Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

KIN 407 > Finals > Flashcards

Finals Flashcards

1
Q

What levels of BP are considered hypertensive?

A

systolic =/> 140 mmHg OR
diastolic =/> 90 mmHg OR
antihypertensive medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does the heart contribute to hypertension?

A 
Heart - pumping pressure
High CO (increased HR and SV0 due to overactive SNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do the blood vessels contribute to hypertension?

A

Blood vessels - systemic resistance
Vasoconstriction mediated by increased SNS activity
Ion channel defects in contractile smooth muscle
Abnormal regulation by local factors (decrease in NO)
An increase in afterload (the pressure in the aorta that needs to be overcome to eject blood from LV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the kidney contribute to hypertension?

A

Kidney - intravascular volume

Retaining excessive sodium and water = increased volume of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two types of hypertension?

A

Primary / Essential Hypertension = no identifiable medical cause
Secondary Hypertension = medical conditions or medications are the cause of the increased pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the consequences of hypertension in the development of atherosclerosis or work on the heart

A

Increased afterload = left ventricular hypertrophy
Leads to increased myocardial wall stress = increased ATP demand = increased oxygen cost and work on the heart
Increased arterial pressure = increased atherosclerosis through increased arterial wall damage = decrease in NO production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the desirable levels for total cholesterol, LDL, HDL, and TG? How do each of these affect CAD?

A

Total Cholesterol <5.18 mmol/L

High Density Lipoprotein (HDL) >1.04 mmol/L
Cardioprotective:
- reverse transport from atherosclerotic plaque to liver
- protect against oxidative stress
- rapid clearance of triglyceride rich products

Low Density Lipoprotein (LDL) <3.37 mmol/L
Promote and progress atherosclerosis via modified LDL (oxidation or glycation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

BP = CO x TPR

Which factor is usually the contributor to increased BP in young population? In old population?

A

Younger people = higher CO causing increased BP

Older people = higher TPR causing increased BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a risk factor?

A

Characteristic that appears to be associated with the development of a disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the effect of smoking on CAD?
What role does nicotine play?
What role does CO play?

A

Nicotine binds to nicotinic receptors in the CNS and adrenal medulla causing the production of NE and E
Catecholamines bind to beta receptors in the heart to cause an increase HR and SV = increased Q and BP which increases the work and O2 demand of the heart
Catecholamines also bind to alpha-adrenergic receptors in the blood vessels causing vasoconstriction = increased TPR and decreased BF which decreases the supply of O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What role does nicotine play?

A

Nicotine binds to nicotinic receptors in the CNS and adrenal medulla causing the production of NE and E
Catecholamines bind to beta receptors in the heart to cause an increase HR and SV = increased Q and BP which increases the work and O2 demand of the heart
Catecholamines also bind to alpha-adrenergic receptors in the blood vessels causing vasoconstriction = increased TPR and decreased BF which decreases the supply of O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What role does CO play with CAD?

A

CO has a 200x binding affinity to hemoglobin than O2 = decreased amount of oxygen that can be carried = decreased O2 supply
CO is highly reactive = increased ROS = endothelial damage = increased inflammatory cytokines & leukocytes = decreased BF and increased vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the effect of smoking on CAD?

A

causes an imbalance of decreased BF and increased work on the heart = imbalanced O2 supply/demand
leading to arrhythmias, angina, MI or sudden cardiac death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the mechanisms by which exercise/PA benefit heart and vascular function independent of changes to traditional risk factors?

A
  • Changing O2 supply/demand
  • Reduced systemic inflammation
  • Decreased blood coagulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does PA improve O2 supply?

A
  • Improved arterial smooth muscle tone through a shift from SNS to PNS (decreased TPR via decreased NE on alpha-receptors = vasodilation)
  • enhanced endothelial function through increased endothelial NO bioavailability
  • Mobilization of endothelial progenitor cells (EPC) (maintain endothelial function, vascular repair and angiogenesis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does PA improve O2 demand?

A
  • optimize autonomic imbalance (increased PNS, decreased SNS = decreased HR (at rest and submaximal work rates), increased HRV = decreased arrhythmias, improved left ventricular function, and increased VO2 max with a decrease in HR and SBP
  • decreased O2 demand at submaximal workrates = increased amount of exercises that can be performed in angina patients
17
Q

How does PA improve systemic inflammation?

A

Decreased levels of TNF-alpha (tissue necrosis factor), IL6, CRP (C reactive protein)

18
Q

How does PA improve blood coagulation?

A
  • Decreased platelet aggregation
  • Decreased fibrinogen levels
  • Increased plasma tissue plasminogen activity
19
Q

What is the risk of patients exceeding a SBP of 250 mmHg during an GXT?

A

high risk of arterial rupture

- stroke, aneurysm

20
Q

What is the risk of patients exceeding DBP of 115 mmHg during a GXT?

A

Constant high pressure requires a very high force to pump blood from ventricles
- high afterload = increased work by the heart

21
Q

What is the risk of patients having ST segment depression of > 3mm during an GXT?

A

Indicative of ischemia

22
Q

What is the risk of patients having ST elevation of >1mm during an GXT?

A

Impending MI

23
Q

What is the risk of a patient having multifocal PVC’s during a GXT?

A

insufficient blood pumping = decreased BF to coronary myoctyes

24
Q

What is the risk of a patient having a decrease in HR with increasing work rate in a GXT?

A 
Since HRxSV = Q
Decreased Q (cardiac output) = decreased O2 supply = ischemia
25
Q

What is the criteria for a positive CAD test?

A 
BLOOD PRESSURE:
SBP > 250 mmHg, decrease with an increase in WR
Diastolic > 115 mmHg
HEART RATE:
Presence of arrythmias
No change OR decrease in HR with increase in WR
ST SEGMENT:
elevation > 1mm
depression >1mm
PAIN:
Moderate - severe angina (2+/4 scale)
26
Q

Under what situations would you expect that a pharmacological stress test be used instead of a graded exercise stress test?

A

Pharmacological Stress Test = evoke myocardial ischemia in those who can’t exercise
- people with unstable angina

KIN 407 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions