CV Diseases & Complications

Question 1

Define chronic HTN.

Answer 1

1) Resting MAP > 100 mmHg
2) DBP > 90
3) SBP > 135

Question 2

What are the types of primary/essential HTN?

Answer 2

1) salt-sensitive

2) salt-insensitive

Question 3

What physiological parameters are associated with primary HTN?

Answer 3

increased: CO, SNS, AngII, aldosterone

Question 4

In what patients is volume-loading HTN commonly seen?

Answer 4

dialysis pts, primary aldosteronism, excessive Na/H2O intake

Question 5

Describe the course, from onset to chronic manifestation, of volume-loading HTN.

Answer 5

1) kidney fx compromised
2) baroreceptor initially causes acute decrease in TPR
3) MAP increase is chronic days after baroreflex

Question 6

Describe the 2 manifestations of circulatory shock?

Answer 6

shock caused by…

1) decreased CO
2) no change in CO, or increased CO

Question 7

What conditions could cause decreased CO leading to shock?

Answer 7

1) cardiogenic: MI, valve dysfunction, arrhythmias

2) decreased preload: hypovolumia, hemorrhage, decreased vascular tone, obstruction

Question 8

What are the stages of circulatory shock?

Answer 8

1) nonprogressive/compensated
2) progressive
3) irreversible

Question 9

How does neurogenic shock come about?

Answer 9

decreased vascular tone -> decreased preload

due to…anesthesia, VMC damage

Question 10

What is the mechanism behind septic shock?

Answer 10

increased fever –> vasodilation –> increased CO

• • heart can’t keep up
• • Ag/Ab agglutination –> clotting

Question 11

What are treatments for shock?

Answer 11

1) transfusion
2) dextran solution (to increase colloidal osmotic pressure)
3) sympathomimetics (neuro & anaphylactic)

Question 12

Define heart failure.

Answer 12

failure of the heart to supply blood to meet the metabolic needs of the body

Question 13

What are causes of CHF?

Answer 13

CAD, MI, cardiomyopathy, valvular heart disease

Question 14

What are the consequences of compensated heart failure?

Answer 14

1) fluid retention –> excessive edema
2) cardiac remodeling & hypertrophy
3) neovascularization

Question 15

How is decompensated heart failure treated?

Answer 15

diuretics & digitalis

Question 16

what occurs during decompensated heart failure?

Answer 16

CO cannot drive kidney filtration

Question 17

How is recovery achieved in acute cardiac failure?

Answer 17

1) sympathetic stimulation

2) kidney

Question 18

What does NPC1 do?

Answer 18

absorbs cholesterol

Question 19

What does G5G8 do?

Answer 19

effluxes cholesterol

Question 20

What does ACAT2 do?

Answer 20

esterifies cholesterol (less toxic form)

Question 21

When is SREBP2 activated?

Answer 21

under low-sterol conditions

Question 22

What does SREBP2 stand for?

Answer 22

Sterol receptor element binding protein 2

Question 23

What does SREBP2 do?

Answer 23

It is cleaved from its regulatory element in the golgi to form a transcription factor to…

1) stimulate LDL receptor synthesis
2) stimulate sterol synthesis…HMG CoA synthase, HMG CoA reductase, squalene epoxidase, e tc

Question 24

What is the target of statins?

Answer 24

HMG CoA reductase to inhibit sterol synthesis

Question 25

Where are ABCA1 & ABCG1 located?

Answer 25

on the macrophage.

Question 26

What does CETP do?

Answer 26

catalyzes reaction from HDL –> LDL