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Pathophysiology > CHAPTER 33: CV alterations > Flashcards

CHAPTER 33: CV alterations Flashcards

1
Q

What is virchow triad

A

Measures DVT risk
1) venous stasis
2) venous intimal damage
3) hypercoag state

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2
Q

HTN is:

A

Grater than 130/80
# 1 primary diagnosis in United States

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3
Q

HTN causes

A

SNS
RAAS
endothelial dysfunction
Insulin resistance
Inflammation
Obesity

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4
Q

Review page in notes on chapter 33 and hypertension

A
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5
Q

Orthostatic hypotension definition

A

⬇️ SBP more than 20 or DBP more than 10 within 3 min of standing

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6
Q

Primary OH

A

Usually neurogenic

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7
Q

Secondary OH causes

A

Altered body chemistry
Acute
Volume depletion
Starvation
Drugs
Immobility
Exhaustion

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8
Q

Superior vena cava syndrome

A

Caused by SVC compression , head and BUE congestion
😖cancer is frequent cause
❤️RA venous return is inhibited ❤️👀

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9
Q

AKI definition

A

Sudden decline in kidney function
⬇️ GFR ⬇️ UO
⬆️ nitrogenous waste in blood 🩸 (bun/creat)

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10
Q

AKI Causes

A

⬇️ EC VOLUME
⬇️ renal 🩸 flow
Toxic/inflammation injury

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11
Q

AKI TYPES

A

Pre renal
INTRArenal
Post renal

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12
Q

Pre renal failure 😨 causes:

A

🔴INADEQUATE KIDNEY PERFUSION🔴
Most common type
Caused by sepsis , hypovolemia, burns , ⬇️ CO, nsaids, contrast

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13
Q

Intra renal failure

A

‼️Most severe damage‼️
Outer medulla affected
Caused by glomerulonephritis, graft rejection, MH, DIC, tumors , ATN, nephrotic damage

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14
Q

Post renal failure

A

Rare , related to UTI

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15
Q

What is ATN

A

A form of intrarenal AKI.

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16
Q

What can cause ATN

A

⏰persistent hypotension , hypoperfusion, hypoxemia⏰

➡️ leads to ischemia , ⬇️ ATP, ⬆️ free radicals , tissue necrosis and swelling / injury

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17
Q

AKI phases 1-4

A

1) initiation
2) extension
3) maintenance
4) recovery ❤️‍🩹

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18
Q

AKI initiation phase :

A

Evolving injury
Reduced perfusion
Toxicity
24-36 hrs long
Prevention possible

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19
Q

AKI extension phase

A

Inflammatory cells
Backleak
Continued ischemia

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20
Q

AKI : maintenance phase

A

Lowest urine output
⬆️ bun and creat
⬆️ K+
Metabolic acidosis

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21
Q

4) AKI recovery phase

A

GFR normalizes
Concentration is difficult

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22
Q

Aneurysm types

A

True : all three layers , weak walk
False: extravascular hematoma
Type A: ascending aorta 🫀
Type B: any other aortic location

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23
Q

Types of PVD

A

Thromboangitis obliterans: 🚬
Reynauds
Reynauds phenomenon

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24
Q

Reynauds risk factors

A

👧 female gender more common
CV disease, smoking , migraines
😨vasospastic disease

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25
Reynaud’s phenomenon
Secondary to systemic disease like scleroderma , cocaine , pulmonary HTN, thoracic outlet sx
26
Reynaud’s sx
Pallor, numbness , cold sensation, bilateral and begins at tips of digits
27
CAD risk factors
DM, dyslipidemia, 🚬, HTN, obesity , sedentary, atherosclerotic diet
28
Metabolic syndrome triad
Dyslipidemia, HTN, Obesity
29
Dyslipidemia : LDL functions
Delivers cholesterol to cells Regulated by liver Part of atherosclerotic disease
30
HDL functions :
Reverse cholesterol transport Protects endothelium Anti inflammatory, anti thrombotic Retunes excess to liver ➡️ bile or cholesterol steroids
31
Stable angina
Gradual luminal narrowing and/or Hardening of arterial walls
32
Prinzmetal angina
Usually benign At night during REM Vasospasm w/o atherosclerosis
33
Silent ischemia /mental stress
🫀Catecholamine release ➡️ ⬆️ HR, BP, CRP, ⬇️ NO
34
ACS Types
❤️‍🩹unstable angina : reversible ischemia 🫀 AMI: Prolonged ischemia, irreversible damage (NSTEMJ/STEMI)
35
Unstable angina pathophys
➡️transient plaque erosion 🩸labile thrombus Less than 20 min occlusion ⏳impending plaque rupture
36
Ekg on unstable angina :
T wave inversion Normalizes with resolving pain ST DEPRESSION trop normal
37
AMI: types
Subendocardial - NSTEMI TRANSMURAL- STEMI
38
NSTEMI patho
❤️‍🩹T wave inversion ❤️‍🩹ST depression 🩸Thrombus does not lodge permanently Not through entire muscle wall
39
STEMI patho
ST elevation 🫀Thrombus lodged Trans mural
40
Reperfusion injury
O2 radical release Inflammation Ca+ flux pH changes
41
Types of pericarditis
Idiopathic (immune) Viral (Also trauma, MI, lupus, RA, urosepsis )
42
Pericarditis sx
😨Usually had fever for few days 🥵severe retrosternal cp worse with lying down or breathing 😫radiates to back - phrenic nerve 🥺dysphagia , restless , malaise, weak , irritable , anxiety
43
Pericarditis findings
Low grade fever 🤒 Friction rub (not all) ⬆️CRP tachycardia
44
Diagnosis of pericarditis requires 2/4:
1) 😵‍💫chest pain r/t pericarditis 2) EKG changes 3) friction rub 4) new or worse effusion
45
Pericarditis treatment
Colchicine NSAIDS
46
EKG changes in pericarditis
Diffuse ST elevation PR depression
47
Pericardial effusion causes
Can occur with pericarditis Neoplasm Infection Normal fluid 20 ml
48
Tamponade sx
Dyspnea JVD Tachycardia Muffled ❤️ sounds Pulsus paradoxus
49
What is pulsus paradoxus
Decreased diastolic filling 🫁exhalation BP more than 10 mmhg higher than inspiration 🫁
50
Constrictive pericarditis causes
Radiation , trauma, ca, transplantation, rheumatic disease
51
Pathophys of constrictive pericarditis
Fibrous tissue scarring , gradual onset
52
Constrictive pericarditis sx
Exercise intolerance DOE Fatigue Anorexia 😵‍💫2/3 present with HF😵‍💫
53
Constrictive pericarditis findings
Hepatic congestion JVD EDEMA T wave inversion Afib
54
Constrictive pericarditis treatment
NSAIDs Excision Diuretics
55
Cardiomyopathy types
1) dilated 2)hypertrophic 3)restrictive
56
Dilated CM causes
Ischemic HD DM , renal failure ETOH / drug toxicity Hyperthyroidism Nutritional deficiency
57
Dilated CM impairs what function
SYSTOLIC leads to eventual LHF
58
Dilated CM sx
Dyspnea Pedal edema Fatigue
59
Dilated CM findings
Displaced apical pulse S2 gallop Peripheral edema JVD pulmonary edema
60
Hypertrophic CM types (2)
Hypertrophic HTN or valvular cause
61
Hypertrophic cardiomyopathy patho
Septal wall thickening Hyperdynamic state LV outflow ⬇️ with exercise 💔AICD reduces sudden death 💔
62
Hypertrophic cardiomyopathy sx
Syncope Palpitations LHF ANGINA
63
Hypertensive or valvular hypertrophic cardiomyopathy patho
⬆️ resistance to ejection Commonly caused by Aortic stenosis
64
Restrictive CM patho
Restrictive filling , ⬇️diastolic volume with normal wall thickness and systolic function
65
Restrictive CM causes
Scleroderma Amyloidosis Lymphoma 👀rigid myocardium 👀
66
Restrictive CM sx
Right heart failure symptoms with venous congestion
67
Which valves most affected by disease
Mitral and aortic (L ❤️ valves)
68
Stenosis patho
Constricted and narrowed Impedes forward flow ⬆️ distal chamber workload
69
Regurgitation patho
Leaflets don’t shut all the way Blood leaks into distal chamber ❤️murmur
70
Aortic stenosis causes
1) calcification 2) congenital biscuspid 3 ) inflammation from RHD
71
AS patho
Lipoprotein deposition in valve Chronic inflammation Leaflet calcification
72
AS symptoms
angina Syncope Heart failure
73
AS findings
🎤 most common valve disease🎸 Slow pulse , faint pulse , systolic murmur
74
Mitral stenosis patho
LA to LV obstruction Most common RHD valve affected
75
MVS sx
⬇️ CO especially exertional JVD Peripheral edema
76
MVS findings
Rumbling diastolic murmur R heart failure Pulmonary HTN
77
Aortic valve regurgitation patho
Regurgitation from aorta to LV Leaflets do not close during diastole
78
AORTIC REGURGITATION causes
Congenital , HTN, RHD, endocarditis, syphilis, trauma
79
Aortic regurgitation sx
Widening pulse pressure , diastolic murmur may radiate to neck , bounding carotid pulse

Pathophysiology (6 decks)

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