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Year 3: Clinical Medicine and Pathophysiology > Lecture 2: CVDs > Flashcards

Lecture 2: CVDs Flashcards

1
Q

what values classify HTN

A

> 130/80

some references say >140/90

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2
Q

BP is a byproduct of what

A

CO and SVR

anything that increases CO or SVR will increase BP

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3
Q

HTN risk factors

A

high BMI
high Na diet
inactivity
high alcohol use
excessive caffeine
smoking
genetics
>65 years old
low K levels

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4
Q

describe how the RAAS works

A

decrease in cardiac output

decrease in renal aa perfusion

renin released from kidneys

renin forms angiotensin I

ACEs convert Ang I to Ang II in lungs, blood vessels, and kidneys

Ang II increases SVR and extracellular fluid

increase in BP

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5
Q

HTN S&S

A

HA
visual impairments
lightheaded
syncope
fatigue
heart palpitations
nosebleeds
dyspnea
N&V
restlessness
chest pain

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6
Q

what is hyperlipidemia and its implications

A

high blood cholesterol

increased risk for atherosclerosis, MI, and CVA

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7
Q

what is cholesterol

A

cholesterol created and metabolized in liver

role in digestion and hormone synthesis

93% makes up cell membranes

remaining 7% circulates in blood by protein carrier

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8
Q

risk factors for HDL

A

high saturated and trans fat diet

high BMI

smoking

diabetes

HTN

inactivity

genetics

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9
Q

what is high density lipoprotein (HDL)

A

carries cholesterol to lover for metabolism and elimination

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10
Q

what is low density lipoprotein (LDL)

A

builds up and creates plaque

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11
Q

is very low density lipoprotein (VLDL)

A

carries triglycerides and adds to plaques

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12
Q

what are triglycerides

A

another type of lipid

comes mostly from dietary fat

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13
Q

ideal cholesterol levels (total, LDL, HDL, and triglycerides)

A

total <200

LDL <100

HDL >60

triglycerides <150

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14
Q

anti-HTN meds effectiveness during exercise

A

anti-HTN meds lower resting BP but don’t always have the same effectiveness during exercise or with isometric activities

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15
Q

risk factors for peripheral vascular disease

A

diabetes
smoking
HTN
CAD
CVA
age >50
males > females

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16
Q

what is PAD

A

atherosclerosis in peripheral aa

common in uncontrolled diabetes and smokers

same pathophysiology and risk factors as CAD

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17
Q

what is claudication

A

pain caused by reduced mm oxygenation caused by arterial occlusion in limbs

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18
Q

what is critical limb ischemia and the S&S

A

advanced stage of PAD

severe lack of blood flow

resting claudication

pain

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19
Q

PT implications for PAD

A

be aware of difference in intermittent and resting claudication and what it indicates

more pt edu opportunities

guided exercise training can improve claudication S&S

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20
Q

what is compartment syndrome

A

increased pressure w/I closed osteofascial compartment resulting in local ischemia from impaired circulation

most frequently seen in anterior compartment of lower leg

typically associated with trauma

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21
Q

compartment syndrome S&S

A

similar to VTE and critical limb ischemia

pain

firmness in compartment from increasing pressure

lack of pulse

22
Q

where is compartment syndrome seen from a cardiovascular context

A

vascular injuries
VTE
improperly fitted or placed prosthetics
bandages
other medical devices

anything that can cause bleeding or swelling in a compartment or lack of blood flow

common with circumferential burns

fasciotomy required to relieve pressure

23
Q

what is chronic venous insufficiency

A

veins are unable to effectively return blood to heart

venous valves become floppy and ineffective

increased venous distal pressures

burst capillaries

24
Q

symptoms of venous insufficiency

A

worse at rest, better with activity

achy tired legs

paraesthesia

leg cramping, worse at night

edema

heavy or full feeling

varicose veins

25
Q

CVI stages 0-6

A

stage 0 = no signs that can be seen/felt; may have tired/achy S&S

stage 1= visible blood vessels, spider veins

stage 2 = varicose veins >3 mm

stage 3 = edema but not skin changes

stage 4 = skin color/texture changes

stage 5 = healed venous ulcer

stage 6 = active venous ulcer

26
Q

risk factors for CVI

A

history of DVT
high BMI
pregnancy
inactivity
smoking
female
prolonged dependent positon
genetics

27
Q

PT implications for CVI

A

aerobic/strength training

leg elevation; sleep in bed rather than recliner/couch

compression therapy; coordinated with medical provider; be aware of contraindications

edu and lifestyle management

28
Q

what is a VTE

A

venous thromboembolism

refers to both DVT and PE

29
Q

risk factors for Virshow’s triad

A

hypercoaguability

venous stasis

endothelial injury

30
Q

classic signs of DVT

A

unilateral pain, tenderness, swelling, warmth, redness

50% asymptomatic

31
Q

factors that increase risk of DVT

A

prolonged immobility
pregnancy
birth control
recent sx
cancer
smoking
obesity
venous stasis
clotting disorders
infection

32
Q

what is a PE

A

blood clots lodged in pulmonary arterial circulation

33
Q

classic signs of PE

A

sudden SOB
chest pain
hemoptysis
O2 desaturation
R heart failure

34
Q

what is a segmental or saddle PE

A

segmental PE is clot more distal in pulmonary circulation

saddle PE is clot lodged in B pulmonary arteries

35
Q

how is a PE related to R heart failure

A

clots lodged in pulmonary circulation cause the R ventricle to have increased ejection pressure against blockage

imaging will show RV dilation or dysfunction

36
Q

what is an aortic aneurysm

A

weakening and dilation of arterial wall

at least 1.5 times the normal diameter

creates higher risk for rupture or dissection

37
Q

type 1 aneurysm

A

L subclavian to renal aa

38
Q

type 2 aneurysm

A

L subclavian to iliac bifurcation

39
Q

type 3 aneurysm

A

mid-descending thoracic aorta to iliac bifurcation

40
Q

type 4 aneurysm

A

sub-diaphragmatic abdominal aorta

41
Q

presentation of an unruptured aneurysm

A

abdominal or back pain

radiculopahy from compressed nn roots

hoarse voice (due to aortic arch aneurysm that stretches the L recurrent laryngeal nn)

42
Q

presentation of ruptured aneurysm

A

“tearing” acute chest pain, abdominal back, or flank pain

loss or altered level of consciousness

hypotension

tachycardia

cyanosis

rapidly progressing hematoma

43
Q

what is an aortic dissection

A

injury to intima allows blood between laters of the aortic wall forcing laters apart and jeopardizes normal blood flow to the body and organs

blood between laters creates a false lumen

44
Q

describe the debakey classifications of aortic dissections

A

type 1 = ascending to descending aorta

type 2 = just the ascending aorta

type 3 = arch portions and descending aorta only

45
Q

stanford classifications of dissections

A

type A = ascending aorta involved

type B = arch portions and descending aorta only

46
Q

dissection presentation

A

tearing or acute chest/back pain

acute syncope or stroke

new diastolic murmur

asymmetric pulse or BP

malperfusion of coronary arteries

sudden death is sometimes first symptom

47
Q

aneurysm vs dissection

A

aneurysm
- mostly asymptomatic
- often found incidentally
- abdominal more common than thoracic
- thoracic has higher mortality
- men > women
- usually > 65

dissection
- most catastrophic medical problem of aorta
- type A more dangerous than B
- 10-15% asymptomatic
- type A is life threatening; 1-2% mortality per hour

48
Q

aneurysm risk factors

A

HTN
smoking
CAD
atherosclerosis
high cholesterol
PVD
congenital connective tissue disease
congenital bicuspid aortic valve
pregnancy

49
Q

dissection risk factors

A

HTN
cocaine or meth use
congenital bicuspid aortic valve
aortic root dilation
congenital connective tissues diseases
familial aortic syndrome
arteritis
syphilis
trauma

50
Q
A

Year 3: Clinical Medicine and Pathophysiology (8 decks)

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