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Cardiovascular > Physiology and Pharmacology > Flashcards

Physiology and Pharmacology Flashcards

1
Q

Defects in impulse formation

A 
Altered Automaticity (physiological or pathological)
Triggered Activity (afterdepolarisation)
Re-entry
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2
Q

Ectopic beat

A

Latent pacemaker initiates the impulse

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3
Q

First Degree Heart Block

A

= simple prolongation of the PR interval (but every P wave is followed by QRS)

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4
Q

Mobitz Type I

A

PR interval gradually increases until AV node fails and ventricular beat is missed

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5
Q

Mobitz Type II

A

PR interval is constant but every nth ventricular depolarisation is missing
- Usually below the nodes e.g. Bundle of His

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6
Q

Complete Heart Block

A

(3rd degree AV block)

No impulses are conducted through the area; ventricular pacemaker is now Purkinje fibres (slow, unreliable)

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7
Q

Increasing the venous return to the heart

A

Increasing the skeletal muscle activity

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8
Q

MAP

A

Diastolic + 1/3(Systolic - Diastolic)

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9
Q

Valsalva Manoeuvre

A
  • Increases the blocking of the AV node
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10
Q

Effect of Low Blood Volume

A

Results in compensatory sympathetic response > pulse rate is fast

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11
Q

Depolarisation of Nodal Cells: Phase 0

A

Increased calcium ions IN

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12
Q

Repolarisation of Nodal Cells: Phase 3

A

Increased potassium ions OUT

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13
Q

Contractile Ventricular Muscle Cells: Phase 0

A

Increased Sodium IN

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14
Q

Plataeu Phase in VMC

A

Increased Calcium IN

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15
Q

Contractile Ventricular Muscle Cells: Phase 3

A

Increased Potassium OUT

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16
Q

Manifestations of Hypokalaemia

A

Muscle Weakness

Cardiac Arryhthmias

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17
Q

Extrinsic Factors which cause bradycardia

A 
Hypothermia
Hypothyroidism
B-Blockers
Cholecstatic Jaundice
AADs
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18
Q

Intrinsic Factors which cause bradycardia

A

Acute ischaemia/infarction

Other causes of fibrosis

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19
Q

2:1 or 3:1 Advanced Block

A

= when every second/third p waves conducts to the ventricles

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20
Q

Complete AV block

A

= when all atrial activity fails to conduct to the ventricles

21
Q

Narrow complex escape rhythm

A 
= implies that originates in His Bundle: block is more proximal to the AV node
Rate: 50-60bpm > unreliable
Treatment:
RECENT (IV atropine, temporary pacing)
CHRONIC (permanent pacing)
22
Q

Broad complex escape rhythm

A

= implies origin below the His Bundle: block is more distal
Rate: 15-40bmp > unreliable
Permanent pacemaker indicated

23
Q

Cause of AV block (OLD)

A

Degenerative Fibrosis

Calcification of distal conduction system

24
Q

Cause of AV block (YOUNGER)

A

Progressive cardiac conduction disease (inflammation)

25
Q

Right BBB

A

= late activation of the right ventricle

  • Deep S wave in I and V6
  • Late R wave in V1
26
Q

Left BBB

A

= late activation of the left ventricle

- Produces abnormal Q waves

27
Q

Anterior block of the LBB

A

Left Axis Deviation

= ventricle activated inferior > superior

28
Q

Posterior/Inferior block of the LBB

A

Right Axis Deviation

29
Q

SVT

A

= arise from the atrium or the AV junction

- QRS usually appears to be normal

30
Q

Paroxysmal SVTs

A

= AVNRT and AVRT

Usually seen in the young

31
Q

AVNRT Pathways

A

Slow and Fast Pathway

32
Q

Slow Pathway

A

If the atrial impulse occurs EARLY when fast pathway is still refractory > slow pathway
- The impulse then travels back through the first pathway which has recovered it’s excitability

33
Q

AVRT Pathophysiology

A

= large circuit normal until the ventricles, where there is abnormal connection of fibres from the ventricle back to the atrium

34
Q

Result of AVRT

A

Atrial activation occurs after ventricular activation

35
Q

Example of AVRT

A

Kent Bundle

36
Q

Delta Wave

A

Wolff-Parkinson-White Syndrome

37
Q

AVRT circuit reversal

A

= broad complex tachycardia

The accessory pathway activates the ventricles and AV node conducts through to the atria

38
Q

Atrial Fibrillation Pathophysiology

A

= maintained by continuous, rapid activation of the atria by multiple re-entry wavelets
- No co-ordinated mechanical action, only a small number conducted to the ventricle

39
Q

Automatic Foci

A

Pulmonary Veins

40
Q

Atrial Flutter Pathophysiology

A

= organised atrial rhythm, involving a macro re-entrant R atrial circuit around the tricuspid annulus

41
Q

Atrial Flutter Rate

A

250-350bmp

42
Q

Life Threatening Tachycardias

A
  • Sustained VT
  • Ventricular Fibrillation
  • Torsades de Pointes
43
Q

Sustained Ventricular Tachycardia

A

= rapid ventricular rhythm: broad abnormal QRS complexes

44
Q

Ventricular Fibrillation

A

= very rapid and irregular ventricular activation with no mechanical effect
- Shapeless, rapid oscillations which are unorganised

45
Q

Brugada Syndrome

A

= right bundle branch block with ST elevation in lateral leads
- Channel mutations

46
Q

Long QT Syndrome

A

= QT interval is hugely prolonged

Clinical: syncope, palpitations

47
Q

Torsades de Pointes

A

= polymorphic ventricular tachycardia

48
Q

Ventricular Premature Beats

A

= broad and bizarre QRS complexes which arise from abnormal sites
- Usually followed by a compensatory pause

Cardiovascular (7 decks)

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