Perfusion - Cardiac + HTN week3/4 - rotation2 Flashcards
ch.43,44,45,46,47,48
ACE Inhibitors, inhibit Angiotensin Converting Enzyme. This enzyme is responsible for converting angiotensin I into angiotensin II in the lungs. If this is blocked, what is happening in the body?
vessles vasodilate and aldosterone is inhibited
Angiotensin II receptors are located in the blood vessels + in the adrenal gland, these receptors are stimulated by ___________ and cause vasoconstriction + aldosterone release.
angiotensin II
Baroreceptors are pressure receptors located in the ______________ + ____________.
They are what stimulate the _________ + _________ to increase or decrease the blood pressure when pressure changes occur.
-arch of the aorta
-carotid artery
-medulla
-hypothalamus
The cardiovascular center, when stimulated, will activate the sympathetic nervous system to increase HR & BP. Where is this center located?
the medulla
What is essential or primary hypertension?
an elevated BP with no underlying cause
The Renin-Angiotensin-Aldosterone-System (RAAS), is important for the regulation of blood pressure. It is a compensatory system that:
increases blood pressure + volume to ensure the kidney’s are perfused
this kicks in when BP drops
What does aldosterone tell the body to do?
produced by the adrenal glands, this hormone is regulating sodium, potassium + fluid
How does severe hypotension lead to shock?
waste products accumulate and that leads to cell death = shock
Hemoptysis is blood tinged sputum because blood is backing up into the lungs and that fluid is leaking into the lung tissue. Is this associated with left or right sided heart failure?
left sided heart failure
Pulmonary Edema is the increased fluid in the lung tissue - is this associated with left or right sided heart failure?
left sided heart failure
Tachypnea is rapid shallow breathing that is seen w/ _________ sided heart failure.
Left
What does Proarrhythmic mean?
tending to cause arrhythmias; many drugs used to treat them also cause them
Angina is the “suffocation of the chest” due to an imbalance of what?
oxygen supply and demand of the heart
Atheroma’s are fatty tumors in the ________.
arteries
Atherosclerosis is the ________ of arteries due to a buildup of the atheroma’s, swelling and platelet accumulation.
narrowing
Coronary Artery Disease (CAD) is the _________ narrowing of arteries due to decreased oxygen delivery.
progressive
What do bile acids do in the small intestine?
They break up fats found in the bile acid
Chylomicron is a carrier for what in the bloodstream?
lipids
High Density Lipoproteins (HDLs) absorb what in the periphery? -that is said to have a protective effect to lower atherosclerosis development that could lead to cardiovascular disease.
fat and remnants of fat
hydroxymethylglutaryl–coenzyme A (HMG–CoA) reductase is an enzyme that regulates synthesis of what?
cholesterol
Hyperlipidemia is increased levels of lipids, what does this put the patient at an increased risk of?
atherosclerotic cardiovascular disease
Which lipoproteins contribute to the development of atherosclerotic cardiovascular disease because they are processed in the arterial lining?
Low Density Lipoproteins (LDLs)
Metabolic Syndrome consists of what 4 factors?
-insulin resistance
-abdominal obesity
-low HDLs/ high triglycerides
-hypertension
What are phospholipids are important in the structure of what 4 structures?
-lipoproteins
-blood clotting components
-the myelin sheath
-cell membranes
proprotein convertase subtilisin/kexin type 9 (PCSK9) is an enzyme that binds to LDL receptors on the liver, which causes _______ LDL levels in the blood.
higher
Triglycerides are “neutral fat” that are primarily used as a source of what in the body?
energy
Anticoagulants prevent or slow ________.
the formation of clots
Antiplatelets prevent the ________ or clumping of platelets to prevent the formation of a platelet plug.
aggregation
Clotting factors are formed in the liver and these help the body form clots when needed, if your body needs a little help with this process what would be given help this process happen?
vitamin K
How do hemostatic agents stop blood loss?
they prevent clot dissolution
What is the difference between the extrinsic and intrinsic pathways?
-Intrinsic pathway responds to spontaneous, internal damage of the vascular endothelium (internal damage)
-Extrinsic pathway becomes activated secondary to external trauma (external damage)
What is your “natural clot busting system” that dissolve clots that have formed + maintain the patency of injured vessels?
plasminogen
What is it called when platelets do their job and adhere to an injured surface, then attract other platelets, which clump together or aggregate at the area, plugging up an injury to the vascular system?
platelet aggregation
What do thrombolytic agents do to blood clots in the body?
they lyse or break down the clots; they activate plasminogen to dissolve the fibrin
heart failure is when the heart muscle has a decreased ability to adequately……..
pump blood around the cardiovascular system
failing to pump blood + leading to congestion/ backup of blood
Antiarrhythmics are effecting the cardiac cells to treat an arrhythmia. What is it restoring to the heart?
a normal rate and rhythm
An MI is the result of a blockage of what in the heart?
-blood vessel
MI can lead to ________ + __________, and those dead cells are eventually replaced with scar tissue.
ischemia + necrosis
Prinz Metals Angina occurs due to a __________ in the artery.
vasospasm
stable angina is relieved by ______ or stopping activity.
rest
true or false?
Unstable angina is unpredictable and can occur even if the patient is resting.
true
Antihyperlipidemic meds. lower _____ levels in the blood.
lipid
The Hageman Factor is the first step in initiating the inflammatory response. What is activating this factor to begin the process?
a blood vessel or cell is injured
A thromboembolic disorders mean that clots or thrombi form at an injured blood vessel and they have a high potential of ………
the clot breaking, forming an emboli, traveling, and occluding another smaller vessel
Having a Hemorrhagic disorder, means you are lacking…… - which could put you in a state of excessive bleeding.
clot forming substances
Rhabdomyolysis is the break down of muscle, which organ(s) are most effected by this/ most damaged?
the kidney’s
what is the PREFERRED anticoagulant for children and why?
LMWH- low molecular weight heparin
** this carries a lower risk than regular heparin**
What is the Antidote for Heparin?
protamine sulfate
What type of reaction are patients receiving protamine sulfate at risk for? Especially with an increased number of uses.
Fatal Anaphylaxis
what is the antidote for warfarin?
vitamin K
What 3 things are happening when the process of blood coagulation is taking place?
-vasoconstriction
-platelet aggregation
-conversion of prothrombin to thrombin
Warfarin’s action is to decrease the production of vitamin K clotting factors in what organ?
the liver
heparin prevents the conversion of what, to prevent coagulation?
prothrombin to thrombin
Which is the preferred/ safer anticoagulant for pregnancy?
heparin
PTT - partial thromboplastin time, is a test that measures how long the it takes the blood to clot. What is the normal range?
60-100 seconds
what 2 laboratory tests should be assessed daily when your patient is on warfarin?
PT + INR
PTT is testing how long is takes the clot, what is PT testing?
how long it takes the plasma in the blood to clot
what is the therapeutic value of INR?
2.0-3.0
aPPT is another lab value monitored while on heparin. what is it measuring and what is the normal/ therapeutic range?
this is testing how long it takes the blood to clot after a reagent is added to a sample, to show clotting abnormalities
25-35 seconds
Lovastatin is prescribed to treat high cholesterol, this drug is going to inhibit the synthesis of __________.
cholesterol
