DAY 4 (patho cardio)

Question 1

What is acute coronary sinus (ACS)?

Answer 1

a range of acute myocardial ischaemic (low o2) states

Question 2

Examples of ACS.

Answer 2

-angina (chest pain)
-STEMI (coronary artery fully blocked)
-Non-STEMI (coronary artery partially blocked)

STEMI= Heart attack (myocardial infarction)

Question 3

What is atherosclerosis?

Answer 3

Blocked vessels, due to plaque

Question 4

What is thrombus?

Answer 4

fixed clot (stationary)

Question 5

What is embolus?

Answer 5

moving clot

Question 6

What is myocardial infarction?

Answer 6

heart attack, due to coronary artery being blocked

Question 7

What is cardiac remodelling?

Answer 7

myocardium is injured, causes heart structure to change
-thinning on myocardium

Question 8

What is cardiac catheterisation?

Answer 8

helps unblock vessel, needle goes it and “blows up vessel” back to original size

Question 9

What are the signs of myocardial infarction?

Answer 9

pain in chest
anxiety
ECG changes
patients general appearance
HR
BP
respiration
temperature
dyspnea (shortness of breath)
diaphoresis (sweating)

Question 10

What is cardiac arrest?

Answer 10

when the hearts not working properly

Question 11

Shockable rhythm examples:
(can defib)

Answer 11

Pulseless Ventricular Tachycardia (VT) (hearts going too fast)
Ventricular fibrillation (VF) (not a normal heart rhythm)
Torsade’s de Pointes (abnormal rhythm: long Q-T interval)

Question 12

Non-shockable rhythm examples:
(can’t defib)

Answer 12

pulseless electrical activity (PEA) (heart can’t convert electricity into contraction)
asystole (flatline) (perform CPR)

Question 13

What is shock?

Answer 13

When the heart fails, blood doesn’t spread to the tissues, so the tissues don’t get enough o2

Question 14

What is the perfusion triangle?

Answer 14

-heart
-blood vessels
-blood

if one is removed shock occurs

Question 15

What is hypovolaemic shock?

Answer 15

not enough blood circulating
e.g due to trauma, internal bleed, burn

Question 16

What is cardiogenic shock?

Answer 16

heart can’t contract, not enough pressure/ outflow is prevented

Question 17

What is obstructive shock?

Answer 17

something is blocking the vessels e.g embolism
-jugular venous distension (vein on neck is bigger than normal)

Question 18

What is distributive shock?

Answer 18

loss of elasticity/ vessel is leaky/ enlargement of vascular space

Question 19

What are the 3 types of distributive shock?

Answer 19

septic
neurogenic (vasogenic)
anaphylactic

Question 20

What is neurogenic shock?

Answer 20

can’t keep shape of vessel
increases vessel size, decreases pressure

Question 21

What is anaphylactic shock?

Answer 21

-allergic reaction, histamine is released which causes arteries and capillaries to dilate/ increase permeability

Question 22

What is septic shock?

Answer 22

from a bacterial infection
toxins alter pressure and permeability

Question 23

What is drowning?

Answer 23

primary respiratory impairment from submersion/ immersion in a liquid

-don’t have to die to drown

Question 24

What is immersion?

Answer 24

partly covered in liquid medium

Question 25

What is submersion?

Answer 25

fully covered in liquid medium

Question 26

Sea water drowning:

Answer 26

hypertonic (lots of salt)
blood viscosity (resistance) increases
hypoxia (low o2 in tissue)
pulls fluid into alveoli
pulmonary oedema (fluid in airway)

Question 27

Fresh water drowning:

Answer 27

hypotonic (not a lot of salt, more water)
impacts blood pH
dilutes surfactant, alveoli collapse

Question 28

What is V/Q?

Answer 28

Ventilation (good o2 supply) and Perfusion (good blood supply)

ventilation (4L/ min)
—————————— = 0.8
perfusion (5L/ min)

Question 29

What is pulmonary shunting?

Answer 29

return of blood to the heart (left atrium) from the lungs (alveoli) that isn’t oxygenated (deoxygenated)

Question 30

What is respiratory failure?

Answer 30

failure of gases exchange
leads to drop in blood o2 (hypoxaemia)

Question 31

What is asthma?

Answer 31

chest tightness (bronchi contract)
chronic, inflammatory
lots of mucus
wall inflamed and thickened

Question 32

What are the symptoms of asthma?

Answer 32

dyspnoea (shortness of breath)
wheezing
hyperinflated chest

Question 33

What is Chronic Obstructive Pulmonary Disease?

Answer 33

progressive lung conditions (inflamed, damaged, narrowed)
frequent respiratory infection
types: chronic bronchitis, emphysema

Question 34

What is chronic bronchitis?

Answer 34

airway swelling and thickening
goblet cells increase mucus
short cilia

Question 35

What is emphysema?

Answer 35

enlarged air sac
loss of elastic
alveoli damaged (hard to breathe)

Question 36

What are chronic bronchitis symptoms?

Answer 36

persistent, productive cough with thick white mucus
wheeze/ breathlessness
green/ yellow/ red sputum

Question 37

what are emphysema symptoms?

Answer 37

breathlessness
barrel shaped chest

Question 38

What is a pulmonary embolus?

Answer 38

It’s a blood clot (embolus= travelling blood clot)
originated from thrombus

Question 39

What are symptoms of pulmonary embolus?

Answer 39

Small/ moderate embolus:
-tachycardia
-chest pain
-wheezing
-breathlessness

large embolus:
-cyanosis
-hypotension (high bp)
-more extreme symptoms

Question 40

What is Pleural Effusion?

Answer 40

Build up of fluid between lungs and chest wall (pleural space)

Question 41

What are the symptoms of Pleural Effusion?

Answer 41

severe, sharp pain when inhaling
friction: grating/ leathery sounds
intercostal tenderness

Question 42

What is Pneumonia?

Answer 42

infection of the alveoli and interstitial

Question 43

What is Pulmonary Oedema?

Answer 43

accumulation of fluid in interstitial spaces/ alveolar spaces
increased permeability/ increased pressure

Question 44

What is eupnoea?

Answer 44

normal, quiet breathing

Question 45

What is apnoea?

Answer 45

absence of breathing

Question 46

What is orthopnoea?

Answer 46

laboured breathing when lying flat