CV Part 4

Question 1

Primary HTN

Answer 1

No identifiable cause

Question 2

Secondary HTN

Answer 2

Uncontrolled BP despite optimal medications
Abrupt onset
There is a cause

Question 3

Angiotensin (4)

Answer 3

Potent vasoconstrictor
Stimulates aldosterone secretion
Can block HP baroceptors
Stimulate release of norepi from post-ganglionic SNS fibers

Question 4

Aldosterone

Answer 4

Na reabsorption from the forming urine

Leads to H2O retention

Question 5

What are some possible treatments for HTN?(5)

Answer 5

ACE inhibitor
Renin inhibitor
B blocker
Ca channel blocker
Diuretic

Question 6

Concentric LVH (5)

Answer 6

Systolic wall stress
Pressure overload
Thick wall
Thin cavity
Sarcomeres in parallel

Question 7

What can cause concentric LVH? (2)

Answer 7

HTN

Aortic stenosis

Question 8

Eccentric LVH (5)

Answer 8

Diastolic wall stress
Volume overload
Thin wall
Thick cavity (dilated)
Sarcomeres in series

Question 9

What can cause eccentric LVH? (2)

Answer 9

Aortic insufficiency

Arteriovenous fistula

Question 10

Conductance is

Answer 10

Blood flow

Question 11

What’s the relationship between velocity and area?

Answer 11

Inversely proportional

Question 12

What happens to FLOW if the difference between arterial and venous pressure increases, while resistance is constant?

Answer 12

Increases

Question 13

Laminar flow

Answer 13

Streamlined movement

Predominant in vasculature under normal conditions

Question 14

Turbulent flow

Answer 14

Random flow

Question 15

How does exchange occur between capillaries and the interstitial space?

Answer 15

Diffusion

Question 16

What are Starling forces?

Answer 16

Forces in the lumen and interstitium of the capillary that determines what direction the fluid will move

Question 17

What is the movement of the fluid on the arterial end of a capillary?

Answer 17

Outward (known as filtration)

Question 18

What is the movement of fluid on the venous end of a capillary?

Answer 18

Inward (reabsorption)

Question 19

Edema

Answer 19

Build up of interstitial fluid

Question 20

2 possible causes for edema

Answer 20

Increased arterial pressure → inc capillary pressure so too much fluid is pushed out

Decreased venous return → back pressure exerted so you inc capillary pressure and too much fluid pushed out

lymphatic is overwhelmed

Question 21

What do we do with the extra fluid in the interstitium that isn’t picked back up by the capillaries?

Answer 21

Picked up and sent to the lymphatic system so that it can go back to venous circulation

Question 22

Capillary allows for exchange of:

Answer 22

H2O soluble molecules → pores

Lipid soluble molecules → blood gases via plasma membrane

Question 23

3 components of the vascular networks

Answer 23

Resistance (arteries and arterioles)
Exchange (capillaries)
Capacitance (veins)

Question 24

Important vasodilator (4)

Answer 24

Adenosine
CO2
H+
lactic acid

Question 25

Anything that obstructs CO can lead to

Answer 25

Elevations in RAP → compromise venous return

Question 26

What can happen if you have right heart failure?

Answer 26

Elevated RAP → increased venous pressure in jugular and hepatic portal circulations

Question 27

Pulse pressure

Answer 27

Systolic - Diastolic pressure

Question 28

When does the majority of myocardial O2 uptake occur?

Answer 28

During diastole

Question 29

How does adenosine work?

Answer 29

Block Ca entry into VSM

Induce vasodilation

Question 30

How is the myocardium supplied with O2?

Answer 30

Coronary arteries

Question 31

What are some factors that modulate coronary vascular tone?

Answer 31

Vasodilators (NO, H+, CO2)

Question 32

What’s the order of myocardial O2 demand?

Answer 32

1. Ventricular wall stress
   HR
   Inotropy (contractility)

Question 33

What is ischemia?

Answer 33

Localized anemia due to reduced blood supply