Tuesday Wk 2 Cardio 2 Flashcards
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
A1/A2, B1
VC
Systolic/diastolic
IP3
Gs
contractility, conduction, HR
no effect
insulin, intestinal
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
vc, urethral, dilation
cAMP
sympatholytic
renin
vasodilation, bronchodilation
glucagon
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 __
afterload
vasodilators
dilated, EDV
NCC, infundibular septum
RA
superior/inferior
AV
LtR, ES
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
hypertensive emergency
tyramine
MAO
Tranylcyrpomaine, phelezine
depression
embolism
systemic venous, shunt
Foramen ovale, atrial septum, ventricular septum
reversal of the shunt
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 __
anaerobic ATP fail Ca, Na, Ca water
A fib
endocardial, septal, coronary sinus
a flutter
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
left internal mammary
GSV
medial, MM
pubic tubercle
femoral
inguinal, sartorius, adductor longus
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
atherosclerotic plaque
crowded, atrophy/fibrosis
Vancomycin
lactate
meiotic nondisjxn, extra copy
35
Edwards, Patau
Robertsonian
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
noninflam
hydrostatic
oncotic
salt/water
lymphatic
Lymhpathic
peripheral
__ 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
diastolic, normal
elevated
obesity
Amyloid, sarcoid
volume, thinning
alcohol, doxorubin, selenium, viral
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
inc
PVR
sclerotic
reversible
PKA
cilostosal
vasodilator, PAD
abciximab
heparin
TPA
warfarin
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
ischemia
bf
ATP
endothelial
arginine, oxygen
pulsatile, stress
VD
cGMP
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
LVEDP
LA
large, medium
aorta, coronary, popliteal, Internal carotid
SNS
HR, stroke, cardiac
vasodilation
bp
SVR, adenosine
__ 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 __
SA suppress conduct atrial, ventricular, repolarization AV node narrow
slow
wide
S2
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
complementary
arginine, PKG
Ca
infarct
A fib
collaterals
ischemic
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 __
left sternal
vasc smooth muscle veins preload afterload, coronary oxygen demand
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
change
necrosis, wavy
contraction
PMN
macro
granulation
collagen
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
necrotizing
kidneys
heart , liver, Gi
hemorrhage
pulmonary
platelet
proliferation
chostocondritis
10
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
arrhythmia, Resp failure
rhabdo, fracture, seizure
lichtenburg
ST
Q
main coronary artery
6
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 __
flecainade, propafenone 0 usse exercise QT
qunidine, procainamide, disopyramide
intermediate
prolonged
lidocaine, mexiletine, weak
shorten
verapamil
bf, O2 demand
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
K
QT
use dependence, slower
hydralazine, minoxidil SNS RAAS severre sympatholytic, diuretc
BB
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 __
BP
SA
dobutamine
Gs
Ca
chronotropy
digoxin, Ca
contractility
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
rate, output, rate
normal, dec, inc
pancarditis
anorexia
regurg
aschoff
anischkow
fibrous
Viral myocarditis has predominant __ interstital infiltrate
T cruzi carditis look for intracellular
lymphocytic
trypanosomes
