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CardioPulm > Exam 2 Wk 1 > Flashcards

Exam 2 Wk 1 Flashcards

1
Q

Fluid flows from ___ pressure to ____ pressure

A

High to low pressure

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2
Q

T or F: Fluid takes the path of least resistance

A

TRUE

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3
Q

What pressure is the primary driving force moving blood into myocardial tissue?

A

Diastolic BP

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4
Q

3 layers of arteries

A

Adventitia: outer - basement membrane
Media: middle; makes adjustments to luminal diameter
Intima: endothelium layer; semipermeable to lipoproteins

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5
Q

Atherosclerosis

A

Accumulation of material between the tunica intima;
- material is debris, calcium, macrophage cells, cholesterol, fibrous connective tissue

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6
Q

Atherosis

A

Fatty streak of lipid laden macrophages and smooth muscle cells

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7
Q

Sclerosis

A

Inability of blood vessel to be compliance
- organization of “fibrous cap” of thrombi

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8
Q

Explain lesion progression

A

Build up of tissue into vessel lumen

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9
Q

Progression of atherosclerosis

A

Fatty streak > plaque > increasing plaque > obstructive atherosclerotic plaque > plaque fissure results in thrombosis

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10
Q

Risk factors for atherosclerosis

A
  • smoking
  • uncontrolled DM
  • HTN
  • hyperlipidemia
  • high velocity/turbulent flow
  • systemic inflammation (Hs-CRP, homocysteine)
  • suboptimal diet
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11
Q

Which of the risk factors of heart and lung disease are non modifiable?

A

Age & Heredity

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12
Q

Total Cholesterol Values

A

Normal < 200mg/dL
Borderline = 200-239 mg/dL
High >= 240 mg/dL

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13
Q

LDL Values

A

Normal <130 mg/dL
Borderline = 130-159 mg/dL
High > 160

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14
Q

HDL Values

A

Low < 40 mg/dL
Cardioprotective > 60 mg/dL

  • this is the good cholesterol
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15
Q

Lack of exercise increases the risk of CV disease by ___%

Stress and depression __x the risk

Healthy diet decreases the risk by close to ___%

A

20%

3x

30%

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16
Q

As HDL gets lower or LDL gets higher, the likelyhood of a cardiovascular event __________

A

Increases

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17
Q

High glucose —> high ____

A

High insulin levels

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18
Q

Obesity BMI

A

> 30

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19
Q

Atherosclerosis

A

Plaques composed of lipid and thrombus

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20
Q

Thrombus

A

Occludes vessel of piece breaks off (embolus)n

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21
Q

Vasospasm

A

Build up or migration of cells in the area

Prinzmetal angina

22
Q

Referred pain patterns in MEN vs WOMEN

A

MEN: substernal pressure type of pain, radiating down LUE, through to the back, up to the jaw

WOMEN: subtle indigestion, unusual fatigue, SOB w activity

23
Q

Angina Pectoris

A
  • distress/pain of the chest
  • secondary to imbalance of coronary oxygen delivery
24
Q

3 types of Angina

A

Stable (typical)

Unstable

Prinzmetal’s (variant)

25
Q

Stable (typical) angina

A

Cause: fixed atherosclerotic lesion; result of not enough blood subtly to meet metabolic demand (after increased exercised)

  • not present at rest but can be reduced by rest
26
Q

unstable angina

A
  • chest discomfort accelerating in freq or severity
    Cause: typically thrombosis of a coronary plaque

EMERGENCY - acute myocardial infarction

27
Q

Prinzmetals Angina

A

Cause: coronary vasospasm due to endothelial dysfunction

  • more difficult to diagnose (even at rest)
28
Q

Acute coronary syndrome

A

Acute MI or unstable angina

29
Q

Non STEMI diagnosis

A

Rupture of coronary plaques; partial occlusion of coronary artery

  • subendocardial wall infarction
30
Q

How does non stemi look on EKG

A

ST Segment Depression
T wave inversion

31
Q

ST Elevation MI

A

Rupture of coronary plaques that causes a thrombus that totally occludes an artery = TRANSMURAL INFARCTION

32
Q

What are the 2 main serum enzymes?

A

Troponin & CK-MB

33
Q

Ratio of CK-MB to total creatine kinase in the blood

A

> 2.5 -3 = MI

34
Q

Beta Blockers effects

A

Reduce work of the heart

35
Q

Organic Nitrates (sublingual nitroglycerine)

A
  • reduce preload —> reduce work
  • potential for excessive preload reduction
36
Q

Thrombolitics are used for

A

Acute mi, ischemic cva, stokes

37
Q

Anticoagulant vs anti platelet

A

Anticoagulant: slow clotting; preventing clots from clotting/growing (heparin)

Antiplatelets: prevent platelets from clumping and prevents clots from forming and regrowing; interfere with clotting cascade (thrombin formation)

38
Q

T or F: a patient should always have their sublingual nitroglycerine tablets with them during exercise

A

TRUE

39
Q

Effects of Antithrombotics

A
  • reduce risk of bleeding and bruising
  • internal hemmorhage risk
  • avoid bumping
40
Q

Potential results of MI

A

MI= death of tissue
- Arrhythmias
- contractile issues
- wall weakening

41
Q

When does cardiac death occur

A

Within the first 2 hours

42
Q

Cardiogenic shock

A
  • heart is damaged and unable to supply blood to other organs of the body ; greater than 40% of LV
43
Q

Ventricular remodeling

A
  • MI tissue death causes change in shape, size, and thickness of myocardium
  • ventricular dilation & hypertropy
44
Q

Factors that effect ventricular remodeling

A
  • size of infarction
  • ventricular load
  • patency of the artery that was infarcted
45
Q

STEMI and non STEMI COMPLICATIONS

A
  • hypertrophy
  • ventricular aneurysm
  • dyskinesia
  • hypokinesia
46
Q

What is a ventricular aneurysm

A

Ballooning out of a weakened LV

47
Q

What is dyskinesia ?

A
  • uncontrolled/ uncoordinated contraction
48
Q

What is hypokinesia

A

Decreased of no wall contraction

49
Q

What VO2 means that the patient will have decreased ability to perform ADLs independently and is a poor prognosis for survival ?

A

<21ml/kg/min

50
Q

Signs and Symptoms of MI

A
  • chest pain
  • SOB
  • Diaphoresis
  • st seg elevation
  • enzymes of cardiac monocytes in blood (CK-MB)

CardioPulm (17 decks)

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