stimulates ALDO (reabsorbs Na, Excretes K, Excretes H
  4. stimulates ADH (reabsorbs water along with urea in collecting duct);
  5. stimulates thirst center in brain
65
Q

MCC of autonomic dysfunction in adults

A

diabetes

66
Q

MCC of autonomic dysfunction in newborns

A

Riley-Day syndrome

67
Q

MCC of autonomic dysfunction in Parkinson pt.

A

Shy-Drager Syndrome

68
Q

MCC of autonomic dysfunction in elderly

A

Sick Sinus Syndrome (calcified carotid sinus)

69
Q

low volume state with high Na

A
  1. diabetes insipidus
  2. elderly neglect (dehydration)
70
Q

low volume state with low Na

A
  1. diarrhea 2. DKA 3. RTA type 2
71
Q

Which two drugs cause nephrogenic DI?

A
  1. lithium 2.demeclocycline
72
Q

most common cause of hyponatremia?

A

low volume state

73
Q

most common cause of hypokalemia?

A

low volume state

74
Q

most common cause of hypochloremia

A

low volume state

75
Q

st common cause of high TPR?

A

low volume state

76
Q

st common cause of metabolic alkalosis?

A

low volume state, can cause kidney stones

77
Q

MOA AceI

A

dilate efferent blood vessels, lower GFR, raise serum creatinine slightly; increase bradykinin; decrease afterload and preload of heart; decreases proteinuria in diabetic nephropathy

78
Q

Which ACEi doesn’t cause angioedema?

A

candesartan (because she is sweet!)

79
Q

If you have sulfur allergy can you take ACEi or ARB?

A

ARB because many ACEi contain sulfur.

80
Q

What is vasculitis?

A

cell mediated inflammation due to low energy state and low volume state; can see schistocytes, petechiae , purpura and ecchymoses

81
Q

MC nephropathy in children?

A

Berger’s (IgA nephropathy); 2 weeks after URI

82
Q

MC vasculitis in children?

A

HSP ; 2 weeks after gastroenteritis; only vasculitis with normal platelet count

83
Q

Alport’s

A

X linked recessive, cataracts, hearing loss; type IV collagen; late onset renal failure

84
Q

thromboangitis obliterans

A

Buerger’s: necrotic fingertips in smokers, necrotizing vasculitis

85
Q

MCC of DIC

A

sepsis

86
Q

sign of DIC

A

fibrin split products; high d-dimers;

87
Q

tx of DIC

A

cryoprecipitate

88
Q

MCC of renal failure in children?

A

HUS

89
Q

MCC of HUS

A

E. Coli infection (raw hamburgers; petting zoo)

90
Q

thrombotic thrombocytopenic purpura

A

VWF esterase deficiency (ADAM TS13)

91
Q

tx of TTP

A

plasmapheresis

92
Q

syphilitic aortitis

A

attacks vaso vasorum; wrinkled tree-bark appearance

93
Q

Granulomatous attack on aortic arch with weak pulses in Asian female

A

Takayasu

94
Q

mucocutaneous lymph node disease in children: inflammed mucosal surface (strawberry tongue), red rash involving palms and soles; diffuse cervical lymph nodes; high fever more than 3 days

A

Kawasaki’s

95
Q

Kawasaki’s is the only vasculitis with high platelet count; what is the tx

A

aspirin daily for 2 years; flu shot yearly while on aspirin

96
Q

8 diseases that have rashes involving palms and soles (True RoCK SStarSS)

A

Toxic Shock Syndrome
Rocky Mountain Spotted Fever
Coxsackie A
Kawasaki
Scarlet Fever
Staph Scalded Skin Syndrome
Syphilis
Streptobacilli’s moniiformis

97
Q

tx for temporal arteritis

A

high dose steroids right away!

98
Q

TX for Ankylosing Spondylitis

A
  1. NSAIDS
  2. TNF drugs (once you see deposition in joints)
99
Q

Name 3 HLA B27 diseases

A

Ankylosing Spondylitis; Psoriatic Arthritis; Reiter’s Syndrome

100
Q

What is Reiter’s Syndrome?

A

post infectious reactive arthritis: conjuctivitis, urethritis, arthritis

101
Q

TX for Reiter’s

A

treat infection; NSAIDs for arthritis

102
Q

If psoriatic pt. has HTN which medicine should you NOT give?

A

Beta Blockers because decrease perfusion to skin will worsen psoriasis

103
Q

Which vitamin should you give psoriatic pts because they have high cell turnover?

A

B9

104
Q

What is PAN polyarthritis nodosa?

A

medium-sized artery vasculitis (blood in stool, blood in urine); does not involve lungs; assoc. with HEP B

105
Q

What vasculitis involves sinus, lungs, and kidneys?

A

Granulomatitis with polyangitis

106
Q

What vasculitis involves anti-glomerular basement membrane; lungs and kidneys involved

A

Goodpasture’s

107
Q

What category of renal dysfunction is Goodpastures?

A

RPGN (crescent formation)

108
Q

What does Goodpastures look like on EM?

A

linear immunofluorescence

109
Q

Sudden severe asthma in young adult; P-ANCA +; eosinophils

A

Churg Strauss also called (EGPA Eosinophilic granulomatosis with polyangitis)

110
Q

3 Pulmonary Infiltrates with Eosinophilia (PIE Syndromes)

A
  1. Churg-Strauss Syndrome
  2. Aspergillosis
  3. Loeffler’s Syndrom (due to parasites)
    (Necator Americanus, Ascaris lumbricoides, Strongyloidiasis; schistosomiasis; Ancylostoma duodenale
111
Q

CREST syndrome

A

Calcinosis
Raynaud’s
Esophageal dysmotility and scarring
Sclerodactyly
Telangectasias

112
Q

antibody associated with CREST

A

anti-centromere antibody

113
Q

antibody associated with scleroderma

A

anti-smooth muscle antibody; anti SCL70

114
Q

most severe form of scleroderma

A

Progressive Systemic Sclerosis

115
Q

What antibody is involved in Progressive Systemic Sclerosis?

A

anti-topoisomerase antibody

116
Q

What disease is caused by anti RNP (ribonucleoprotein) antibodies?

A

Mixed Connective Tissue Disease (combination of several collagen vascular diseases such as CREST, Scleroderma, RA, etc.

117
Q

What is rheumatoid factor?

A

antibody against Fc portion of IgG

118
Q

What test for RA is most sensitive?

A

Anti-CCP (citrullinated plasma protein)

119
Q

What is the only arthritis that affects the joint lining (synovium, pannus)?

A

RA

120
Q

TX of RA

A
  1. Methotrexate
  2. within 90 days add TNF inhibitor (etanercept, imatinib)
  3. follow this treatment at least 2 years+
121
Q

What is Felty’s Syndrome?

A

RA with leukopenia and splenomegaly

122
Q

What is Behcet’s Syndrome?

A

RA with GI and GU ulcers and uveitis

123
Q

What is Sjorgen’s Syndrome?

A

RA with xerostomia, xerophthalmia (dry mouth and dry eyes)

124
Q

What antibodies are positive in Sjorgen’s?

A

Anti-Ro, Anti- La, SSA &SSB antibodies

125
Q

Which marker will show a more severe disease in Juvenile Idiopathic Arthritis?

A

RF +

126
Q

complication of JIA and prevention?

A

blindness; see ophthalmologist yearly

127
Q

PSGN, Serum Sickness, SBE, SLE, membranoproliferative glomerular nephritis, and cryoglobinemia are what kind of collagen vascular diseases?

A

with low complement

128
Q

When does PSGN occur?

A

2 weeks after ASO + pharyngitis

129
Q

What does PSGN look like on renal EM?

A

sub-epithelial humps

130
Q

What may cause Serum sickness?

A

vaccinations, MC MMR vaccination

131
Q

Roth spots, Osler nodes, Janeway lesions

A

Sub bacterial endocarditis (SBE)

132
Q

SBE caused by which bacteria?

A

strept viridans

133
Q

anti-dsDAN, anti-Smith, anti-cardiolipin

A

SLE markers

134
Q

MCC death SLE

A

renal failure

135
Q

TX for lupus nephritis

A

mycophenolate

136
Q

4 bad associations of cardiolipin antibody?

A
  1. stimulates intrinsic clotting system
  2. blocks vWF, causing vWF like disease
  3. multiple spontaneous abortions
  4. false + VDRL
137
Q

tram trak appearance (split basement membrane) in kidney; type 1 normal complement, C3 nephritic factor; type 2 low complement, dense deposit disease

A

MPGN (membranoproliferative glomerular nephritis type 1, 2

138
Q

cold agglutins (IgM)

A

cryoglobinemia

139
Q

5 MC causes of cryoglobinemia

A

I AM HE
Influenza
Adenovirus
Mycoplasma
Hepititis B,C
EBV

140
Q

warm antibody, bacterial, chronic inflammation

A

IgG

Pass Program (17 decks)

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