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Med Path Fall 2020 > Things I cannot Remember Test 1 > Flashcards

Things I cannot Remember Test 1 Flashcards

1
Q

Blood pressure extrinsic factors

A

Disease

Obesity

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2
Q

HTN is a key risk factor for

A

Stroke

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3
Q

Primary HTN has what kind of etiology

A

Heterogenous, unknown

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4
Q

Risk factors for secondary HTN in women due to hormones

A

Smoking*
History of HTN during pregnancy
Family history

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5
Q

Symptoms of hypertensive urgency

A

Severe headache and anxiety

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6
Q

HTN emergency symptoms and potential complications

A

End organ damage
Chest pain
SOB
Difficulty speaking

Complicaitons:
Stroke
Pulmonary edema- blood leaks out of heart into lungs.

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7
Q

CVD

A

Disease of the heart and vessels that affect the efficient functioning of the cardiovascular system.

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8
Q

How many adults have CVD? What are the 4 types of CVD

A
  1. Hypertension
  2. Coronary heart disease
  3. Stroke
  4. Heart failure
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9
Q

Leading cause of mortality in the US from CVD

A
  1. Heart disease

2. Stroke

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10
Q

Primary form of CVD

A

Coronary heart disease- disease of blood vessels that supply the heart.

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11
Q

Hyperlipidemia levels

A

Tg 150+
HDL less than 40
LDL over 100
Cholesterol over 200

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12
Q

Secondary Hyperlipidemia due to what

A

Polygenic. Due to high fat diet and sedentary lifestyle. Much more common than primary/genetic.

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13
Q

Most common chronic disease in the US

Responsible for 80% of CVD

A

Atherosclerosis

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14
Q

CHD risk factors (4)

A

Smoking, HTN, hyperlipidemia, diabetes.

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15
Q

What causes MI

A

Thrombosis

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16
Q

Elevated blood indicators for MI

A

myoglobin
Troponin
Creatine kinase

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17
Q

Pericardium tamponade

A

Pericardium fills with blood. Decrease CO- swells. Less room in heart for blood.

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18
Q

Percutanous coronary intervention PCI for CAD

A

Angioplasty

Intracoronary stents

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19
Q

Heart failure causes

A

MI*
HTN
Valvular disease
Cardiomyopathy- muscle heart disease

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20
Q

Heart failure

A

Inability to increase cardiac output as needed

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21
Q

Left side HF

A

Pulmonary edema
Tachypnea- rapid breathing
Cyanosis

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22
Q

Right side HF

A

Most commonly caused by left sided failure
Peripheral edema
Hepatomegaly- enlargement of liver
Ascites- Excess venous pressure drains into abdomen.

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23
Q

Main cause of cardiac arrhythmia

A

MI- most common side effect of MI is arrhythmia.

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24
Q

Two forms of cardiomyopathy

A
  1. Ischemic due to thrombosis
  2. Non-ischemic
    - Toxic: Alcohol
    - Metabolic disease: hyperthyroid disease, amyloidosis,
    - Infection: HIV, COVID. Post viral myocarditis.
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25
Q

Primary cause of cardiomyopathy myocyte injury

A

MI

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26
Q

Hypertrophic cardiomyopathy is what type of genetic defect

A

Autosomal dominant

AA men most likely to have

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27
Q

Mitral valve regurgitation may be due to

A

Mitral valve prolapse

backflow from left ventricle to circulation

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28
Q

Mitral valve prolapse

A

Degeneration of connective tissue in the valve.

May lead to mitral valve regurgitation.

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29
Q

Acute pericarditis is caused by what

A

Neoplasm

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30
Q

chronic pericarditis is caused by what

A

Idioparthic

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31
Q

Systemic associations to pericardial disease

A

Uremia- excessive ammonia in blood

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32
Q

Ocular manifestations of infective endocarditis

A

Roths spots

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33
Q

The defining feature of diabetes

A

Hyperglycemia

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34
Q

Primary pathology of Diabetes due to hyperglycemia

A

Vascular damage happens all over body

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35
Q

Normal blood glucose levels

A

F 70-99
R less than 140
A 5.7 or below
O Less than 140

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36
Q

Diagnostic criteria for diabetes

A

F 126+
R 200+
A 6.5 +
O 200+

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37
Q

Average patient with diabetes has what A1C

A

8.5%

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38
Q

Predicts likelihood of disability and death

A

AIC

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39
Q

eAG

A

6% AIC = blood sugar 125

For every 1% increase in AIC, add 30 mg/dl

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40
Q

Most common endocrine disorder in the US

A

Diabetes 9-11% of population.

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41
Q

2 main risk factors of Diabetes

A

Overweight, sedentary life style

42
Q

diabetes is the number __ cause of death

A

7

43
Q

3 major diabetes complications

A

Retinopathy
Cerebrovascular disease- stroke
Neuropathy- palsy

44
Q

Diabetic is the leading cause of

A

Kidney failure
non traumatic lower limb amputation
New cases of blindness in adults due to retinopathy

45
Q

Diabetes is a major contributor to

A

coronary heart disease

Stroke

46
Q

Prediabetic stats

A

F 100-125
R 140-199
A 5.7-6.5
O 140-199

47
Q

Prediabetic risk factors

A

Overweight, sedentary lifestyle

History of high BMI, gestational diabetes, having a baby over 9 pounds

48
Q

Two causes of type 1 diabetes

A

Immune mediated - molecular mimicry, altered beta cells.

Idiopathic

49
Q

What is type 2 diabetes mellitus

A

Insulin resistance

50
Q

Risk factors of type 2 diabetes

A

Sedentary lifestyle, obesity

51
Q

Gestational diabetes increases risk of type

A

2 by 50%

52
Q

DOC for gestational diabetes

A

insulin

53
Q

Metabolic syndrome

Percentage of people it affects

A

Cluster of conditions that occur together

Affects 23-25% of population

54
Q

Diagnosis of metabolic syndrome

A

3 or more of the following

  • TG over 150
  • Fasting glucose over 100
  • HDL less than 40
  • Large waistline
  • Blood pressure 135/85
55
Q

3 main effects of chronic hyperglycemia

A
  1. Glycation of proteins causes abnormal crosslinking
  2. PKA levels increase
  3. Sorbital causes edema
56
Q

Macrovascular results due to diabetes

A

Coronary artery disease
Peripheral artery disease - Amputations= ulcerations
Cerebrovascular disease - transient ischemic attack, stroke.
Other- hearing loss and immunosuppression

57
Q

DM is the number 1 cause of

A

Lower leg amputation

58
Q

Microvascular Diabetes mellitus side effects

A

Retinopathy
Neuropathy
Nephropathy

59
Q

What damages endothelium in microvascular DM

A

Endothelial glycation. Basement membrane thickens and reduces O2 transmission.

Loss of pericyes = microaneursyms leak

Glycated platelets cause thrombosis- blood leakage and ischmia

60
Q

prevalence of diabetic retinopathy

A

28-33%

61
Q

Leading cause of renal failure

A

Diabetic nephropathy due to glomerulosclerosis

62
Q

Risk factors of diabetic nephropathy

A

Hyperglycemia and HTN

63
Q

Most common cause of death in type 1 diabetse

A

Diabetic nephropathy

64
Q

Diabetes is the number 1 cause of

A

ESRD

65
Q

Most common diabetic neuropathy

A

Peripheral

Other:
Autonomic
Proximal
Focal (cranial nerve palsies)

66
Q

Incidence of diabetic retinopathy increases with ____

A

Duration of DM

67
Q

How does diabetes contribute to cataract formation

A

40% increase in risk

Sorbital in lens fibers causes swelling, apoptosis, and increased free radical formation

68
Q

DKA triad

A

Hyperglycemia
Acidic blood
High ketones

69
Q

Diabetic ketoacidosis sugar level

A

200 mg/dl

70
Q

Hypoglycemic shock sugar level

A

70

Severe is 50-55

71
Q

Most common neurological disorder

A

Headaches

72
Q

3 types of primary HA

A

TTN (80%)
Migraines (20%)
Cluster (0.4%)

73
Q

Secondary HA are associated with what

A 
Fasting 
Sinus inflammation 
Infections
Stroke
Trauma
Refraction 
Medication over use
74
Q

TTH are due to what?

A

Persistent myofascial input- constantly contracting muscle somewhere Causes pain and sterile inflammation.

75
Q

Migraine neurovascular theory

A

Lower threshold to stimuli leads to cortical hyper excitability followed by cortical spreading depression (CSD). CSD activates trigeminal nerves and causes pain in dural blood vessels.

starts in occipital lobe

76
Q

54321 Migraine criteria

24321 for classic migraines

A

5 or more attacks
4 hours - 3 days
2 of the following: Unilateral, throbbing, severe pain, activity worsens
1 of the following: photophobia, photophobia, vomitting, nausea

77
Q

Childhood periodic syndromes

A

Migraines in kids. Car sickness

78
Q

Probable migraine

A

Hasn’t met 54321 critera, but on their way.

79
Q

What primary HA causes conj injection and tearing due to neuromuscular problems?

A

Migraines and cluster

80
Q

Migraines without aura (common) has what percentage of risk for what

A

25% increased risk for stroke and MI

81
Q

Migraines with aura “classic migraine” has what risks associated?

A

2x risk of MI in women

2x risk of stroke in men= women

82
Q

Retinal migraines

A

Transient, monocular visual disturbance. Vascular spasm causes ischemia = visual disturbances. Send to neuro

83
Q

What kind of primary headache causes projectile lacrimation

A

Cluster HA

84
Q

Ophthalmodynia Periodica

A

Shooting eye pain

Prob occurs along CN V ophthalmic branch

85
Q

HA work up

A 
History 
CN eval 
Sinus eval 
Blood pressure 
Refraction 
Bino testing
Health asses
VF screening
Consider brainscan
Refer to neuro
86
Q

Thrombosis causes

A

Endothelial damage due to atherosclerosis. Collagen exposed and pro clotting factors cause thrombosis.

Blood flow irreg due to immobility or anything that causes turbulent blood flow

hypercoaguability due to predisposition towards clotting. Congenital or acquired.

87
Q

Thrombosis is more frequent when

A

During sleep when blood is static + decreased blood pressure (no pressure to push blood along)

88
Q

Arterial thrombosis

cause

Effects

Risk factors

A

Cause: Endothelial damage- atherosclerosis

Effects: MI, Stroke

Risk factors: Smoking, HTN, hyper cholesterol, diabetes

89
Q

Venous thrombosis

  1. Associations
  2. Location
  3. Effect
  4. Risk factors
A
  1. Associations- venous stasis and hypercoaguabiltiy
  2. Location- deep veins
  3. Effect- thromboembolism, DVT, pulmonary embolism
  4. Risk factors- Immobilization
90
Q

DVT tests

A

D Dimer test

Angiography ultra sound

91
Q

Pulmonary embolism symptoms

A

Shortness of breath
Hemoptysis - cough up blood
Sharp chest pain

92
Q

Venous thrombosis ocular manifestations

A

Papilledema due to venous sinus thrombosis, BRVO/CRVO

93
Q

Aneurysm risk factors

A

Tobacco use

94
Q

Location of aneurysms

A

Cerebral arteries

Brain stem

95
Q

3 Aneurysm complications

A

Rupture- hemorrhagic stroke
Dissecction– ischemia
Thrombus due to turbulent flow causes ischemia

96
Q

Ocular manifest of aneurysm

A

Posterior communicating artery out pouching causes CN III palsy

97
Q

Shock shared feature

A

Inadequate tissue perfusion leads to anaerobic metabolism

98
Q

3 shock MOA

A
  1. Inadequate oxygen delivery - respiratory failure, heart failure, fluid loss, hemorrhage or anemia.
  2. Inadequate oxygen uptake- poisoning
  3. Inadequate nutrients
99
Q

Final common pathway of shock

A

Metabolic acidosis and cell death

100
Q

5 types of shock

A
  1. Hypovolemic - loss of blood volume due to injury, child birth, or dehydration.
  2. Cariogenic- heart damage. Unable to pump blood. MI, HF.
  3. Septic - bacterial infection. Causes fever and peripheral thrombus formation. May lead to hypovolemic or cardiogenic shock.
  4. Anaphylactic/hypotonic - Type I hypersensitivity. Widespread vasodilation.
  5. Neurogenic - damage to brain or spinal cord.
101
Q

three phases of shock

A

Compensatory
Progressive
Refractory

102
Q

presentation of compensatory phase of shock

A

Decreased skin perfusion

Med Path Fall 2020 (20 decks)

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