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My Cardiovascular > Problem of the week > Flashcards

Problem of the week Flashcards

1
Q

What does a thrill feel like?

A

buzzing

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2
Q

What type of murmur is mitral regurgitation?

A

systolic

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3
Q

What type of murmur is aortic stenosis?

A

systolic

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4
Q

What are the five stages of the cardiac cycle?

A
  • passive filling
  • atrial contraction
  • isovolumetric ventricular contraction
  • ventricular ejection
  • isovolumetric ventricular relaxation
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5
Q

What do statins do?

A

competitive inhibitor of HMG CoA reductase in the liver - decrease in hepatocyte cholesterol synthesis causes compensatory increase in LDL receptor and LDL clearance

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6
Q

What do fibrates do?

A

stimulates activity of lipoprotein lipase (LPL) to increase breakdown of TAGs (via nuclear receptor (PPARα) to enhance the transcription of several genes, including that encoding LPL)

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7
Q

What do PCSK9 inhibitors do?

A

monoclonal antibody inhibits binding of PCSK9 to LDLR, so increases number of LDLRs available to clear LDL, thereby lowering LDL-C levels

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8
Q

What do bile acid binding resins do?

A
  • cause the excretion of bile salts resulting in more cholesterol to be converted to bile salts by interrupting enterohepatic recycling
  • cause decreased absorption of TAGs and increase LDL receptor expression
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9
Q

What does Ezetimibe do?

A

inhibits NPC1L1 transport protein in enterocytes of the duodenum, reducing the absorption of cholesterol

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10
Q

What do diuretics do?

A

block Na reabsorption in the kidneys

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11
Q

What do beta blockers do?

A

block B1 and B2 receptors, reduce sympathetic activity, reduce renin release, reduce CO

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12
Q

What do calcium channel blockers do?

A

block L-type Calcium Channels in vascular smooth muscle cells to prevent contraction and vasoconstriction

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13
Q

What do angiotensin receptor blockers do?

A

block the agonist action of AT-II on receptors in a competitive manner

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14
Q

What do potassium channel openers do?

A

cause hyperpolarization in vascular smooth muscle to promote relaxation and vasodilation

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15
Q

What do alpha blockers do?

A

cause vasodilation by blocking vascular alpha 1 adrenoceptors - reduce sympathetic transmission and decrease MABP

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16
Q

What so mineralocorticoid antagonists do?

A

block aldosterone receptors

17
Q

What are the common causes of peripheral vascular disease?

A 
atherosclerosis is the most common
smoking
hypercholesterolaemia
hypertension
diabetes
18
Q

What vascular diseases is diabetes linked to?

A

retinopathy
nephropathy
neuropathy

19
Q

What are the clinical signs of limb ischaemia?

A

pale and cold
weak or absent pulses.
limb hair loss, skin changes (atrophic skin, ulceration, or gangrene
thickened nails

20
Q

What are the names of the pulses in the legs?

A

popliteal, femoral, dorsalis pedis, posterior tibial

21
Q

What are the 6Ps of limb ischaemia?

A

pain, pallor, paleness, perishingly cold, paraesthesia, paralysis

22
Q

What are the main drugs used to treat angina?

A 
beta-blockers
calcium channel blockers
vasodilators
ivabradine
metabolic modulator
23
Q

What do beta blockers do relative to angina treatment?

A

slow heart beat, decreases preload and afterload, reduce RAAS activity, less vasoconstriction

24
Q

What do calcium channel blockers do relative to angina treatment?

A

block calcium channels - decreased contraction rate which increases efficiency and decreases myocardial strain

25
Q

What do vasodilators do relative to angina treatment?

A

dilate veins, more blood getting to areas of ischemia, decreases afterload

26
Q

What does Ivabradine do relative to angina treatment?

A

reduces pacemaker potential, takes longer to reach threshold so slows heart rate

27
Q

What do metabolic modulators do relative to angina treatment?

A

decreases calcium load on heart, slows heart rate and strain on heart

28
Q

What are the symptoms of DVT?

A

● pain, swelling and tenderness in one of your legs (usually your calf)
● a heavy ache in the affected area.
● warm skin in the area of the clot.
● red skin, particularly at the back of your leg below the knee

29
Q

What are the risk factors for venous thrombosis?

A
  • surgery
  • lower-extremity paralysis due to spinal cord injury
  • lower long bone fracture
  • multiple trauma
  • prolonged immobility
  • contraceptive pill
30
Q

What is the pathology of DVT?

A

Thrombus formation and propagation depend on the presence of abnormalities of blood flow, blood vessel wall, and blood clotting components, known collectively as Virchow’s triad

31
Q

What is an aneurysm?

A

Abnormal and persistent dilation of an artery due to a weakness in its wall

32
Q

What are the causes of aneurysm?

A

Mycotic, atherosclerotic, dissecting, congenital, arteriovenous, traumatic, syphilitic

33
Q

What are the complications of aneurysm?

A

rupture (6cm), thrombosis (result of stasis), embolism, pressure erosion of adjacent structures (not common anymore - associated with syphilis), infection

34
Q

What are the causes of atheroma?

A 
●	Cigarette Smoking
●	Hypertension
●	Hyperlipidaemia
●	Diabetes
●	Age (older)
●	Sex (males)
●	Genetics
35
Q

What ate the effects of hypertension?

A

damage to kidneys, eyes and brain

36
Q

What is a list of differential diagnoses for acute chest pain?

A 
●Acute coronary syndromes including myocardial infarction
●Pulmonary embolism
●Aortic dissection
●Pneumothorax
●Herpes Zoster (shingles)
●Pericarditis
●Heartburn
●Oesophageal spasm
37
Q

What other conditions can troponin be raised in?

A
  • hypertension
  • renal failure
  • sepsis
  • PE
  • stroke
  • pericarditis
  • post-arrhythmia
38
Q

What are the contraindications for thrombolysis?

A 
●suspected aortic dissection
●recent haemorrhage
●major surgery or trauma within previous two weeks
●active peptic ulceration
●CVA in previous six months
●uncontrolled hypertension
●aggressive CPR
●warfarin therapy

My Cardiovascular (13 decks)

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