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GI cancers > cv questions 2 > Flashcards

cv questions 2 Flashcards

1
Q

features of coagulation disorders?

A

DEEP BLEEDING
DELAYED ONSET
SPORADIC BLEEDING INTO JOINTS
BLEEDING AFTER SURGERY

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2
Q

tests for coagulation disorders?

A

APTT, PT
BLOOD COUNT
CF ASSAYS

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3
Q

Which 3 conditions see a raised SPTT and normal PT?

A

HAEMOPHILIA A AND B

FACTOR 11 AND 12 DEfICIENCY

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4
Q

when is a normal APTT and raise PT seen?

A

factor 7 deficiency

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5
Q

which conditions see a normal APTT and raised PT

A

factor 7 deficiency

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6
Q

in which conditions are both aptt and pt raised?

A

liver failure
transfusion
dic
anticoagulant

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7
Q

what is seen in cryoprecipitate?

A

wvf
factor 2
factor 8
factor 13

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8
Q

what 2 new therapies could be used for haemophilia?

A

gene therapy

bispecific antibodies which bind to f9a and f10 and mimics the procoagulant function of 8

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9
Q

how does thrombophilia present?

A

YOUNG AGE,
THROMBOSIS DESPITE
ANTICOAGULATION

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10
Q

what do proteins c and s do

A

prevent clotting by inactivating 5a and 8a

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11
Q

what does antithrombin do?

A

inactivates 2a and 10a

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12
Q

how does warfarin work?

A

vit k inhibitor

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13
Q

what are the 3 layers of blood vessels?

A

ADVENTITIA - VASA VASORUM, NERVES
TUNICA MEDIA - SMOOTH MUSCLE
LAMINA INTIMA - ENDOTHELIUM

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14
Q

how are capillaries and venules supported?

A

1 cell thick

suppoted by matrix and mural cells

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15
Q

what 5 functions does the endothelium regulate?

A 
ORGAN REGENERATION 
INFLAMMATION 
PROLIFERATION 
VASCULAR TONE AND PERMIABILITY 
HAEMOSTASIS AND THROMBOSIS
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16
Q

outline how an atheroscleroma form?

A 
increased vascular permiability due to endothelial activation 
more LDLs in, bind to proteoglycan 
more immune cells macrophages in
foam cells release metalloproteinases
angioneogenesis
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17
Q

roles of no on endothelium?

A

VASODILATES
REDUCES PROLIFERSTION
LESS WHITE CELL ADGESION
LESS OXIDATION OF LDL

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18
Q

what does laminar flow promote?

A

antiinflammatory
antiproliferative
antithrombotic

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19
Q

what are the 3 laters of the heart?

A

endocardium
myocardium
epicardium

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20
Q

what is the tetrology of fallot

A

pulmonary stenosis
overriding aorta
VSD
rv hypertrophy

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21
Q

what is heard on ascultatino of aortic stenosis?

A

systolic murmur moving towards s2

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22
Q

risk factors of aortic stenosis?

A 
rheumatic fever 
age 
elevated CRP 
hypertension
ckd 
ldl
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23
Q

outline the pathophysiology of aortic stenosis

A

STIFFENING OF VALVES - MORE DIFFICULT TO GET BLOOD OUT -
REDUCED CARDIAC OUTPUT AFTER COMPENSATION MECHANISMS FAIL.
LEFT SIDED HYPERTROPHY.
SYSTOLIC HEART FAILUTE

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24
Q

how does aortic stenosis present?

A

tachynpoea, chest pain, ejection murmur

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25
Q

5 investivgations for aortic stenosis?

A 
echo 
ecg
cardiac mri
cxr 
cardiac catheterisation
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26
Q

primary treatment for aortic stenosis?

A

valve replacement

beta blockers, alpha blockers, bp control, statins

27
Q

2 things which may cause aortic vavle insufficiency

A

rupture due to infection or dilation of aortic root

28
Q

sequelae of chronic aortic regurgitation

A

congestive heart failure

oedema

29
Q

sequelae of acute aortic regurgiation?

A

acute decompensation,
cardiogenic shock,
pulmonary oedema

30
Q

5 causes of aortic regurgitation?

A

infective endocarditis
rheumatic fever
marfans
trauma

31
Q

outline the pathophysiiology of acute AR?

A

RUPTURE OF VALVES,
REDUCED CARDIAC OUTPUT, REDUCED DIASTOLIC PRESSURE,
BACKFLOW TO PULMONARY VEINS LEADING TO PULMONARY OEDEMA HYPOPERFUSION TO ORGANS AND SHOCK

32
Q

outline the pathophysiology of chronic ar?

A

SAME BUT INSIDIOUS WITH COMPENSATION MECHANISMS.

LV HYPERTROPHY, DYSNPNOEA, LOW CORONARY PERFUSIUON

33
Q

how does acute ar present?

A

austin flint murmur
tachycardia
pulmonary oedema

34
Q

how does chronic ar present

A

wide pulse pressure

pistol shot pulse

35
Q

how is chronic ar treated?

A

ASYMPTOMATIC - BETA BLOCKERS AND BP MEDICATIONS

SEVERE ASYMOTOMATIC - REPLACEMENT

SYMPTOMATIC - REPLACEMENT

36
Q

how is acute ar treated?

A

valve replacement and vasodilators

37
Q

how does mitral stenosis cause pulmonary hypertension?

A

STIFFENING OF MITRAL VALVE, BACKFLOE INTO PULMONARY VEINS AND PULMONARY HYPERTENSION

38
Q

3 causes of mitral stenosis?

A

theumatoid fever
sle
carcinoid syndrome

39
Q

how does mitral stenosis present?

A

dyspnoea, haemoptysis, chest pain, diastolic murmur

40
Q

when is a balloon valvectomy offered in mitral stenosis/

A

severe asymptomatic

severe symptomatic

41
Q

pathophysiology of mitral tegurgitation?

A

BACKFLOW, PROLONGED VOLUME OVERLOAD, VENTRICULAR DYSFUNCTION, LV FAILURE

42
Q

how does mitral regurgitation present?

A

murmur,
deminished s1
atrial fibrilation

43
Q

how is acute mitral regurgitation treated?

A

replacement
intraaortic balloon counterpulsation
preop diuretics

44
Q

how is chronic asymptomatic ar treated?

A

ACEi

drugs and surgery if EF<60

45
Q

what is the first line treatment for mr if ef is low?

A

intraaortic balloon counterpulsation

46
Q

pathyphysiology of dilated cardiomyopathy?

A 
enlargemet of lv
low ef
increase in esv and wall stress
compensation fails 
hf
47
Q

presentation of dilated cardiomyopathy

A

displaced apex beat

48
Q

treatment of dilated cardiomyopathy

A 
councelling 
diet modification 
treat underlying condition
ace i b blockers diuretics 
heart transplant
49
Q

hypertrophic cardiomyopathies

A 
abnormal diastolic function as small cavity 
increased ventricular pressure 
ventricular failure 
ischaemia t ocoronary vessels 
myopathy 
death
50
Q

investifations for hypertrophic cardiomyopathy

A 
hb level (low)
bnp 
troponin (higher levels of these indicate higher risk)
echo
chest xray
cardiac mri
51
Q

management of hypertrophic cardiomyopathy?

A

beta blockers
veramapril (ccb)
pacemaker
septal ablation

52
Q

what is restrictive cardiomyopathy?

A

characterised by diastolic dysfunction and normal systolic function

volume and thickness of ventricles usually normal

the muslce is stiffened so cant contract properly in diastole

53
Q

some causes of restrictive cardiomyopathy?

A

familial (troponin muttion)
sacoidosis
fabrys disease
scleroderma

54
Q

outline the pathophysiology of restrictive cardiomyopathy

A

muscle is stiff so cant relax or contract properly in diastole - reduced compliance

increased stiffness leads to increased ventricular pressure, reduced compliance, cant fill properly

lower co

55
Q

presentation of restrictive cardiomyopathy

A 
comfortable in sitting pos 
hepatomegaly 
weight loss
easy bruising 
low sv and co
56
Q

investigations for restrictinve myopathy

A 
cbc serology, amyloidosis check 
xray 
ecg 
cho
 catheterisation
57
Q

management

A

heart failure medication (acei and arbs, diuretics)

anti arrhythmia
steriods for immunosuppression
pacemaker
cardiac transplantation

58
Q

what is the equation for ph?

A

[H+]= 10(-pH)

59
Q

what is the role of macrophage scavenger receptors a and b?

A

A - BINDS TO OXIDISED LDL AND DEAD CELLS AND BACTERIA

B - BINDS TO OXIDISED LDL AND MALARIA

60
Q

what free radicals do macropgages release?

A

METALLOPROTEINASES
NADPH OXIDASE
MYELOPEROXIDASE

61
Q

what does il 1 do to vcam

A

upregulates it

62
Q

what 3 other things do macrophage do to cause atherosclerosis

A

CYTOKINES IL1
CHEMOKINES - MCP UP
EXPRESS CHEMOATTRACTANTS
FREE RADIACS

63
Q

what does nuclear factor kappa b do?

A

MASTER REGULATOR OF ATHEROSCLEROSIS
MATRIX METALLOPROTEINASES
NO SYNTHASE
IL1

GI cancers (18 decks)

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