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Cardiovascular JC > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What does the coronary venous blood drain into?

A

The coronary sinus into the right atrium

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2
Q

What are some of the special features of the coronary circulation?

A

High basal blood flow
High capillary density
High oxygen extraction

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3
Q

What is the only way to increase perfusion of the heart?

A

Increasing oxygen flow to the heart y increasing blood flow due to the extraction of o2 from haemoglobin already being max

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4
Q

What changes in gas and metabolic contents cause vasodilation of the coronary arteries?

A

If Po2 decreases

Adenosine from ATP degradation

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5
Q

Why can tachycardia led to poor perfusion of the heart and chest pain?

A

Due to perfusion of the left coronary arteries occurring during diastole and the tachycardia shortening diastole. Results in poor perfusion. These are perfused during diastole due to the high pressure during systole constricting sudendocardial blood flow

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6
Q

What arteries make the circle of willis

A

Basilar artery (from vertebral arteries made from the subclavian arteries) and carotid arteries anastamosing

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7
Q

What is the effect on cerebral blood flow to increased MAP?

A

Vasoconstriction to avoid damage of vessels

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8
Q

What is the effect of A. increased B. Decreased carbon dioxide in cerebral circulation

A

A. Increased Co2; cerebral vasodilation

B. Decreased co2; cerebral vasocontriction

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9
Q

Describe the physiology behind someone hyperventilating fainting

A

As they have a decreased Pco2 the cerebral vessels constrict so o2 doesnt flow to the brain causing fainting

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10
Q

A young athlete suddenly dies, histologically the heart had swirled myofibres. What did they have?

A

Hypertrophic cardiomyopathy

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11
Q

A man presents with multiple myeloma, and has had developed arrhythmias. What type of cardiomyopathy has he developed?

What stain could be used histologically to confirm the diagnosis?

A

Restrictive cardiomyopathy due to amyloidosis (deposition of paraproteins) reducing compliance

Histologically; congo red stain positive

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12
Q

Women presents with long history of alcohol missuse and is undergoing chemotherapy with doxorubicin. She has breathlessness, fatigue and chest discomfort. Histologically on the heart there is no signs. What is the diagnosis?

A

Dilated cardiomyopathy

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13
Q

What heart valve can be affected in a person that has had rheumatic fever ?

A

Mitral valve to be stenosed

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14
Q

What viral infections can cause myocarditis?

A

Coxsackie A/B

ECHO virus

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15
Q

What are the common causes of endocarditis?

A

Congenital defects\
Rheumatic fever
Prosthetic valves

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16
Q

What action aggrevates pericarditis?

A

Posture related

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17
Q

What is the function of statins?

A

To reduce cholesterol

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18
Q

What are the two revascularisation techniques?

A

Cardiac cathetrisation

Coronary angioplasty

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19
Q

Describe cardiac catheterisation

A

Insertion of a catheter (hollow tube) into a chamber or vessel of the heart

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20
Q

Describe coronary angioplasty (PCI)

A

Using a balloon to stretch open a narrowed of blocked artery with a stent on the outside

21
Q

What does the internal mammary artery supply? (Internal thoracic artery

A

Supplies anterior chest wall and breasts

22
Q

What is cardioplegia

A

The intentional cessation of cardiac activity for cardiac surgery

23
Q

A catheter was inserted to inject contrast dye into the vessels of the heart to identify their structure and see if there were any occlusions. What diagnostic test is this called?

A

Coronary angiography

24
Q

Define an aneurysm

A

Dilation of a vessel by more than 50% of normal diameter by all its layers without a breach in the wall

25
Q

What is the epidemiology of people with aneurysms

A

Elderly, male, smoker, hypertensive

26
Q

Symptoms of abdominal aortic aneurysm?

A

Central chest pain perhaps mimicing renal colic

When ruptures can radiate to the back

27
Q

Male elderly patient with past history of smoking and hypertension presents with central pain in chest with a pulsatile mass. What investigations do you order?

A

Suspect AAA

Duplex ultrasound and CT angiogram

28
Q

What are the 6 P’s of acute limb ischaemia

A 
Pain 
Pallour
Pulseless
Perishingly cold
Paraesthesia (pins and needle)
Paralysis
29
Q

If you suspect acute limb ischaemia what investigations should you order?

A

Arterial imaging

CT angiogram

30
Q

Man presents with lower left leg feeling extremely cold, with lack of function, pulseless and painful; what is your treatment?

A

Embolectomy

If it was swollen a fasciotomy may be appropriate

31
Q

What is diabetic neuropapthy?

A

Nerve damage secondary to diabetes

32
Q

What types of infectious organisms can cause diabetic foot sepsis?

A

Staph aureus
E coli
Enterobacteria

33
Q

Diabetic presents with a swollen foot with black patches, that is tender and ulcerated. The ulcer is pussing and the foot looks angrily red. In the redder tissues there are crepitations. What is the diagnosis?

A

Diabetic foot sepsis

34
Q

Lady presents with possible lower limb ischaemia, investigations and potential treatment?

A

Comparative BP in legs
Duplex ultrasound scanning
MRI

Treamtnet

Aspirin, statins, ace inhibitors, potential surgery or amputations

35
Q

What are the components of an arterial embolism?

A

Mostly platelet rich due to high blood flow

36
Q

What is the components of a venous embolism

A

Mainly RBCs due to stasis

37
Q

What is the function of the drugs apixaban and rivaroxaban?

A

They are Xa inhibitors so prevent clot formation in the coagulation cascade

38
Q

What are the components in virchows triad?

A

Hypercoaguable state
Endothelial injury
Circulatory stasis

39
Q

What is an ischaemic stroke? What is it caused by?

A

Where a clot blocks blood flow to an area of the brain

Caused by thrombus, embolism and hypoperfusion

40
Q

What is haemorrhagic stroke? What can it be caused by?

A

Where bleeding is inside the brain causing an increase in pressure and decreased blood flow to an area

Can be caused by hypertension, aneurysm, trauma

41
Q

What increases the risk of stroke?

A

Hypertension, TIA (transient ischemic attack), smoking, hyperlipidaemia, atrial fibrillation, obesity, smoking

42
Q

What is TIA

A

Transient ischaemic attack

Brief episode of neurological dysfunction caused by loss of blood flow in the brain, spinal cord or retina without tissue death

43
Q

If you suspect stroke what investigations would you do

A

CT brain angiography, MRI with diffusion weight insquence

Blood tests; to investigate cause of thrombosis or embolism so lipids, glucose, thrombophillia, hypertension

44
Q

Describe treatment of a stroke

A

If its been less than 4 hours then treat with thrombolysis medication to dissolve the clot e.g streptokinase

If more than this leading to 6 hours use thrombectomy to remove the clot surgically

If clot from the heart use anticoagulation like rivaroxaban, dabigatran, apixaban and edoxaban

45
Q

What are the common infectious causes of endocariditis?

A

HACEK

Haemophilus, actinobacillus, cardiobacteria, eikenella, kingella

46
Q

What is included in virchows triad?

A

Hypercoaguable stgate
Endothelial injury
Circulatory stasis

47
Q

Pleuritic cardiac pain is aggrevated by what ?

A

Breathing deeply, it is a sharp catching pain

48
Q

What are some examples of Xa inhibitors in the coagulation cascade?

A

Apixaban and rivaroxaban

Cardiovascular JC (8 decks)

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