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MEDS 532 > Lecture 2 - Introduction to CVD > Flashcards

Lecture 2 - Introduction to CVD Flashcards

1
Q

What is Cardio-Vascular Disease?

A

Broke down in two things::

  1. Heart disease
  2. Vascular disease
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2
Q

Systole vs. Diastole

A

Systole - phase when CONTRACTION is causing blood to be pumped to arteries (pressure is high)

Diastole - phase when muscle is RELAXED and the heart is filling with blood (pressure is low)

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3
Q

Cardiac Output (CO)

A

CO = HR x SV

Heart rate x Stroke Volume

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4
Q

Ejection fraction

A

Measurement of the % of blood that leaves your heart for each contraction

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5
Q

Ischemia

A

Not enough oxygen

Supply and demand not met

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6
Q

Consequences of Atherosclerosis-What Could Go Wrong?

A
  • Coronary Heart Disease (CHD)
  • Carotid Artery Disease (CAD)
  • Peripheral Artery Disease (PAD)
  • Renal Arter Stenosis (RAS)
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7
Q

What can smoke do to our bodies?

A
  • Raise triglycerides
  • Lower “good” cholesterol
  • Increase risk of clots
  • Damage cells that line the blood vessels
  • Increase the buildup of plaque in blood vessels
  • Cause thickening and narrowing of blood vessels
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8
Q

The Global Severity of Cardiovascular Disease

A
  • CVDs are the number 1 cause of death globally

- Americanized diets are the cause as well as smoking and drinking

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9
Q

Hyperlipidemia:

A

• An abnormally high concentration of fats or lipids in the blood

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10
Q

Dyslipidemia:

A

A condition in the body that is marked by abnormal concentrations of lipids or lipoproteins in the blod

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11
Q

Hypertriglyceridemia:

A

• A condition in which triglyceride levels are elevated

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12
Q

Etiology of Dyslipidemia

A

Primary:
• Familial (two alleles if you have hetero you are premature for CVD if homo you have severe child CVD issues and is an issue with the receptor or lipoprotein)

Secondary/Acquired:
• Diet/lifestyle 
• Drugs 
• Diseases 
 Disorders & altered states of metabolism
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13
Q

Major lipids in body:

A
  • Cholesterol
  • Triglycerides
  • Lipoproteins
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14
Q

Major classes of lipoproteins found in

serum are:

A
  • Chylomicrons
  • VLDL
  • Intermediate density lipoproteins
  • LDL
  • HDL
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15
Q

Lipid metabolism: Chylomicrons

A
  1. Eat fat, carbs, proteins,
  2. Lipid droplets absoced into intestinal cells as monoglyercols
  3. Packaged into chylomicrons
  4. Absorbed into blood
  5. Circulate and devlier chylomicrons to tissues in need
  6. Remnants of chylomicrons arrive at liver
  7. Bind LDL receptors and are endocysoed by heptic cells
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16
Q

Lipid metabolism: Glucose

A
  1. Glucose in blood.
  2. Absorbed by liver
  3. Glycolysis –> pyruvate
  4. Pyruvate –> Acetyl CoA
  5. Acetyl-CoA eventualy converted to cholesterol voa HMG CoA reductase
  6. Acetyl-CoA can form Malonyl CoA –> Fatty Acids
  7. TG, Cholestoerols, phospholupids are packaged together in golgi to form lipoproteins
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17
Q

How does the body respond to lack of oxygen?

A
  • Body wants to increase BP
    1. Constricts vessels
    2. Retain water
    3. Increase cardiac output
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18
Q

Heart Disease vs. Vascular Disease

A
  1. Heart disease is within your heart (CAD, arrhythmias, failure)
  2. Vascular disease is stuff like hypertension, lipid disorders, atherosclerosis
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19
Q

Describe the path blood takes through the heart starting at the superior vena cava

A
  • Superior vena cava
  • Right atrium
  • Tricuspid valve
  • Right ventricle
  • Pulmonary valve
  • Pulmonary artery
  • Lungs
  • Left atrium
  • Left ventricle
  • Aorta
  • Rest of the body
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20
Q

What is damaged when atherosclerosis occurs?

A

Inside lining of the endothelial

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21
Q

Blocked vessels caused by Atherosclerosis can lead to __________

A

Ischemia

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22
Q

Atherosclerosis

A

Plaque buildup in arterial walls

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23
Q

Ischemia is when

______ does not meet _______

A

Supply (Coronary blood flow)

Demand (Heart rate, contractility)

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24
Q

List the four consequences of Atherosclerosis - What Could Go Wrong?

A
  • CHD/CAD (Coronary)
  • Carotid Artery Disease
  • PAD (Peripheral)
  • Renal Artery Stenosis (RAS)
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25
Q

What can smoke do to our bodies?

6

A
  • Raise triglycerides
  • Lower “good” cholesterol
  • Increase risk of clots
  • Damage cells that line blood vessels
  • Increase plaque
  • Cause thickening and narrowing of blood vessels
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1
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26
Q

Hyperlipidemia

A

An abnormally HIGH concentration of lipids and fats in blood

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27
Q

Dyslipidemia

A

A condition in the body that is marker by abnormal (high or low) concentrations of lipids or lipoproteins in the blood

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28
Q

Hypertriglyceridemia

A

A condition in which triglyceride levels are elevated

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29
Q

** Major lipids in the body

4

A

Cholesterol
Triglycerides
Lipoproteins
Phospholipids

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30
Q

Chylomicrons transport ______

3

A

Cholesterol
Triglycerides
Lipids (Lipoproteins, Phospholipids)

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31
Q

** Major classes of lipoproteins found in serum are:

A 
Chylomicrons
VLDL
Intermediate density lipoproteins
LDL
HDL
32
Q

**Chylomicrons deliver ______ to tissues in need

A

Triglycerides

33
Q

Remnants of chylomicrons go where?

A

Liver

After bind LDL receptors and are endocytosed by hepatic cells

34
Q

**Acetyl-CoA is eventually converted to cholesterol via_______

A

HMG CoA Reductase

35
Q

Acetyl-CoA can form _______ –> Fatty Acids

A

Malonyl CoA

36
Q

What enzyme plays a viatable role in fatty acid biosynthesis

A

Malonyl CoA

37
Q

Liver produces which two lipoproteins?

A

HDL

VLDL

38
Q

Describe fate of HDL after production from the Liver

A
  • Enters circulation
  • Picks up excess cholesterol from tissues
  • Binds scavenger receptors on hepatocytes

(Empty)

39
Q

Describe fate of VLDL after production from the Liver

A
  1. Transport fatty acid to tissue to create energy or be stored as fat
  2. Become an intermediate before becoming LDL which transports cholesterol to tissues
  3. Recycled
40
Q

What is cholesterol the precursor for synthesis for (3)

A

Steroid hormones
Bile acides
Vitamin D

41
Q

What is the structure of triglycerides and what is their function?

A

Formed from glycerol and three fatty acids

Function as energy storage

42
Q

What is cholesterol transported by?

A

Chylomicrons
LDL
HDL

43
Q

What are triglycerides transported by?

A

Chylomicrons

VLDL

44
Q

What are foam cells

A

A sign of early stage of atherosclerosis when LDLs(cholesterol) are devoured by macrophages to become these fat-laden cells?

45
Q

**Maintenance of arterial blood pressure is necessary for organ ____

A

perfusion

46
Q

The primary factors determining the blood pressure: (3)

A
  1. Sympathetic nervous system
  2. Renin angiotensin-aldosterone system (RAAS)
  3. Plasma volume
47
Q

**Hypertension is quantitatively the major ____for premature

cardiovascular disease

A

Modifiable

48
Q

Prevalence of hypertension in the US is strongest in which ethnic group?

A

Non-hispanic blacks

49
Q

Primary vs secondary hypertension

A

Primary - idiopathic

Secondary - lifestyle ( illness, drugs)

50
Q

**Drugs That Can Cause or Worsen HTN

7

A
  • Oral contraceptives
  • NSAIDs
  • Corticosteroids
  • Decongestants
  • Sodium containing antacids
  • Stimulants
  • Illicit drug use
51
Q

Physiological Causations of Essential HTN

7

A
  • Excess sodium intake
  • Abnormalities in RAAS system
  • Over-activity of sympathetic nervous system
  • Increased CO
  • Obesity
  • Aging
  • Increased PVR
52
Q

Renin cleaves _____ to ________

A

Angiotensinogen to Angiotensin I

53
Q

What enzyme converts Angiotensin I to Angiotensin II

A

ACE

Angiotensin converting enzyme

54
Q

Angiotensin II increases or decreases BP

How?

A

Increases

via fluid retention and VASOCONSTRICTION

55
Q

Volume regulation can occur by which two ways?

A

Angiotensin II

Sympathetic Nervous System

56
Q

Angiotensin II increases BP how?

A
  • Vasoconstriction
  • Release of aldosterone (adrenal gland)
  • Release of Vasopressin/ADH (pituitary)
57
Q

Aldosterone from the adrenal gland does what to volume regulation

A

Increase BP by Na+ retention

58
Q

Vasopressin/ADH from the pituitary gland does what to volume regulation

A

Increase BP by vasoconstriction and water retention via aquaporins

59
Q

Sympathetic nervous system increases BP how?

A

Norepinephrine increases heart rate and constricts blood vessels that increase the systemic vascular resistance (SVR)

60
Q

Increase in systemic vascular resistance (SVR) does what to BP?

A

(Think vasoconstriction)

It increases BP

61
Q

Hypertension

A

Medical condition in which the blood pressure in the arteries is persistently elevated

62
Q

What is Metabolic Syndrome?

A

Clustering of several metabolic risk factors in one patient

63
Q

**Current ATP III criteria define the metabolic syndrome as the
presence of any ____of the following five traits:

A

Three

64
Q

What are the five risk factors that are a part of the ATP III criteria for metabolic syndrome

A 
Large waistline
High Triglyceride 
High BP
High sugar
Low HDL
65
Q

** Abdominal obesity, defined as a waist circumference in ____________

A

men ≥ 40 in

women ≥ 35 in

66
Q

**Serum triglycerides ≥ _________ for elevated

triglycerides

A

150 mg or drug treatment

67
Q

**Serum high-density lipoprotein (HDL) cholesterol:
_____ in men
_____ in women
_________

A
  • <40 mg/dL in men
  • <50 mg/dL in women
  • or drug treatment for low HDL cholesterol
68
Q

Blood pressure ≥ ___________ for HTN

A

130/85 mmHg or drug treatment

69
Q

Fasting plasma glucose (FPG) ______ or drug treatment for elevated blood glucose

A

≥100 mg/dL

70
Q

95 million U.S. adults age 20 or older have TC > _____mg/dL.

A

200

71
Q

______% of U.S. children and adolescents ages 6 to 19 have high total cholesterol

A

7%

72
Q

Slightly more than _____ of U.S. adults who need cholesterol medicine are currently taking it

A

half

73
Q

TG > _____ can lead to pancreatitis

A

500

74
Q

Approximately ______ adult Americans have elevated BP, defined as ≥140/90 mm Hg

A

1 in 3

75
Q

Worldwide, raised blood pressure is estimated to cause 7.5 million deaths, about _____% of the total of all deaths

A

12.8

MEDS 532 (4 decks)

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