CV Diseases & Complications Flashcards
Define chronic HTN.
1) Resting MAP > 100 mmHg
2) DBP > 90
3) SBP > 135
What are the types of primary/essential HTN?
1) salt-sensitive
2) salt-insensitive
What physiological parameters are associated with primary HTN?
increased: CO, SNS, AngII, aldosterone
In what patients is volume-loading HTN commonly seen?
dialysis pts, primary aldosteronism, excessive Na/H2O intake
Describe the course, from onset to chronic manifestation, of volume-loading HTN.
1) kidney fx compromised
2) baroreceptor initially causes acute decrease in TPR
3) MAP increase is chronic days after baroreflex
Describe the 2 manifestations of circulatory shock?
shock caused by…
1) decreased CO
2) no change in CO, or increased CO
What conditions could cause decreased CO leading to shock?
1) cardiogenic: MI, valve dysfunction, arrhythmias
2) decreased preload: hypovolumia, hemorrhage, decreased vascular tone, obstruction
What are the stages of circulatory shock?
1) nonprogressive/compensated
2) progressive
3) irreversible
How does neurogenic shock come about?
decreased vascular tone -> decreased preload
due to…anesthesia, VMC damage
What is the mechanism behind septic shock?
increased fever –> vasodilation –> increased CO
- heart can’t keep up
- Ag/Ab agglutination –> clotting
What are treatments for shock?
1) transfusion
2) dextran solution (to increase colloidal osmotic pressure)
3) sympathomimetics (neuro & anaphylactic)
Define heart failure.
failure of the heart to supply blood to meet the metabolic needs of the body
What are causes of CHF?
CAD, MI, cardiomyopathy, valvular heart disease
What are the consequences of compensated heart failure?
1) fluid retention –> excessive edema
2) cardiac remodeling & hypertrophy
3) neovascularization
How is decompensated heart failure treated?
diuretics & digitalis
what occurs during decompensated heart failure?
CO cannot drive kidney filtration
How is recovery achieved in acute cardiac failure?
1) sympathetic stimulation
2) kidney
What does NPC1 do?
absorbs cholesterol
What does G5G8 do?
effluxes cholesterol
What does ACAT2 do?
esterifies cholesterol (less toxic form)
When is SREBP2 activated?
under low-sterol conditions
What does SREBP2 stand for?
Sterol receptor element binding protein 2
What does SREBP2 do?
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
What is the target of statins?
HMG CoA reductase to inhibit sterol synthesis
Where are ABCA1 & ABCG1 located?
on the macrophage.
What does CETP do?
catalyzes reaction from HDL –> LDL
