Wed Wk 3 Cardio 3 Flashcards
N__ used for stable angina
mediate systemic __ w dec in LV EDV and wall stress
this dec myocardial __
AE include H__ and cutaneous __, lightheaded and __TN, w reflex tachycardia
avoid in H__ due to inc outflow obs, __ infarct due to reduced preload, and __ inhibs (synergistic effect)
nitrates
venodilation, o2 demand
HA, flushing, hypoTN
HCM, RV, PDE
AV conduction block is a SE of CCB like V/D and Beta blockers P/M
cold extremities seen in Raynauds + vaso__ type drug
elevated plasma H__ can inc risk of thrombotic events
direct/indirect induction of __
Homocysteine can be metabolized to methione via donation of methyl group from __ and methionine synthase w B12 as cofactor
MTHFR uses __ as cofactor to regenerate MTHF
homocysteine can be converted to C__ and __ via transsulfuration by CBS
cofactor is ___
verapmil, diltiazem
Propanolol, metoprolol
constriction
homocysteine
endothelial damage
MTHF
B12
cystathione, cysteine
VB6
distal extremity vasc insufficiency in heavy smoker less than 35 indicates __ as dx
vasculitis of __/__ arteries, usually tibial/radial
acute/chronic inflamm of __ w thrombosis of lumen
often extends into __/__ and encases all 3 strucures w __ tissue
may see superficial __ and cold sensitivity
look for hypersensitivity to __ extracts
Marfans assc w __ prolapse and cystic medial __ of aorta
most common causes of death are aortic __ and cardiac failure due to __/__
Thromboangitis obliterans small/medium aterial walls veins/nerves fibrous phlebitis tobacco
MV
degen
dissection
MVP/regurg
in pt w suspected marfan syndrome, another possibility is H\_\_ inherited \_\_ \_\_ disability T and downard \_\_ dislocation \_\_ anemia and fair complexion
pregnancy inc risk of VTE due to venous __, __ injury and hypercoag state
dec protein __ w upregulated coag factors
tx w low molecular weight __ such as Enoxaparan
do not cross __
direct thrombin inhib D
factor Xa inhibs A
W__ assc w fetal toxicity
homocystinuria AR intellectual thrombosis, lens megaloblastic
stasis, endo
S
heparan
placenta
digabitrin
apixiban
warfarin
stanford type A aortic dissection involves any part of __
usually occurs in S__ jxn
stanford type B is all others, usually located near left __
either type can propagate __
__ drains myocardium into RA, bw IVC and TC valve
dilates w any process that inc __ pressure
usually __ HTN, or persistent left __ or T__
AA
sinotubular
subclavian artery
distally
Coronary sinus
RA
Pulm, SVC, TAPVR
class 1A antiarrhthmics inhibit phase 0 depolarization by \_\_ channels, slowing conduction also moderate \_\_ channels, leading to slow \_\_ and prolonged AP
A__ activates K channels by interacting w A1 receptors on cardiac cells
causes membrane __ w slowing of HR and inc AV blockade
D__ inc vagal output to AV node, slowing conduction
CCB are class 4 antiarrhythmics V/D inhibit Ltype \_\_ slow depolarization of \_\_/\_\_ nodes slow \_\_ and prolong AV \_\_ which dec contractility
Na
K, repolarization
Adenosine
hyperpolarized
digoxin
Verapamil, diltiazim
AV/SA
HR, conduction
N__(sacubitril) is metalloproteinase that inactivates bradykinin, glucagon, and ANP
ANP released by __ cardiomyocytes due to inc stretch, which is __ expansion
lowers BP via peripheral __ and N/D
upregs cGMP, causing dilation of __ and rise in GFR
this leads to __/__ excretion, and inhibits renin
ANP stops __ sec, promoting Na/Water loss
relaxes vasc __ in arteries/veins
inc capillary ___
neprilysin
atrial, volume
vasodilation, natriuresis, diuresis
AA Na/water aldosterone smooth muscle permeability
pt w assymetric ventricular septal hypertrophy has __
dynamic __ obstruction causes the crescendo-decrescendo murmur at the LLSB/apex
degree of obs varies based on LV __
dec preload reduces LV EDV, inc __
murmur dec w __ and sustained __ or passive __ as these inc afterload
V_ and abrupt __ and __ admin dec preload, in the murmur
HCM
LVOT
EDV
obs
squatting, handgrib, leg raise
valsalva, standing, NG
w volume expansion, atria/ventricle releases natriretic peptide hormones __/__
both work to activate __ and promote cGMP release
__ is a tumor that expresses CD31
promotes endothelial cells for leuk __ into endothelium
myocardial perfusion comes from the __ arteries during diastole
wall tension is highest in the __ region, making it susceptible to ischemia
relaxation of ventricle during diastole allows for adequate __
inc HR shortens duration of __ and is major limiting factor for blood supply to endocardium
diastolic __ pressure is driving force for myocardial blood supply
ANP/BNP
GC
liver angiosarcoma
migration
coronary
subendocardial
perfusion
diastole
aortic
AS present w S/D/A
rf include __ aortic valve, C__ and RF
comps of RHF include mitral __ early and mitral __ later
audible S3 occurs in MR as __ pressure rises, supplying LV during diastole
absence of __ can be used to exclude severe MR
major SE of statins are __ and H__
severe myopathy/rhabdo can be seen w statin and __ which impairs hepatic clearance
syncope, dizzy, angina
bicuspid, calcific
regurg, stenosis
LA
S3
myopathy, hepatitis
fibrates
in severe AR, portion of LV __ reenters the LV
this inc LVEDV aka __
results in __ hypertrophy, which attempts to inc __ and maintain CO
if this is acute, small LV cannot compensate, causing rise in __ pressure and dec CO w pulm edema
first sign on ECG of MI is peaked __ wave, followed by __ elevation, and __ wave appearance
in contrast __ angina will respond to NG
stroke volume
preload
eccentric
stroke volume
LVEDP
T, ST, Q
Prizmental
endocardial thickening/firbsosis of T/P valves are classic for __ HD
excessive sec of __ stimulates fibroblast growth/differentiation
leads to plaque like deposits of __ in endocardium, w TR and RHF
damage limited to R side bc vasoactive products inactivated by __ in the pulm vasc
myocardial oxygen extraction is extremely __
cardiac venous blood from __ before RA is most deoxy blood in body
thus, w inc demand, coronary __ must be upregulated to meet demand
carcinoid
serotonin
fibroblasts
MAO
high
CS
blood flow
GCA produces __ inflam of media
as does __ arteritis, usually involving the __ and braches
may have low __/__ in upper extremities compared to lower extremities or paresthesias
leukocytoclastic vasculitis includes MP, HV, MP
segmental __ necrosis of small vessels
__ is segmental transmural inflam of S/M arteries
due to deposition of __
plaque stability determined by mech strength of __
thin cap fibroatheromas have large __ core and thin cap
constantly remodeled by __, to degrade ECM proteins
which can lead to ACS
granulomatous
takayusa, AA
BP, pulse
microscopic polyangitis, hypersenstivity vasc, microscopic polyarteritis
fibrinoid
PAN
immune complexes
fibrotic cap
necrotis
metalloproteinases
Lysyl oxidase strengthens __ fibers by mediating cross link formation
thickening/fusion of valve leaflets in CRHD is cause of __
can lead to __ enlargement, mural __
__ hydrolyzes TG into chylomicros/VLDL and FFA
Fibrates activate __ and dec VLDL production, w inc LPL activity
causes great reduction in __ levels
may be used alongside __ to reduce prodxn of VLDL and apoB
collagen
MS
atrial, thromboses
LPL
PPAR alpha
TG
fish oil/omega 3 fatty acid
E__ blocks cholesterol absorption
PCSK9 inhibs reduce __ degredation in the liver
blunt aortic injury most commonl casued by sudden __
this affects the aortic __ near the ligamentum arteriosum,
just distal to left ___
cryptogenic stroke is evalulted w __ test for RtL shunt/valsalva
freq assc w patent __/__
in developing, as PVR dec, LA pressure __
pushes septum __ against secundum to close FO
conditions that cause inc __ pressure can produce transient __
worse w hypercaog like __ use
pt gets DVT and paradoxical __ embolism
ezetemibe
LDL receptor
deceleration
isthmus
subclavian artery
bubble
FO, AS
rises primum RA shunt OCP brain
