Week 3 Flashcards
What is athersclerosis?
Build up of plaque in the arteries
What forms plaque (in relation to athersclerosis)?
Fatty substances Cholesterol Cellular waste Calcium Fibrin
What is a chylomicron?
Lipoprotein
Which lipoprotein has a protective effect for risk of athersclerosis?
HDL
What do statins do?
Reduce total cholesterol and LDLs
Where are xanthelasma found?
Eye
What can be used to help estimate the risk of developing cardiovascular disease?
Assign score
BP = X x Y
CO
TPR
What is Conn’s syndrome?
Excess production of aldosterone by the adrenal glands
What is Cushing’s syndrome?
Condition caused by high levels of cortisol in the body (fromthe adrenal gland)
What is phaeochromocytoma?
Condition caused by excess noradrenaline
What is coarctation of the aorta?
Congenital narrowing of segments of the aorta
What is benign hypertension?
Asymptomatic, incidental finding
Is a cause of life threatening morbidity
What does hypertension do to the heart?
Left ventricular hypertrophy
Poor perfusion
Interstitial fibrosis
Micro-infarcts
Diastolic dysfunction
What does arterial stenosis cause?
Narrowing of the arterial lumen
Reduced elasticity
Reduced flow in systole
Tissue ischaemia
What should be offered to a patient if their BP is 140/90 or higher in order to confirm the diagnosis?
ABPM
Ambulatory Blood Pressure Monitoring
What is ABPM?
Two measurements per our throught the day during a normal person’s waking hours
What is stage II hypertension?
Clinical BP 160/100 mmHg or higher AND ABPM/HBPM daytime average of 150/95
What should be offered to all patients diagnosed with hypertension?
Urine test for protein
Blood to measure glucose, electrolytes, creatinine, estimated glomerular filtration rate and cholesterol
Examine fundi for hypertensive retinopathy
Arrange a 12-lead ECG
Renal disease, obstructive sleep apnoea, aldosteronism and reno-vascular disease all increase the risk of what?
Secondary hypertension
What do 60% of hypertensive patients have inappropriate secretions of?
Aldosterone
What is haemostasis?
Arrest of blood loss from a damaged vessel
What are the 3 stages involved in haemostasis?
Local vasoconstriction at the site of injury
Adhesion, activation and aggregation of platelets at site of injury
Formation of fibrin (blood coagulation)
What does exposed collagen bind to?
von Willebrand factor
What is the pivotal event in the complex amplifying cascade in the events of coagulation?
The production of the protease thrombin that cleaves fibrinogen to fibrin
What does thrombosis mean?
Pathological haemostasis
A heamatological plug in the abscence of bleeding
What does an arterial thrombus look like?
White thrombus
Mainly platelets in a fibrin mesh
Primarily treated with anti-platelet drugs
What does a venous thrombus look like?
Red thrombus
White-head, jelly-like red tail, fibrin rich
Primarily treated with anti-coagulants
What does warfarin block?
Vitamin K reductase
What are anticoagulants used in the treatment of?
Venous thrombosis and embolism
Name an anticoagulant
Warfarin
What can an overdose of warfarin be treated with?
Vitamin K1 e.g. phytomenadione
What does heparin bind to?
Antithrombin III
Name 2 antiplatlet drugs
Aspirin
Clopidogrel
When is streptokinase?
Drug used to reduce mortality in an acute MI
What is the thymus?
Gland/lymphoid organ producing T-lymphocytes in childhood-involutes and becomes replaced by adipose tissue after puberty
What lymphatic duct drains the left venous angle?
Thoracic duct
What is the swollen start of the thoracic duct in the abdomen called?
Cisterna chyli
How is extra oxygen supplied to the heart when it is required?
Increasing coronary blood flow
A decrease in partial pressure of oxygen does what to coronary arterioles?
Vasodilates them
What nervous system supplies coronary arterioles?
Sympathetic
What parts of brain are very sensitive to hypoxia?
Grey matter
Basilar and carotid arteries anastomes to form what?
The circle of WILLIS
A MABP below what results in confusion, fainting and brain damage if not quickly corrected?
50mmHg
An increase in PCO2 causes what?
Cerebral vasodilation
A decrease in PCO2 can lead to what?
Vasoconstriction
What causes the blood brain barrier?
Tight intercellular junctions found in cerebral capillaries
How does glucose cross the blood brain barrier?
Facilitated diffusion using specific carrier molecules
What is the blood brain barrier impermeable to?
Hydrophilic substances such as ions, catecholamines, proteins etc
What does the skeletal muscle pump reduce the chances of?
Postural hypotension and fainting
What are varicose veins?
When blood pools in lower limb veins when venous valves become incompetent
What is the end point of the coagulation cascade?
Fibrin
Where is vitamin K stored?
Fat soluble
Stored in the liver
