Effects of systemic Disease on the CV System

Question 1

what are the 2 main pathogenic types of diabetes?

Answer 1

1- autoimmune

2- insulin resistance

Question 2

what is type 1 diabetes?

Answer 2

destruction of beta cells in pancreas by an immune process

Question 3

what is type 2 diabetes?

Answer 3

loss of insulin function associated with insulin resistance can lead to peripheral tissue problems
islets of langerhans deposition of amyloid material

Question 4

what are the effects of Diabetes on the kidney?

Answer 4

areas of matrix where there is poor perfusion and these leak = microvascular disease
small vessel disease- damaged leaky kidney vessels in time failure due to reduced circulation

Question 5

how is diabetes related to cardiovascular disease and how does this effect the CV system?

Answer 5

Cv disease affected by diabetes in terms of atherosclerosis and small vessel damage
glycation- non enzymatic addition of glucose to protein basement membrane of small vessel altering permeability leading to protein trapping altering its electrical charge

Question 6

how do endocrine disorders lead to hypertension?

Answer 6

retention of sterone or aldosterone hence retaining sodium and therefore water leading to increased blood volume and increased blood pressure

Question 7

what are the effects of hypertension on the CV system? how would the patient be likely to present?

Answer 7

-LV hypertrophy due to increased workload of the heart

present with: retinopathy, headaches, renal failure, cardiac symptoms

Question 8

what is familial hyperlipidaemia? what causes it?

Answer 8

increased risk of atherosclerosis, have fibrosis because of cholesterol crystals
causes: genetic, high HDL or LDL cholesterol

Question 9

how does familial hyperlipidaemia lead to CV problems?

Answer 9

can lead toatherosclerosis increasing resistance=hypertension
can get MI or ischaemia

Question 10

describe the features of COPD

Answer 10

abnormally large holes in lung
capillary circulation necessary for gas exchange holes increase surface area less area for oxygenation of blood
emphysema can additionally affect

Question 11

what is emphysema?

Answer 11

enlargement of airspaces by destruction
destroy alveolar walls you have no capillary circulation hence you have no gas exchange leading to symptoms of breathlessness

Question 12

how does COPD affect the CV system?

Answer 12

still got to get CO from the right side of heart to get to left side of heart
holes= less channels to push blood through leading to increased resistance
increased pressure of blood needed to be pumped by R side = pulmonary hypertension

Question 13

how does pulmonary hypertension affect the heart?

Answer 13

right ventricular hypertrophy

Question 14

effects on heart as a result of COPD leading to pulmonary hypertension?

Answer 14

increased workload because increased muscle therefore requires more oxygenation
back pressure in R side is not used to it so harder for blood to drain= congestive cardiac failure leading to accumulation of blood in the body

Question 15

what is the effect of congestive cardiac failure?

Answer 15

blood accumulates in the body
harder for blood to drain from veins
accumulation of fluid=oedema

Question 16

what is amyloidosis?

Answer 16

disease accumulation of amyloid, amyloid binds to iodine to give a blue colour

Question 17

what is amyloid?

Answer 17

protein with a specifically organised structure which allows iodine to bind this structure is a beta pleated sheet

Question 18

what are the 2 types of amyloid?

Answer 18

amyloid light chain AL

amyloid associated protein

Question 19

describe the features of AL

Answer 19

produced by plasma cells
associated with underlying problems with plasma cells= malignancy
cancerous plasma cell= myeloma

Question 20

describe the features of amyloid associated protein

Answer 20

produced by the liver as part of an acute response

abnormal inflammatory or acute phase response such as sepsis, TB, rheumatoid arthritis RA, osteomyelitis

Question 21

where may amyloid tissue be deposited? what can this lead to?

Answer 21

• damaged microvasculature amyloid may be deposited in vessels and intersitium leading to problems getting O2 and nutrients
• give ischaemia, if in heart may leading inefficient pumping leading to heart failure and ischaemia, localised in brain = alzeihmers or Creutzfeld Jakubs, or in pancreas type 2

Question 22

how would patients present with amyloid deposition?

Answer 22

renal failure

diarrhoea

Question 23

how can RA affect the heart?

Answer 23

associated with direct pathology of the heart
the valves and pericardium of heart can be a target
excess cardiovascular death

Question 24

how can vasculitis effect the CV system?

Answer 24

autoimmune type pneumonia where blood vessels are the target

takyasus target coronary arteries and patients present with acute coronary symptoms

Question 25

how can thyroid dysfunction affect the CV system?

Answer 25

increase cardiovascular mortality with patients with hypothyroidism
patients are treated with thyroxin which speeds up heart and puts extra stress on CV system

Question 26

how does sarcoidosis affect the CV system?

Answer 26

T cell mediated response, type 4
granulomas formed if formed in heart it can lead to problems with the conduction system because you are altering the conduction pathway
leads to: arrhythmias, bradycardia

Question 27

how does nutrition lead to problems with the CV system?

Answer 27

due to famine

lack of energy balance and the proper foundations being laid down

Question 28

how do drugs lead to problems with the CV system? which drugs?

Answer 28

cancer drugs can knacker the CV system

serious damage to heart or ill patients if they already have a damaged myocardium