Tuesday Wk 2 Cardio 2 Flashcards

1
Q

NE acts on the __/__ Alpha receptors and __ beta receptors
stimulating A1 receptor leads to __ in skin/viscera
this inc __/__ BP
occurs via __ second messenger

stimulating B1 receptor in heart inc cAMP through __ second messenger
this inc cardiac __/__ and __
HR is counterracted, so usually __ is seen

stimulation of A2 receptor dec cAMP in panc B cells, dec__ secreetion and reducing __ motility

A

A1/A2, B1
VC
Systolic/diastolic
IP3

Gs
contractility, conduction, HR
no effect

insulin, intestinal

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2
Q

A1 receptor inc peripheral __
__ constrction and pupillary __

A2 dec __
CNS s__

B1 inc cAMP to inc cardiac contractility and __ release by JG cells of kidney

B2 inc cAMP for peripheral __ and B___
inc __ release by panc

A

vc, urethral, dilation

cAMP
sympatholytic

renin

vasodilation, bronchodilation
glucagon

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3
Q

blood flow goes forward w dec __ pressure
seen w arterial __, esp w MR

when MR is dependent on ventricular size (Ie __ cardiomyopathy), inc in LV __ can worsen condition

VSD occurs due to abnormal __ migration
anterior/cephalad deviation of __ results in patho

in TAPVR, pulm/systemic venous systems flow into __ leading to RA/RV dilation

Endocardial cushion defect leads to failed fusion of __/__ endo cushions
defects in __ septum/valves
initial __ shunt, can reverse and form __

A

afterload
vasodilators

dilated, EDV

NCC, infundibular septum

RA

superior/inferior
AV
LtR, ES

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4
Q

severe HTN w HA/blurry vision indicates ___
w sympathetic activity, can be due to __ containing foods
indirect sympathomimetic metabolized by GI __

when using MAO inhibs T/P, cannot degrade tyramine, leading to severe HTN
drugs normally used for severe __

a CV event in setting of known DVT suggest paradoxical __
emboli originate in the __ circ and enter systemic arterial circ via __
could be patent FO/AS, VS

paradoxical embolism can also occur w transient __ of shunt w inc Right sided pressure

A

hypertensive emergency
tyramine
MAO

Tranylcyrpomaine, phelezine
depression

embolism
systemic venous, shunt
Foramen ovale, atrial septum, ventricular septum

reversal of the shunt

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5
Q

when BF cannot meet cardiac demands, heart uses __ metabolism
no __ can be used
thus N/KATPase and SR _
inc intracellular __/__ and intramitochondrial __
this brings __ in, leading to swelling

radiofreq ablation of the AV node is used for intractable __
AV node is located on the __ surface of RA, near __ leaflet of TC valve and orifice of the __

may ablate isthmus bw IVC and tricuspid annulus for __

A
anaerobic
ATP
fail
Ca, Na, Ca
water

A fib
endocardial, septal, coronary sinus

a flutter

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6
Q

when LAD is occluded, __ artery is used for bypass
w others/multiples, use __ vein instead

GSV located on the __ foot, anterior to __, up medial leg
inferolateral to the ___
can be found in the __ triangle, branching off the femoral artery

femoral triangle is the __ lig, __ muscle, and __ muscle

A

left internal mammary
GSV

medial, MM
pubic tubercle
femoral

inguinal, sartorius, adductor longus

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7
Q

most common cause of RAS is __ at origin of renal artery
w atrophy, see __ glomeruli, tubulointerstitial __/__ and inflam infilrates

__ binds to D-alanyl-D-alanine in cell wall to stop formation of peptidoglycan
VRE replaces it w D-alanine-D-___

In __, chromosomes fail to separate, leading to daughters cell w __ of chromosome
usually occurs in women > __
assc w Down syndrone, T18 __ and T13 ___

__ translocation occurs w break centromeres of 2 chromos and allows for transfer of genetic material

A

atherosclerotic plaque
crowded, atrophy/fibrosis

Vancomycin
lactate

meiotic nondisjxn, extra copy
35
Edwards, Patau

Robertsonian

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8
Q

w heart failure, __ edema develops due to transudative fluid
inc caillary __ pressure, such as by arterolar dilation impaired VR

dec plasma __ pressure, such as w dec albumin

__/__ retention w kidney probs

__ obstruction

as interstitial fluid inc, so does __ drainage
when central venous pressure rises too high, this can lead to __ edema

A

noninflam
hydrostatic

oncotic

salt/water

lymphatic

Lymhpathic
peripheral

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9
Q

__ HF is caused by dec ventricular compliance
LVEF and volume is __
but LV filling pressure is ___
seen w HTN, O__ and infiltrative disorders like A/S

systolic HF shows inc LV __ due to __ of wall and inc compliance
seen w A__, D__, s__ deficiency, and ___ myocarditis

A

diastolic, normal
elevated
obesity
Amyloid, sarcoid

volume, thinning
alcohol, doxorubin, selenium, viral

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10
Q

ASD results in __ flow through PA
muscular PA can lead to inc __ above systemic resistance, leading to reversal of the shunt
over time, this becomes __ and irreversible

RV can enlarge, but this is __

in platelets, inc cAMP can activate _ which inhibits platelet aggregation
C__ inhibits PDE, leading to cAMP accumulation
acts as direct arterial __, and can dec __ sx

A__ is antibody against Gp2B3A
H__ potentiates AT3
T__ converts plasminogen to plasmin to cause fibrinolysis
W__ inhibits VK epoxide reductase

A

inc
PVR
sclerotic

reversible

PKA
cilostosal
vasodilator, PAD

abciximab
heparin
TPA
warfarin

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11
Q

in zone of autoregulation, blood flow is inc due to myocardial __
w inc O2 demand, inc __ is necessary bc O2 extraction is at max
Adenosine is derived from _) and acts to VD the small coronary arteries

NO is released from __ cells in coronary vasc
synthesized from A/O, and is released in response to NT, platelet products, amines

also __ stretch and shear __
major regulator of ___ in large arteries, via Gs and release of __ for smooth muscle relaxation

A

ischemia
bf
ATP

endothelial
arginine, oxygen

pulsatile, stress
VD
cGMP

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12
Q

in diastole, LA pressure is normally equal to __
in MS, inc in __ pressure backs up and causes rise in PCWP

atherosclerosis is predominantly in __/__ arteries
usually A, C, P, IC

in exercise, __ activation leads to development of maximum blood flow to muscles
inc __ and __ volume and __ output (predominantly HR)

SNS also leads to __ in arterioles of working muscle to inc blood flow
slight inc in __
this dec ___, caused by A, K, and ATP

A

LVEDP
LA

large, medium
aorta, coronary, popliteal, Internal carotid

SNS
HR, stroke, cardiac

vasodilation
bp
SVR, adenosine

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13
Q

__ node has fastest generation of HR
works to __ impulses by other areas
if SA node is interrupted, other areas __
look for __ depolarization (P), __ depoarization (QRS) and ventricular __ (T) on ECG

in 3rd degree heart block, __ causes ventricular contration
QRS node is ___

below AV node, HR becomes extremely __
QRS will be __

PDA is a continuous murmor w inspiratory splitting/max intensity at __

A
SA
suppress
conduct
atrial, ventricular, repolarization
AV node
narrow

slow
wide

S2

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14
Q

TP and false neg are __ such that an inc in one produces an equal dec in the other

A__, O2 and NADPH can syntesize NO from eNOS
activates GC to release cGMP and activate __
this reduces cytosolic __ levels, relaxing vasc smooth muscle

kidney is at high risk for __ due to higher rate of perfusion
systemic thromboemboli most likely occur from __ and clot formation
kidney has few __ as it is end organ supply
this leads to __ infarcts and pale wedges

A

complementary

arginine, PKG
Ca

infarct
A fib
collaterals
ischemic

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15
Q

ASD best heard at upper __ border

Nitrates directly relax __
vasodilate peripheral __ and arteries, mostly veins
dec LV wall stress to reduce __
can reduce __ slightly, and dilate __ arteries
in sum, dec myocardial __

A

left sternal

vasc smooth muscle
veins
preload
afterload, coronary
oxygen demand
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16
Q

0-4 hrs after MI, minimal __

4-12 hrs, early coag __ w edema, hemorrage and __ fibers

12-24 hrs, coag necrosis and __ band necrosis

1-5 days __ infiltrate
5-10 days __ phagocytosis

10-14 days __ forms

2w to 2m __ deposition and scar formation occurs

A

change

necrosis, wavy

contraction

PMN
macro

granulation

collagen

17
Q
PAN is segmental, transumural \_\_ inflam
mostly of _
also H/L/Gi tract
promotes ischemia, infarct and \_\_
spares \_\_\_ arteries

following endothelial injury in atherosclerotic olaque, __ adhesion occurs and upregulates PDGF
this results in __ of plaque

__ is seen w chest pain worse w palpation/movement
BP < __ difference is normal

A

necrotizing
kidneys
heart , liver, Gi
hemorrhage

pulmonary

platelet
proliferation

chostocondritis
10

18
Q

most pt w lightening strike die due to __ and __
other comps include R__ and F__, S__ and autonomic dysfxn
look for __ figures n skin

acute MI has __ elevations
old MI seen w __ waves

occlusion of left __ can lead to anterolateral infarct
elevations in V1-__ and avL

A

arrhythmia, Resp failure
rhabdo, fracture, seizure
lichtenburg

ST
Q

main coronary artery
6

19
Q

QRS complex should dec during __

Class 1C antiarrhtymics F/P tx supraventricular tacchycaridas
bind to sodium channels for phase __ depolarization, prolging QRS
have __ dependence, thus effects on QRS wave intensify w inc __
no effect on __

Class 1A antiarrhythmics Q/P/D
__ inhib of phase 0
AP potential length is __

Class 1B L/M __ inhibition of phase 0
__ AP

Class 4 antiarrhymthic V slows SA/AV node conduction
inc coronary __ and dec myocardial __

A
flecainade, propafenone
0
usse
exercise
QT

qunidine, procainamide, disopyramide
intermediate
prolonged

lidocaine, mexiletine, weak
shorten

verapamil
bf, O2 demand

20
Q

D is class 3 antiarrhtyhmic
blocks outward __ channel
increases __ duration, no effect on QRS
has reverse __, so affects __ HR more

arteriolar vasodilators H/M lower BP by reducing SVR
leads to reflex __ activation, inc HR/CO/contractility
overtime, leads to activation of __ system, w Na/Fluid retention and edema
only used for __ HTN
often given w S/D

__ dec CO leading to peripheral VC and cold hands/feet

A

K
QT
use dependence, slower

hydralazine, minoxidil
SNS
RAAS
severre
sympatholytic, diuretc

BB

21
Q

Alpha adrenergic agonists inc __ w reflexive dec in HR via vagal influence on the heart
this dec __ conduction and therefore myocardial contractility

D__ is B agonist w activity on B1 receptors
activates __ w release of cAMP
inc __ concentration, promoting positive inotropy
also inc HR by inc Na and Ca activation, so also positive __

D__ inhibits Na/K atpase
inc intracellular Na dec Na-Ca exchanger, thus higher __
this improves myocardial __

A

BP
SA

dobutamine
Gs
Ca
chronotropy

digoxin, Ca
contractility

22
Q

cardipresp response to exercise results in inc heart __ and cardiac __ and resp __
this keeps Arterial blood gas __ while venous O2 is __ and CO2 is __

most serious manifestation of ARF is P__
fever, fatigue, a__ w altered vitals
leads to mitral __ and holosystolic murmur

biopsy shows fibrosis w lymphs/macros/giant cells aka interstital myocardial granuloma or __ body

plump macros w abundant cytoplasm and chromatin ribbons are __ cells

aschoff body replaced by __ scar tissue leading to mitral stenosis

A

rate, output, rate
normal, dec, inc

pancarditis
anorexia
regurg

aschoff

anischkow

fibrous

23
Q

Viral myocarditis has predominant __ interstital infiltrate

T cruzi carditis look for intracellular

A

lymphocytic

trypanosomes