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EXSC 433 > EXAM3 > Flashcards

EXAM3 Flashcards

1
Q

an active process involving molecular signals that produce altered cellular behavior as well as endothelial dysfunction and a subsequent inflammatory response

A

atherosclerosis

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2
Q

explain the disease progression of atherosclerosis

A
  1. injury to endothelial lining
  2. fatty streak
  3. fibrous plaque
  4. possible disruption of the lesion
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3
Q

ischemia

A

lack of blood flow to the heart

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4
Q

angina pectoris

A

chest pain

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5
Q

myocardial infarction

A

heart attack (death to heart cells; lack of blood flow due to plaque build-up)

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6
Q

causes of atherogenesis

A

chronic injury to endothelial cells from tobacco LDL hypertension etc

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7
Q

endothelial dysfunction in atherosclerosis is dangerous because…

A

endothelial dysfunction leads to:

  • increased adhesiveness [platelets monocytes stick]
  • increased permeability to LDL
  • impaired vasodilation & vasospasm
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8
Q

rupture or fissuring of a plaque formed within the artery in atherogenesis cases is called a

A

thrombus

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9
Q

SBP & DBP in hypertension

A

SBP >140

DBP >90

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10
Q

most commonly diagnosed CV disease?

A

hypertension

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11
Q

hypertension causes constriction of _____ ______ so that blood flow is hindered, increasing workload of the heart

A

peripheral arteries

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12
Q

hypertension can cause ________ damage to large arteries as well

A

endothelial

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13
Q

manifestation of advanced atherosclerosis progression in the coronary arteries

A

coronary heart disease

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14
Q

pain resulting from myocardial ischemia (inadequate blood flow to the heart)

A

angina pectoris

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15
Q

how is angina pectoris characterized?

A

substernal pressure, heaviness, burning, sometimes accompanied by dyspnea (trouble breathing)

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16
Q

angina pectoris is labeled “classic” if..

A

elicited by physical or emotional stress

relieved by nitroglycerin or rest

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17
Q

angina pectoris is labeled “vasospastic” if…

A

it occurs at rest for no reason

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18
Q

angina pectoris is labeled “unstable” if … **

A

new onset, lasts for longer duration then last time, increased frequency, occurs at lower level of exertion than usual, (changing, getting worse)

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19
Q

death of myocardial muscle cells that occur when blood flow through the coronary artery is disrupted & tissues are deprived of oxygen for long periods of time

A

myocardial infarction

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20
Q

what is an acute myocardial infarction

A

sudden ischemia leading to myocardial damage & infarction (lack of blood flow causing a part of the heart to die)

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21
Q

10 complications of MI

A
  1. arrthymias [irregular heartbeat]
  2. conduction disturbance
  3. bundle bunch block
  4. cardiogenic shock
  5. infarct extension/expansion
  6. myocardial rupture [muscle cells killed]
  7. new mitral valve regurgitation
  8. pericardial effusion [fluid collection] & pericarditis [inflamed sac around heart]
  9. post-infarction syndrome
  10. left ventricular mural thrombus [blood not being pumped out sits & clots]
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22
Q

S&S of MI

A
  1. angina pectoris
  2. unusual SOB
  3. profound weakness/fatigue
  4. profuse sweating
  5. loss of consciousness
  6. confusion
  7. dizziness
  8. nausea
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23
Q

death resulting from an abrupt loss of heart function is known as

A

sudden cardiac death

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24
Q

chronic degenerative condition in which the ability of one or both ventricles to fill with or eject blood is impaired

A

chronic heart failure

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25
Q

chronic heart failure is usually due to

A

poor circulation in the heart

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26
Q

chronic heart failure manifestations (S&S)

A
  • dyspnea
  • fluid retention
  • exercise intolerance
  • fatigue
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27
Q

two types of chronic heart failure

A

left ventricle systolic & right ventricle diastolic dysfunction

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28
Q

LV systolic dysfunction

A
  • reduced blood put out by heart [ejection fraction]
  • assessed using echocardiogram, radio-nucleotide test, cardiac catheterization
  • ejection fraction
29
Q

RV diastolic

A
  • diagnosis less exact

- clinical syndrome of congestive HF in the presence of normal ejection fraction

30
Q

loss of brain function subsequent to the interruption of blood flow

A

stroke [cerebrovascular accident]

31
Q

causes of stroke

A
  1. ischemic (blockage): decreased blood flow to a portion of the brain
  2. intracranial hemorrhage: sudden rupture of an artery in the brain leading to compression of the brain structures (hemorrhage/aneurism)
32
Q

symptoms of stroke

A

weakness in face arm leg, typically on one side of the body, numbness, sudden confusion, trouble understanding, trouble speaking, etc.

33
Q

4 risk factors for stroke

A
  1. asymptomatic coronary disease
  2. atrial fibrilation (beat irregularity)
  3. pregnancy (increases chances of blood clot)
  4. postmenopausal women (lack of estrogen)
34
Q

a series of disorders in which blood flow through non-coronary arterial beds is inhibited by atherosclerotic plaque

A

peripheral arterial disease

35
Q

PAD is characterized by what 5 things

A
  1. diminished functional capacity
  2. limb dysfunction
  3. reduced QOL
  4. increased cardiovascular ischemic risk
  5. increased risk of death
36
Q

PAD manifestation

A

intermittent claudication [leg pain that follows physical exertion & is relieved at rest - calf thigh buttocks]

37
Q

how do you diagnose PAD

A
  • palpate peripheral pulse
  • ankle to brachial index 1-1.29
  • resting ABI less than 0.5
38
Q

classifications of PAD

A

1 - assymptomatic
2 - intermittent claudication
2a - distance to pain onset >200m
2b - distance to pain onset

39
Q

________ is released by the kidneys in response to _______ stimulation or a decline in renal blood flow

A

Renin; sympathetic

40
Q

Explain the renin-angiotension system

A
  • Renin is released by the kidneys in response to sympathetic stimulation or decline in renal blood flow
  • renin converts angiotensin to angiotensin I
  • angiotensin I is modified to angiotensin II
  • angiotensin II stimulates aldosterone secretion, ADH secretion, thirst, & cardiac output [arteriole constriction]
41
Q

interfere with the coagulation cascade [clotting mechanism]

A

anticoagulants [warfarin, heparin]

42
Q

anticoagulants are also referred to as ____ ____, & may cause easy bruising & bleeding

A

blood thinners

43
Q

anti-ischemic agents

A

beta blockers

44
Q

what do beta blockers do

A
  • reduce ischemia (lower oxygen demand for any work load)
45
Q

beta blockers reduce 1st year mortality rate in patients after MI by ___-____%

A

20-35%

46
Q

with beta blockers there is a reduced __ respond to exercise and a decreased _____ exercise capacity

A

HR; maximal

47
Q

what do calcium channel antagonists do

A

reduce ischemia by altering major determinants of myocardial oxygen supply/demand

48
Q

Calcium channel antagonists cause ______ by inhibiting _____ influx in vascular ___ muscle {HR decreases because of calcium inhibition in conduction tissue}

A

vasodilation; calcium; smooth

49
Q

what do nitrates do?

A

reduce ischemia by reducing myocardial oxygen demand with a small concomitant increase in oxygen supply

50
Q

what does a vasodilator do ?

A
  • decreases work load on the heart

- dilates coronary arteries (more blood to heart muscle & pain relief in ischemia–used in acute treatment)

51
Q

you should not use a vasodilator if BP is

A
52
Q

renin is released by the kidneys in response to what two things

A

sympathetic nerve stimulation

decline in renal blood flow

53
Q

[medications]

angiotensin-converting enzyme inhibitors

A

reduce myocardial oxygen demand by reducing systemic vascular resistance [reduce work of heart; may cause cough]

54
Q

[medications]

ARBs

A

used when ace can’t be used

prevent binding of angiotensin II (a vasoconstrictor) to its receptors

55
Q

[medications]

Aldosterone antagonists

A

blunts SA & AV node conduction resulting in a lower ventricular response [less work for the heart]

56
Q

[medications] digitalis

A

enhances contractility of myocardium [increased stroke volume]

57
Q

[medications] diuretics

A

loss of water in urine [decrease blood pressure]

58
Q

nitrates affects on exercise

A

increase resting HR

decrease ischemia

59
Q

all medications cause a decrease in HR and BP except

A

nitrates

60
Q

FITT for PAD [peripheral arterial disease]

A

F: 3-5 days
I: moderate - pain score of 3
T: 30-60min. 10 min bouts
T: R training recommended [weight & non weight bearing]

61
Q

FITT for hypertension

A 
F: aerobic daily; resistance 2-3
I: moderate 40-59% RPE 11-13
T: 30-60min. 1 set 8-12 reps
T: any
*progress gradually; remember BP meds changes comorbitities
62
Q

beta blockers may ______ the chance of hypoglycemia, especially in those on ____ or _______

A

increase; insulin or secretagogues

63
Q

beta blockers may mask the signs of ________ [tachycardia]

A

hypoglycemia

64
Q

beta blockers and diuretics may affect the ________ function

A

thermoregulatory

65
Q

BP medication may cause excess decrease in..

A

BP post exercise [post-exercise hypotension]

66
Q

those with known ischemia during exercise should keep intensity at least _____ beats per minute below the ______ threshold

A

10; ischemic

67
Q

5 surgical treatments for hypertension

A
  1. percutaneous transluminal coronary angioplasty
  2. stent [balloon catheter]
  3. coronary artery bypass graft [pull artery from somewhere else]
  4. atherectomy [drill pulls out plaque; common in peripheral]
  5. laser angioplasty
68
Q

other treatment options

A

pacemakers

automatic internal

EXSC 433 (3 decks)

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