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Phase2A > CV > Flashcards

CV Flashcards

1
Q

what is neointima?

A

growth of new vessel walls

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2
Q

what is stage 1 of atherosclerosis?

A

fatty streaks

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3
Q

what is syncope?

A

loss of consciousness

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4
Q

what should the speed and gain of an ECG be set at?

A

speed 25mm/s

gain 10mm/mV

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5
Q

what is the order of conduction in the heart?

A

SA-AV-bundle of his-bundle branches-purkinje fibres

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6
Q

above what is considered high BP?

A

140/90mmHg

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7
Q

in hypertensive patients what does pharmacology target?

A

peripheral resistance

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8
Q

what can ECGs identify? (6)

A 
arrhythmias
ischaemia and infarction
chamber hypertrophy
pericarditis
electrolyte imbalance
drug toxicity
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9
Q

what is the dominant pacemaker of the heart?

A

sinoatrial node

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10
Q

what is the intrinsic rate of the SA node?

A

60-100bpm

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11
Q

what are the backup pacemakers?

A

atrioventricular node and ventricular tissue

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12
Q

what is the intrinsic rate of the AV node?

A

40-60bpm

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13
Q

what are tachycardia and bradycardia?

A

tachy-fast heart beat

brady-slow heart beat

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14
Q

what is dextrocardia?

A

heart on the wrong side of the chest

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15
Q

what is stroke volume?

A

volume ejected from each ventricle during systole

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16
Q

what are risk factors for atherosclerosis?

A 
age
obesity
smoking
diabetes
cholesterol
hypertension
family history
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17
Q

what are 4 components of atherosclerotic plaque?

A

lipid, necrotic core, connective tissue, fibrous cap

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18
Q

what initiates atherosclerosis?

A

endothelial damage

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19
Q

what are 3 inflammatory cytokine found in plaques?

A

IL-1 ***
IL-6
IFN gamma

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20
Q

what is angina?

A

chest pain caused by ischaemia

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21
Q

what is characteristic of stable angina?

A

induced by effort

relieved by rest

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22
Q

what is characteristic of unstable angina?

A

continues at rest

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23
Q

what is the first line for treatment of angina?

A

GTN spray

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24
Q

how does GTN spray help relieve angina?

A
  1. causes systemic veno-dilation meaning the venous return to the heart is less and hence preload is lower. This means the demand on the heart is less.
  2. causes coronary arteries to dilate
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25
Q

what does PCI stand for?

A

percutaneous coronary intervention

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26
Q

what are positives of PCI?

A

less invasive
short recovery
repeatable

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27
Q

what are the negatives associated with PCI?

A

risk of stent thrombosis
infection
not good for complex cases

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28
Q

what does CABG stand for?

A

coronary artery bypass graft

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29
Q

what are the negatives associated with CAGB?

A

invasive
stroke and bleed risk
long recovery time
one off treatment

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30
Q

what are the positives with CABG?

A

good prognosis

deals with complex disease

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31
Q

which conditions make up acute coronary syndromes?

A

STEMI
N-STEMI
unstable angina

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32
Q

what are the characteristics of a patient with STEMI in:

a) coronary artery
b) heart muscle ?

A

a) full occlusion of coronary artery

b) full thickness damage to muscle

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33
Q

what are the characteristics of a patient with NSTEMI in:

a) coronary artery
b) heart muscle

A

a) partial or complete occlusion

b) partial thickness damage to muscle

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34
Q

what is the detectable difference between NSTEMI and unstable angina?

A

high serum troponin or creatine kinase MB

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35
Q

what are 5 stages of atherosclerosis leading to MI/stroke?

A
  1. fatty streak
  2. fibrotic plaque
  3. atherosclerotic plaque
  4. rupture and thrombus
  5. MI/stroke
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36
Q

what test can be used to check for cardiomegaly, pulmonary oedema or widened mediastinum due to aortic rupture?

A

chest xray

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37
Q

what is the target range for oxygen sats in a normal individual?

A

94-98%

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38
Q

what is the target range for oxygen sats in someone with COPD?

A

88-92%

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39
Q

what type of drug is aspirin and how does it work?

A

antiplatelet

COX1 inhibitor- blocking formation of thromboxane A2

40
Q

what are the consequences of hypertension?

A

‘cerebrovascular events’- stroke
IHD
peripheral vascular disease

41
Q

what level is considered hypertension?

A

140/90 mmHg

42
Q

at what level, in clinic, does hypertension reach stage 2?

A

160/100mmHg in clinic

43
Q

how is severe hypertension quantified?

A

systolic 180mmHg+

diastolic 110mmHg+

44
Q

what causes of hypertension make up primary hypertension?

A

primary cause unknown but any combination of:

  • genetics
  • sympathetic activity
  • high salt
  • faulty membrane transporters
  • RAAS abnormalities
45
Q

what are the causes of secondary hypertension?

A

renal disease

pregnancy

46
Q

what is the most common cause of secondary hypertension?

A

chronic kidney disease

47
Q

what is the most common cause of chronic kidney disease?

A

diabetes

48
Q

which drugs can cause hypertension?

A 
corticosteroids
erythropoietin
contraceptive pill
alcohol
ecstasy
cocaine
49
Q

what are risk factors of hypertension?

A 
age
race
family history
obesity
lack of exercise
smoking
salt intake
alcohol
diabetes
stress
50
Q

what is malignant hypertension?

A

high blood pressure with life threatening side effects, risk to one or more organs

51
Q

what are the consequences of malignant hypertension?

A

cardiac failure
blurred vision
renal failure
severe headache

52
Q

what are the treatments for hypertensives?

A

-lifestyle changes
-ACD
ace inhibitors
calcium channel blockers
diuretics

53
Q

what is treatment goal for BP in hypertensives?

A

140/90mmHg

54
Q

how do hypertensives usually present clinically?

A

asymptomatic unless malignant hypertension

55
Q

what tests can be done in a hypertensive do detect LV hypertrophy?

A

ECG, echocardiography

56
Q

what is infective endocarditis?

A

infection of the endocardium or vascular endothelium of the heart

57
Q

what type of endocarditis is common in IVDU?

A

right sided endocarditis

58
Q

which type of virulent organisms commonly infect normal valves?

A

streptococcus pneumoniae

staphylococcus aureus

59
Q

what are risk factors for infective endocarditis?

A 
IV drug use
poor dental hygiene
dental treatment
IV cannula
pacemaker
cardiac surgery
60
Q

how does poor dental hygiene increase risk of infective endocarditis?

A

gum disease causes bleeding gums and therefore bacteria is able to enter bloodstream

61
Q

what are the 4 valvular heart diseases?

A

mitral stenosis
aortic stenosis
mitral regurgitation
aortic regurgitation

62
Q

what type of valve is the mitral and where does it sit?

A

bicuspid valve

between left atrium and ventricle

63
Q

what is heart failure?

A

inability of the heart to deliver blood (o2) at equivalent rate to requirement of metabolising tissue

64
Q

what is the main cause of heart failure?

A

IHD

65
Q

what are causes of heart failure?

A 
IHD
cardiomyopathies
valvular diseases
cor pulmonale (pul hypertension causes)
hypertension
alcohol
arrhythmias
pregnancy
etc
66
Q

risk factors for heart failure

A 
65+
African descent
male
obesity
previous MI
67
Q

what are the 2 types of acute MI?

A

STEMI and NSTEMI

68
Q

what is an acute myocardial infarction?

A

necrosis of cardiac tissue due to prolonged ischaemia from occlusion of artery by thrombus

69
Q

what are the risk factors for MI?

A 
age
male
CHD
premature menopause
diabetes
smoking
hypertension
high lipids
obesity
family history
70
Q

what are clinical presentations of someone suffering MI?

A 
chest pain- radiating left arm, jaw, neck
breathlessness
fatigue
anxiety
pale, clammy. sweating
hypotension
brady or tachy
71
Q

what type of valve is the aortic valve and where is it located?

A

tricuspid valve

separates left ventricle from aorta

72
Q

how big is the aortic valve in normal adult heart?

A

3-4cm2

73
Q

what is the most common valvular disease in the western world?

A

aortic stenosis

74
Q

what are the 3 types of aortic stenosis?

A

supravalvular
valvular
subvalvular

75
Q

which type of aortic stenosis is most common?

A

VALVULAR

76
Q

what type of aortic stenosis is common in elderly?

A

CAVD- calcific aortic valvular disease

77
Q

what type of aortic stenosis is a common congenital disease?

A

BAV- bicuspid aortic valve

calcification of BAV

78
Q

which congenital disease predisposes to aortic stenosis?

A

congenital bicuspid aortic valve

79
Q

from which cells do platelets form?

A

megakaryocytes

80
Q

what is menorrhagia?

A

heavy periods

81
Q

what are possible causes of macrocytic anaemia?

A

b12/folate deficiency
liver disease/alcoholism
hypothyroidism

82
Q

what is anaemia?

A

reduced red cell mass

83
Q

what are consequences of anaemia?

A

reduced o2 transport

tissue hypoxia

84
Q

what are the compensatory changes as a consequence of anaemia?

A

increased tissue perfusion
increased O2 transfer to tissues
increased red cell production

85
Q

what is the normal range roughly for erythrocyte volume in humans?

A

80-100 fl

86
Q

what are the 3 categories for anaemia clinically?

A

macro, normo and microcytic

87
Q

what are 3 causes of microcytic anaemia?

A

iron deficiency
chronic disease
thalassaemia

88
Q

what are 3 causes of normocytic anaemia?

A

acute blood loss
anaemia of chronic disease
combined haematinic deficiency

89
Q

how long does a normal red cell survive?

A

120days

90
Q

how can a small decrease in red cell numbers be compensated for?

A

increased erythropoietin

decreased apoptosis

91
Q

what are the 3 classifications of B thalassaemia clinically?

A

major, intermedia, carrier

92
Q

at what age does a patient with B thalassaemia major commonly present~?

A

6-12 months, baby

93
Q

what is the lifespan of platelets?

A

7-10days

94
Q

what are possible causes of low platelets?

A 
congenital
marrow problems
drugs
splenomegaly
autoimmune
haemorrhage
95
Q

what is the name given to the condition of low platelet count?

A

thrombocytopenia

96
Q

where are platelets produced and destroyed?

A

bone marrow

spleen

Phase2A (8 decks)

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