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STEP 1 > High Yield Topics-Cardiovascular > Flashcards

High Yield Topics-Cardiovascular Flashcards

1
Q

Intravenous drug users are at ↑ risk of _____ endocarditis

A

Tricuspid Valve

  • HINT: remember staph. aureus sketchymicro!
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2
Q

An abnormal breathing pattern characterized by crescendo-decrescendo (spindle-like curve) pattern of tidal volumes followed by a period of apnea

A

Cheyne-Stokes breathing

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3
Q

Common causes of Cheyne-Stokes breathing is usually due to

A

cardiac insult (HF)

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4
Q

Dyspnea, bilateral lower extremity edema, increased JVP, and right axis deviation on ECG indicate

A

Right Heart Failure

aka. Right Ventricular Dysfunction

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5
Q

What physiological mechanism is causing lower extremity edema seen in RHF?

A

increased capillary hydrostatic pressure due to RHF causing venous congestion (backflow) –> fluid leakage into interstitium —> edema

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6
Q

Pulmonary hypertension will present with what heart sound?

  • HINT: due to increased right ventricular afterload
A

Split S2 (Loud P2)

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7
Q

Cold temperature activates increased (para/sympathetic) system

A

sympathetic system

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8
Q

Increased sympathetic system in response to cold cause what change in vasculature

A

peripheral vasoconstriction to preserve heat

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9
Q

Cold temperature activates heating center in the

A

posterior hypothalamus

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10
Q

Activation of posterior hypothalamus in response to cold causes

A

shivering

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11
Q

Hot temperature activates cooling center in the

A

Anterior hypothalamus

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12
Q

Describe hemodynamic measurements in “Hypovolemic Shock” as ↑ ↓

CVP (right heart preload)
PCWP (left heart preload)
CO (cardiac output)
SVR (afterload)
SvO2 (oxygen saturation)
HR (heart rate)
A 
CVP: ↓ 
PCWP: ↓
CO: ↓
SVR: ↑  
SvO2: ↓
HR: ↑
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13
Q

Pathophysiology of “Hypovolemic Shock”

A

Hemorrhage/Fluid Loss –> ↓ left heart preload –> ↓ CO –> ↓ CVP (less blood returning to right heart) –> compensatory ↑ HR, ↑ SVR (vasoconstriction to prevent blood loss)

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14
Q

Describe hemodynamic measurements in “Cardiogenic Shock” as ↑ ↓

CVP (right heart preload)
PCWP (left heart preload)
CO (cardiac output)
SVR (afterload)
SvO2 (oxygen saturation)
HR (heart rate)
A 
CVP: ↑
PCWP: ↑
CO: ↓
SVR: ↑
SvO2: ↓
HR: ↑
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15
Q

Pathophysiology of “Cardiogenic Shock”

A

Dysfunction of Heart (MI, HF, arrhythmia) –> ↓ heart pumping –> ↓ CO –> compensatory ↑ HR, ↑ SVR (vasoconstriction due to increased catecholamines)

↓ heart pumping –> ↑ back flow of blood –> ↑ left heart preload & ↑CVP

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16
Q

Describe hemodynamic measurements in “Obstructive Shock” due to PE as ↑ ↓

CVP (right heart preload)
PCWP (left heart preload)
CO (cardiac output)
SVR (afterload)
SvO2 (oxygen saturation)
HR (heart rate)
A 
CVP: ↑ 
PCWP: ↓ 
CO: ↓
SVR: ↑
SvO2: ↓
HR: ↑
17
Q

Pathophysiology of “Obstructive Shock” due to PE

A

PE –> Obstruction of pulmonary arteries –> ↑ CVP (due to back flow) –> ↓ diastolic filling (preload) in left heart –> ↓ CO –> compensatory ↑ HR, ↑ SVR

18
Q

Why is PCWP paradoxically ↑ in an obstructive shock caused by “cardiac tamponade”?

A

Due to EXTERNAL compression by pericardial fluid

19
Q

Describe hemodynamic measurements in “Distributive Shock” due to sepsis as ↑ ↓

CVP (right heart preload)
PCWP (left heart preload)
CO (cardiac output)
SVR (afterload)
SvO2 (oxygen saturation)
HR (heart rate)
A 
CVP: ↓
PCWP: ↓
CO: ↑
SVR: ↓
SvO2: ↑
HR: ↑
20
Q

Pathophysiology of “Distributive Shock” due to sepsis

A

Infection –> Vasodilation (↓ SVR) & capillary leakage (↓ CVP due to fluid redistribution from intravascular to the extravascular compartment) –> ↑ CO (due to ↓ SVR & compensatory ↑ HR) –> ↓ PCWP (less fluid sitting in the left heart due to increased CO)

21
Q

Describe hemodynamic measurements in “Distributive Shock” due to anaphylaxis as ↑ ↓

CVP (right heart preload)
PCWP (left heart preload)
CO (cardiac output)
SVR (afterload)
SvO2 (oxygen saturation)
HR (heart rate)
A 
CVP: ↓
PCWP: ↓
CO: ↑
SVR: ↓
SvO2: ↓
HR: ↑
22
Q

Pathophysiology of “Distributive Shock” due to anaphylaxis

A

Anaphylaxis (type 1 HSR) –> Degranulation of mast cells –> ↑ histamine release –> Vasodilation (↓ SVR) & capillary leakage (↓ CVP due to fluid redistribution from intravascular to the extravascular compartment) –> ↑ CO (due to ↓ SVR & compensatory ↑ HR) –> ↓ PCWP (less fluid sitting in the left heart due to increased CO)

23
Q

Describe hemodynamic measurements in “Distributive Shock” due to CNS injury as ↑ ↓

CVP (right heart preload)
PCWP (left heart preload)
CO (cardiac output)
SVR (afterload)
SvO2 (oxygen saturation)
HR (heart rate)
A 
CVP: ↓
PCWP: ↓
CO: ↓
SVR: ↓
SvO2: ↓
HR: ↓
24
Q

Pathophysiology of “Distributive Shock” due to CNS injury

A

CNS injury –> loss of sympathetic activation (↓ HR & ↓ contraction & ↓ SVR (vasodilation) –> ↓ CO –> ↓ PCWP (less fluid sitting in the left heart due to increased CO)

  • ↓ CVP due to fluid redistribution (don’t know why)
25
Q

Why is SVR all ↓ in all distributive shock types?

A

They all cause vasoDILATION

26
Q

What type of shock has ↓ HR?

A

“Distributive Shock” due to CNS injury

27
Q

What type of shock has ↑ O2 saturation?

A

“Distributive Shock” due to sepsis

STEP 1 (19 decks)

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