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Clinical Medicine 3 > Dr. Houston (Cardio)- Exam 1 > Flashcards

Dr. Houston (Cardio)- Exam 1 Flashcards

1
Q

What is the pathway of the heart?

A
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2
Q

What are the different components of heart fibers (histology?

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3
Q
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4
Q

What is cardiomyopathy?
* What is primary and secondary?

A

Cardiomyopathy: Disease of the myocardium

  • Primary Cardiomyopathy – disease manifests directly (idiopathic, genetic, infection, alcohol/drugs)
  • 2nd Cardiomyopathy – develops to compensate for other diseases (e.g. hypertension, valve diseases
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5
Q

Dilated cardiomyopathy:
* What are the causes?

A

Idiopathic, Genetic mutations, Infection, Alcohol/drug abuse

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6
Q

What is the patho behind dilated cardiomyopathy? Txt?

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7
Q

Hypertrophic Cardiomyopathy
* What are the causes?

A

Most commonly - Autosomal missense mutation in sarcomere protein

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8
Q

Hypertrophic cardio
* What is the patho?

A
  • New cardiomyocytes added parallel
  • Causes myocardium becomes thick, heavy, and hypercontractile
  • Usually LV hypertrophy (mostly on interventricular septal wall)
  • New muscle fills chamber = decreased chamber volume
  • New muscle = increased stiffness (less compliant)
  • Both = decreased preload = decreased CO
  • Classified as Diastolic heart failure
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9
Q

Hypertrophic Obstructive Cardiomyopathy
* What does it cause?
* Decreases what?
* What type of mumor?
* What can happen?

A
  • Interventricular septal wall bloc.
  • Mitral valve can be pulled medially (Venturi effect) = decreased SV
  • Crescendo-decrescendo mumor
  • Ischemia (more muscle, but less efficient CO to coronary arteries
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10
Q

txt of hypertrophic cardio?

A

Beta blockers, calcium channel blockers, surgery

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11
Q

Restrictive Cardiomyopathy
* What are the causes?

A

Misfolded cardiac proteins (amyloidosis) – either genetic or w/age, sarcoidosis (granulomas), fibrotic deposits (fibroelastosis), hemochromatosis, ROS-induced inflammation

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12
Q

What is the patho and txt of restrictive cardio?

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13
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14
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15
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16
Q

What are the stages of the slow action potential?

A
  • 4: Na+ funny channels open = Na+ influx = RMP to threshold
  • 0: Ca2+ channels open, Ca2+ influx = depol
  • 3: K+ channels open = K+ efflux = repol
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17
Q

What are the steps of the fast action potential

A

4: Na+ influx = RMP to threshold

0: rapid Na+ influx = rapid depol, Na+ channels close

1: K+ (voltage gated) channels open, K+ efflux = repol

2: Ca2+ influx maintains plateau

3: Ca2+ channels close,
K+ channels open = repol

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18
Q
  • What is fibrillation?
  • What are the causes?
A
  • Fibrillation – quivering or twitching contraction – inefficient for pumping blood
  • Causes: Not fully understood. Risk factors - Inflammation of atria via CV disease (hypertension, coronary artery disease, valvular disease). Poor diet/lifestyle. Possible genetic factor.
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19
Q

What is the patho of afib

A
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20
Q
  • What is heart block?
  • What are the causes?
A

Heart block: arrhythmia where electrical signal delayed or blocked

Causes
* Damage or fibrosis to conduction system; Lev’s disease – idiopathic scarring
* Ischemic heart disease - heart attack = hypoxia = cardiomyocyte scar tissue
* Cardiomyopathies, Myocarditis, Medication

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21
Q

What is Atrioventricular block?

A
  • delay/interruption of electrical signal from atria to ventricles
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22
Q

What is first degree, second degree (type 1+2) and third degree?

A
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23
Q

Bundle branch block
* What is it?
* What are the causes?

A
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24
Q

What is the patho of bundle branch block?

A
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25
Q

Paroxysmal supraventricular tachycardia (PSVT)
* What is paroxysm?
* May last how long?
* What are the causes?

A
  • paroxysm = sudden, violent, Tachycardia = rest >100bpm, Supraventricular = in Atria
  • may last anywhere from a few minutes to a few days, and some people have no symptoms at all.
  • Causes: Stress, overexertion, Alcohol use, Caffeine use, Illicit drug use, Smoking, hyperthryodism, - medications (Digoxin)
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26
Q

What is the patho of Paroxysmal supraventricular tachycardia (PSVT)?

A
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27
Q

Premature beats
* What are they?
* What are the causes?

A
  • Earlier than normal contraction due to ectopic focus
  • Causes: Electrolyte imbalance, ischemic damage, drugs, anxiety, or Reenterant loop
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28
Q

What is the patho of premature beats (PAC and PVCs)?

A
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29
Q

Sick sinus syndrome (sinus node dysfunction)
* What are the causes?
* What is the patho?

A
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30
Q

What is first degree, second one and two and third degree SA block

A
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31
Q

Ventricular tachycardia
* HR?
* What is in a row?
* What happens with high HR?
* What are the causes?

A
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32
Q

What is the patho for the two types of v tach?

A
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33
Q

Ventricular fibrillation (VF, Vfib)
* What is fibrillation?
* What are the causes?
* What is the txt?

A
  • Fibrillation – quivering or twitching contraction – inefficient for pumping blood. High risk of sudden cardiac death
  • Causes: stress or damage causes cardiomyocyte heterogeneity - medications, illicit drugs, electrolyte
    imbalance, ischemia to cardiac tissue
  • Txt:Defibrillation to depolarize a critical mass of cells back into sinus rhythm
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34
Q

Long QT wave and Torsades de pointes
* What are the causes?
* What is the pahto?

A

Causes
* Genetic abnormality, medications (channel blockers).

Pathophysiology
* Long QT wave means ventricular repolarization lasts longer than normal in some heart cells
* Due to ion channel problems – dysfunctional L-type Ca2+ channels or Na+ & K+ channel problems

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35
Q
  • PVCs can form causes what?
  • Can causes polymorphic VT known as what?
A
  • PVCs can form causes reentrant circuits and reentrant tachycardia
  • Can causes polymorphic VT known as Torsades de pointes (twisting of points)
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36
Q

Cardiogenic shock
* What are the causes?

A

MI, obstructive shock – pericadical effusion leading to cardiac tamponade – fluid in pericardial sac - trauma

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37
Q

What is the patho of cardiogenic shock?

A
38
Q

What are the different layes of the heart?

A
39
Q
  • What are the different tropinins?
  • What happens to damage cells?
A
40
Q

What are the main braches of the coronary?

A
41
Q

Coronary Heart Disease
* What is the patho?

A
42
Q

Acute MI:
* What are the causes?

A
  • MI mostly due to endothelial (tunica intima) dysfunction
  • Via atherosclerosis – plaque build up (fat, cholesterol, proteins, calcium, WBC). Take years to fully form
43
Q

What is the patho of MI?

A

Degree of damage and ECG changes depends on duration of ischemia:
* Inner 1/3rd closest to endocardium most damaged by ischemia (farthest from artery and under high pressure from chamber lumen)
* If clot suddenly lysis and bloodflow restored damage can be limited to inner 1/3rd – subendocardial infarct nottransomural
* ECG of subendocardial infarct shows a ST-segment non elevation (NSTEMI).
* If ischemia persists = necrosis to entire heart wall
* Called a Transmural Infarct
* ECG show ST-segment elevation (STEMI

44
Q

What is the difference in NSTEMI and STEMI on EKG?

A
45
Q
A
46
Q

Angina pectoris
* What is angina? Pectoris?
* What is it?
* Causes?

A
  • Angina – “to strangle”
  • Pectoris – “chest”
  • Reduced coronary blood flow = tissue ischemia = anaerobic respiration = lactate = pain, but no damage
  • Causes: same as MI
47
Q

Angina pectoris patho? (3 types)

A

Different types of Angina depending on whether pain w/ or w/o physical exertion
1. Stable angina – pain during exercise/stress – releveled by rest
2. Unstable angina – pain during exercise/stress – continues during rest (doesn’t go away)
3. Vasospastic angina (Prinzmetal) – can occur anytime (even at rest)

48
Q

Coronary Heart Disease
* Unstable vs vasospastic?

A
49
Q
A
50
Q

What is the difference bn vein, venule, large/mid artery and arteriole?

A
51
Q
A
52
Q

What is the clotting casade pathway?

A
53
Q

What is the patho of aneursym?

A
  • Aneurysm – abnormal dilation/bulge in vessel
  • Define as when diameter 1.5x that of normal
  • Any artery (rarely in a vein)
  • Due to weakness in vessel wall
54
Q

What are the types of aneurysms?

A
55
Q

Types of aneurysms:
* What are the causes?

A
56
Q

Aortic aneurysm
* What is MC?
* What is the MC site?

A
  • Most common - Aortic aneurysms most common (40% thoracic aorta, 60% abdominal aorta)
  • Most common site between renal arteries and common iliac artery bifurcation (less elastin in walls)
57
Q

what is the patho of aortic aneurysm?

A
58
Q

What can Aortic aneurysm lead to?

A
  • Ruptured aneurysm = loss of blood delivery = ischemia distally
  • If aneurysm near aortic valve can cause aortic insufficiency
  • If in brain = Subarachnoid space bleed
  • Clots
  • Syphilis (tertiary) causes inflammation/fibrosis of vasa vasorum – Endarteritis obliterans
59
Q

Aortic dissection
* Tear where?
* Blood pools where?
* What are the causes?

A
60
Q

What is the patho of aortic dissection? What can it lead to?

A
61
Q

Arterial embolism/thrombosis
* What are the causes?
* What is the patho?

A
62
Q
  • What is vasculitis? What is it classified by?
  • What are the causes?
A
63
Q

What is the patho of vasculitis?

A
64
Q

Giant cell arteritis
* What is it?

A

Vasculitis of branches of the carotid arteries

65
Q

Peripheral vascular/artery disease (PVD or PAD)
* Affects what?
* Narrowing of what?
* What are the causes?

A
66
Q

Peripheral vascular/artery disease (PVD or PAD)
* What is the patho?

A
67
Q

Phlebitis/thrombophlebitis
* What is it?
* Can be classified as what?
* What is it called if infected?

A
  • Thrombus (clot), Phleb (vein), Itis (inflammation)
  • Blood clot that gets lodged in a vein and causes inflammation
  • Can be classified either as superficial or deep (DVT) – usually in legs
  • If infected called septic thrombophlebitis (e.g. Staph at IV site). Can lead to shock
68
Q

Phlebitis/thrombophlebitis
* What are the causes?

A
69
Q

Phlebitis/thrombophlebitis
* What is the patho?

A
  • Damage to endothelium
  • Causes vasoconstriction – limits blood flow * Primary hemostasis – Platelet plug
  • Secondary hemostasis – Fibrin Clot
    * Clot grows – decreases blood flow, including blood pressure = reduced venous return
    * Potentially thromboembolic
70
Q

Venous Thrombosis
* What is it?
* What are the causes?
* What is the patho?

A
71
Q

Varicose veins
* What is it?
* What are the causes?
* What is the patho?

A
72
Q

What is variocele? WHat can it cause?

A
73
Q

Venous insufficiency
* What is the tho?

A
74
Q

What are the stages of chronic venous disease?

A
75
Q

How are the valves together?

A
76
Q
  • What is stenosis? What is regurg?
  • What are common causes?
A
77
Q

What are the common effects of vavular patho?

A
78
Q

Aortic Valve Stenosis
* What are the cuases?
* What is the patho?

A

LESS THAN 1 CM2

79
Q

Aortic valve regurg causes?

A
  • 50% Root dilation (mostly idiopathic, some from aortic
    dissection, aneurysms, or sypillis)
  • 50% Valvular damage (infective endocartitis, chronic rheutic fever)
80
Q

Aortic Valve Regurgitation
* What is the patho?

A
81
Q

Mitral Valve Stenosis
* Causes?
* What is the patho?

A
82
Q

Mitral valve prolapse causes?

A
83
Q

Mital regurg causes?

A
84
Q

Mitral Valve Regurgitation & Prolapse
* What is the patho?

A
  • LA experiences increased volume on ventricular systole
  • Then subsequent increased LV preload as blood drains form LA
  • Thus, LA and LV volume overload = Eccentric hypertrophy
  • Eventually heart becomes overwhelmed = Left sided heart failure (congestive heart failure)
  • Pulmonary edema
85
Q

Tricuspid Valve Stenosis
* What are the causes?
* What is the patho?

A

  • RA dilation can compress esophagus = dysphagia
86
Q

Tricuspid Valve Regurgitation
What are the causes?

A
87
Q

What is the patho of Tricuspid Valve Regurgitation
?

A
88
Q

Pulmonary Valve Stenosi
* What are the causes?
* What is the Patho?

A
89
Q

Pulmonary Valve Regurgitation
* What are the causes?

A
  • Valvular damage (infective endocarditis), bacterial infection
  • Rheumatic heart disease
  • Previous surgeries (e.g. on stenotic valve)
  • Malfunctioning prosthetic valve
90
Q

Pulmonary Valve Regurgitation
* What is the patho?

A

Clinical Medicine 3 (27 decks)

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