Wed Wk 2 Cardio 5 Flashcards

1
Q

___ diuretics are preferred for blood pressure
SE is a dec secretion of __ and reduced peripheral glucose uptake
can also inc __/TG levels due to altered lipid metabolism
can raise serum __/__ levels
drop __/__/__ levels

acute hemodynamic change can produce a __ heart murmur
this can be dec w lowering __/__

A
thiazide
insulin
LDL
Ca, uric acid
Na/K/Mg

functional
preload/afterload

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2
Q

fracture at the __ is a region where frontal/parietal/temporal/sphenoic bones meet
risk of rupture to teh __artery
this is a branch of the __ artery, arising from the ECA
maxillary artery enters the skull at the ___ and supplies dura/periosteum

__ is most posterioly located chamber
lies near __ and __ can visualize the LA, atrial septum, and MV
w LA enlargement, __ can result

A

pterin
middle meningeal
maxillary
foramen spinosum

LA
esophagus, TAA
dysphagia

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3
Q

descending __ lies posterior to the esophagus/LA
allows visualization of __/__ on TEE

during systole, coronary vessels supplying __ are compressed
systolic reduction in blood flow is greatest in __ region, making it particularly susceptible to ischemia

in CHF, RAAS is __
A1 is converted to AT2 by ACE present in the __
__ from the PP is also upregulated in CHF

A

thoracic aorta
dissection/anuerysm

lv myocardium
subendocardial

upregulated
pulm veins
ADH

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4
Q

HCM caused by point missense mutation in Beta myosin __ gene or __ protein C gene

mutations in dystrophin gene can result in Xlinked __

Cardiac __ characterized by SOB, peripheral edema, ascites

pt w spontaneous IC hemorhage likely due to __ malforms, ruptured __ aneurysm, or abuse of __
Ruptured Berry aneurysm is more likely to occur w __ of aorta due to excessive HTN

A

heavy chain, myosin binding

dilated cardiomyopathy

amyloidosis

AV, cerebral, cocaine
coarctation of the aorta

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5
Q

Phase 4 of cardiac pacemaker is spontaneous __
influx of __ causes rise in membrane potentials
later, Ca opens and accelerates rise in AP, this dec time until __
Class 4 antiarrhythmics act here to slow __
works on slow response __ such as AV/SA nodes

use class 1 drugs on __ response tissues

pt w anxiety, sudden onset palpitations, light headed has P\_\_\_
tx w class _ antiarrhthmic
A

depolarization
Na
plateau
responsive tissues

fast

paroxysmal supraventricular tacchycardia
4

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6
Q

mental status change, seizure, resp depression w inc HR/hypoTN, prolonged ECG intervals has __ overdose
may have addtl __ sx

arrhythmias caused by blockage of fast __ channels, w inhibition of Ach/Histamine/A1 receptors

wide QRS interval or ventricular arrhythmia is tx w __
this alkalinizes the drug, preventing it from binding __ channels

rise in Na also overcomes Na channel ___

A

TCA
anticholinergic

Na

NaHCO3
Na

blockade

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7
Q

total myocardial ischemia immediately results in cessation of __ glycolysis
metabolites like __ accumulate
loss of contractile fxn w/in __ min is reversible
duration of myocardial __ depends on duration of ischemia

adenosine initially inc to promote __ to myocardium
after 30 min, complete absence results in __ injury

A

aerobic
lactate
30

blood flow
irreversible

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8
Q

left renal vein pressure is higher than right due to compression by _ and _
over time, this can lead to leaflet failure and V___
presents w H__
phenomenon called __ effect

in pt w chronic aortic stenosis, LV __ hypertrophy develops
thus, atrial __ is necessary for filling
w a fib, reducton in LV __ reduces CO, resulting in systemic __
this leads to inc pulm vein __ which backs up and causes pulm edema

A

SMA and aprta
varicocele, hematuria
nutcracker

concentric
contraction
preload, hypoTN
pressure

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9
Q

in ToF, the __ is large and allows for equalization of pressures
amount of __ obstruction determines degree of sx
can by __ and inc suddenly

infarct of RCA can affect either __ or __ ventricle
w RHF, hypoTN and distended jugular veins occurs, but no __
thus, there will be dec RV __ and dec RV __
overall, reduction in cardiac __
PCWP is __ as well, backing up into CVP

A

VSD
RVOT
dynamic

Right, left
pulm edema
stroke volume, preload
output
dec
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10
Q

in septic shock, SVR is __ and CO is __
pt is __ feeling

causes of cardiac tamponade
Malig or \_\_ therapy
I
D
\_\_ dz

D__ is B1 agonist
used for severe LV __ dysfxn and __ shock
inc cAMP resulting in positive I/C
inc cardiac contractility and output w dec LV __
mild __
overall, inc myocardial O2 ___

A

dec
inc
warm

radiation
infections
drugs
connective tissue

dobutamine
systolic, septic
inotropy, chronotropy
filling pressure
vasodilation
consumption
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11
Q

Calcific aortic stenosis caused by chronic __ stress or __ inflammtion

Nitroprusside is short acting __/__ vasodilator
dec / while maintaing stroke volume

BB overdose leads to blockade of __ beta receptors
this dec myocardial __ w bradycardia and AV block

tx w __, which inc cAMP and Ca in muscles
inc HR/Cardiac __

A

hemodynamic, atherosclerotic

arterial/venous
preload/afterload

peripheral
contractility

glucagon
contractility

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12
Q

necrosis leads to loss of membrane __ w leakage of proinflammatory material that can injure srrounding material

sharp, pleuritic chest pain days post MI suggest __ pericarditis
reaction to transmural ___
affects adjacent viscerla/parietal __ overlying the necrotic segment
can involve phrenic nerve w radiation to __
or affect posterior pericardium w difficulty __

A

integrity

fibrinous
necrosis
pericardium
shoulder
swallowing
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13
Q

hypoTN, tachycardia, and cool extremities indicates __ shock
dec intravascular volume leads to activation of the __ and ___

stimulation of heart inc __/_
constriction of arterioles riases ___, shunting blood towards __
inc venous return to __
inc __/__ retention

in tx, rapid infusion of __/__ inc volume, and therefore RV __
stretches myocardium, inc __ length
downstream, this inc __/__

A

hypovolemic
SNS, RAAS

contractility, hr
TPR, vital organs
heart
Na/water

blood/saline
preload
sarcomere
stroke volume, output

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14
Q

Hypovolemic shock RA preload is __, PCWP is __, cardiac output is ___, and afterload is __

Cardio shock RA pressure is __, PCWP is ___, cardiac output is ___, afterload is ___

Septic shock preload is __, PCWP is ___, CO is ___, afterload is ___

A

dec, dec, dec, inc

inc, inc, dec, inc

dec, dec, inc, dec

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15
Q

blanching of vein that NE is being administered w induration/pallor indicates __
this activates A1 __ w local tissue __
tx w injecting __ an A1 blocker, w resultant vasodilation

W__ inhibits VK dependent clotting factors 2, 7,9, 10
this prolongs __ time
to monitor response, pt should have __/__ monitored closely

Warfarin can be used in A__, D__, and P__

SE Is excessive __ and skin __
usually bridged w _ to prevent SE
monitor aPTT w __

A

extravasation
vasoconstrion, necrosis
phentolamine

warfarin
PT
PT/INR

AFib, DVT/PE

anticoag, necrosis

heparin

unfractionated heparin

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16
Q

post MI, major concern is ventricular ___
tx w antiarrhythmics like A/L

class 1B drugs are weakest \_\_ blockers
bind Na channel in \_\_ state, w little effect on QRS
ischemic myocardium has higher membrane potential, delays voltage dependent \_\_
inc binding of _ agents

Lidocaine is esp used for inhiting ischemia induced __

A

arrhythia
amiodarone, lidocaine

Na channel
inactive
recovery
class 1b

ventricular arrhythmia

17
Q

tx for acute MI is PCI or __ w PCI preffered
when not available, use fibrinolytics T/A

binds fibrin in clot, converting Plasminogen to __
results in clot __ and restored coronary __
major SE is subsequent ___

carotid artery thrombosis w ischemic stroke has __ sx
abrupt onset of sx w lost conciousness more likely indicates __

A
fibrinolytics
tenectalplase, alteplase
plasmin
lysis, blood flow
hemorrhage

fluctuating
hemorrhage

18
Q

SE of bile acid sequestrants is __ issues

Niacin __ FA release, and VLDL synthesis
__ HDL release
SE include F, H, G

Fibrates SE include M and G

A

GI

dec
dec
flushing, hepatotox, gout

myopathy, gallstones

19
Q

AV shunt presents w pulsatile __ w thrill
AV shunt inc cardiac __
as blood bypasses arterioles, TPR is __ which dec afterload

A

masses
preload
dec

20
Q

epinephrine acts on B1, B2 and __ in that order
stimulation of B1 receptor inc cardiac __ and __, inc BP
stimulating B2 receptors promotes __ and dec diastolic __
Activating A1 inc peripheral __

at low doses, B2 mediated vasodilation __
higher doses prefer __ receptors

w nonselective B antagonist P, peripheral __ occurs
also blocks __ receptor keeping HR normal
all that is open is __ which inc blood pressure

A

A1
contractility, rate
vasodilation, BP
vasoconstriction

predominates
A1

propanolo, VC
B1
A1

21
Q

dihydropiridine CCB affect __
result is primarily __

NDCCB V affect __, w neg __/__

Diltiazem affects both VSM and __ to have combined effects

N__ can be used to treat HTN, as it promotes VD
can result in reflex __

first degree AV block has PR __

A

VSM
vasodilation
verapamil, myocetes
chrono/inotropic effects

myocytes

nifedipine, tachycardia

prolongation

22
Q

sterile platelet rich thrombi attached to mitral valve leaflets is characteristic of nonbacterial __ endocarditis
assc w advanced __ and inflam do like __ syndrome, S__, and D__
usually __ adenocarcinomas

endothelial injury caused by circulating __
platelets deposited due to __ state
bland thrombus w strands of F__ and __ complexes and monocytes
vegetations can __ and cause infarct

A
thrombotic
malignancy
AP. SLE, DIC
mucinous
cytokines
hypercoag
fibrin, immune
dislodge
23
Q

HTN causes medial __ in aortic vaso vasorum, reducing blood flow
media then __ w loss of smooth muscle
w inc wall stress, risk of __ tearing and dissection formation

Monckeberg sclerosis or medial __ sclerosis seen w Ca deposits in medial layer of arteries
isolated __ w arterial hardening

A

hypertrophy
degenerates
intimal

calcific
HTN

24
Q

A1 has __ protein, 2nd messenger is __
A2 has __, dec __

B1 has __ protein
B2 has ___ 2nd messenger is ___

M1/M3 have __ protein, second messenger is __
M2 has __, dec __

A

Gq, DAG/IP3
Gi, cAMP

Gs
Gs, cAMP

Gq, IP3/DAG
Gi, cAMP

25
Q

B1 receptors are found in __ tissue and renal __ cells
blockade dec __ w/out affecting vascular smooth muscle

B2 receptors found on __ and __ smooth muscle

A

cardiac, JG
cAMP

vascular, bronchial