Wed Wk 2 Cardio 5 Flashcards
___ 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 __/__
thiazide insulin LDL Ca, uric acid Na/K/Mg
functional
preload/afterload
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
pterin
middle meningeal
maxillary
foramen spinosum
LA
esophagus, TAA
dysphagia
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
thoracic aorta
dissection/anuerysm
lv myocardium
subendocardial
upregulated
pulm veins
ADH
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
heavy chain, myosin binding
dilated cardiomyopathy
amyloidosis
AV, cerebral, cocaine
coarctation of the aorta
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
depolarization
Na
plateau
responsive tissues
fast
paroxysmal supraventricular tacchycardia
4
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 ___
TCA
anticholinergic
Na
NaHCO3
Na
blockade
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
aerobic
lactate
30
blood flow
irreversible
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
SMA and aprta
varicocele, hematuria
nutcracker
concentric
contraction
preload, hypoTN
pressure
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
VSD
RVOT
dynamic
Right, left pulm edema stroke volume, preload output dec
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 ___
dec
inc
warm
radiation
infections
drugs
connective tissue
dobutamine systolic, septic inotropy, chronotropy filling pressure vasodilation consumption
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 __
hemodynamic, atherosclerotic
arterial/venous
preload/afterload
peripheral
contractility
glucagon
contractility
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 __
integrity
fibrinous necrosis pericardium shoulder swallowing
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 __/__
hypovolemic
SNS, RAAS
contractility, hr
TPR, vital organs
heart
Na/water
blood/saline
preload
sarcomere
stroke volume, output
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 ___
dec, dec, dec, inc
inc, inc, dec, inc
dec, dec, inc, dec
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 __
extravasation
vasoconstrion, necrosis
phentolamine
warfarin
PT
PT/INR
AFib, DVT/PE
anticoag, necrosis
heparin
unfractionated heparin
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 __
arrhythia
amiodarone, lidocaine
Na channel
inactive
recovery
class 1b
ventricular arrhythmia
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 __
fibrinolytics tenectalplase, alteplase plasmin lysis, blood flow hemorrhage
fluctuating
hemorrhage
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
GI
dec
dec
flushing, hepatotox, gout
myopathy, gallstones
AV shunt presents w pulsatile __ w thrill
AV shunt inc cardiac __
as blood bypasses arterioles, TPR is __ which dec afterload
masses
preload
dec
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
A1
contractility, rate
vasodilation, BP
vasoconstriction
predominates
A1
propanolo, VC
B1
A1
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 __
VSM
vasodilation
verapamil, myocetes
chrono/inotropic effects
myocytes
nifedipine, tachycardia
prolongation
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
thrombotic malignancy AP. SLE, DIC mucinous cytokines hypercoag fibrin, immune dislodge
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
hypertrophy
degenerates
intimal
calcific
HTN
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 __
Gq, DAG/IP3
Gi, cAMP
Gs
Gs, cAMP
Gq, IP3/DAG
Gi, cAMP
B1 receptors are found in __ tissue and renal __ cells
blockade dec __ w/out affecting vascular smooth muscle
B2 receptors found on __ and __ smooth muscle
cardiac, JG
cAMP
vascular, bronchial
