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Flashcards in Cardio 2.0 Deck (44):
1

What can left atrial enlargement cause

Esophageal compression--> dysphagia

LA is anterior to esophagus

2

What is middle meningeal artery a branch of

Maxillary a.

artery is deep to the pterion (skull junction)

3

WHat is most common COD 2-3 days after MI

V fib

4

What is a common COD 5-14 days post MI

LV wall rupture

happens when immune system has substantially weakened the wall --> coag necrosis

5

What is the #1 risk factor for aortic dissection

HTN

6

What is nitric oxide synthesized from

Arginine

NO gets made when ↑ Ca--> eNOS--> Arg + O2 to NO + citrulline

7

What does NO act upon to cause vasodilation

NO acts on Guanylate Cyclase to:

GTP-- (guanylate cyclase)--> cGMP --> vasodilation

8

What mediates vascular endothelial vasodilation

AcH
Bradykinin
5HT
Substance P
shear forces

9

What are some non- infective causes of endocarditis

it is platelets stuck to the valve

asc. w/ advanced malignancy, chronic inflammation, and sepsis

10

How long does it take to lose contractility in heart after ishmeia

loss of cardiac contractility occurs after 60 seconds

11

How long for irreversible damage after cardiac ischemia

30 minutes

12

How do you calculate CO with the fick principle

CO= O2 consumed / AV O2 difference

cardiac output is equal to oxygen consumption of tissue / av oxygen difference

13

What can niacin treat

Hyperlipidemia

↑ HDL, ↓ LDL and ↓ TriGlyc

14

What are the s/e of niacin

flushing, warmth, itching

Mediated by PGs*

Aspirin 30 min before can minimize s/e

15

Wht is the most common congenital heart defect

VSD

causes holosystolic murmur over left sternal border

16

why might someone have right heart failure and no edema

↑ lymph drainage can compensate for moderate cvp elevations

when lymph capacity overwhelmed--> edema

17

If cardiac upstroke is slanty like, what antiarrhythmic drug drug are

Class 1
Blocks Na channel

18

What are the class 1a Cardiac Drugs

quinidine
disopyramide
procainamide

(prom queen disappears, to heartbreak hotel)

19

What two factor are the most important in determining coronary blood flow

NO- from arginine, for larger vessels
Adenosine- from atp, for small vessel

both vasodilate

20

What rxn type does warfarin block

carboxylation

21

What is the name of factor 2a

thrombin

22

What does thrombin do

fibrinogen --> fibrin

23

When would you/ when would you not use spironolactone/ eplerenone

Use in: decomp heart failure to improve survival

avoid in: hyperk or renal failure

24

Describe the use dependance of class 1a arrhythmia drugs

class 1a= Na blocker drugs w/ use dependance

use dependance= higher rates of depolarization lead to increased Na blocking

25

What mediates phase 0 non pacemeaker AP

phase 0= rapid depol

rapid Na entery in voltage gated na channel

26

what mediates phase 1 non pacemaker AP

transient outward K current - early repolarization

Rapid decline of inward Na

27

Describe phase 2 non pacemaker AP

Plataue phase

Late inward ca current
Outward k current

28

Describe phase 3 non pacemaker AP

late repolerization

Opening more k channel

29

Describe phase 4 non pacemaker AP

normal resting membrane -80 to - 95 mV

Na K ATPase pumps k in and na out
but k leaks out

30

Compare phase 0 of non pacemaker and pacemaker cell

non pacemaker= na influx

pacemaker= ca influx

31

How do statins work on cell surface

-statins cause LDL receptor density increase
- ↑ receptors--> ↑ LDL uptake --> ↓ serum LDL

32

What heart drug leads to hyperK

Digoxin- Na-K-ATPase inhibitor

33

What are s/s of digoxin toxicity

NV
AMS
Weakness
color vision change
hyperk

34

What are s/s of spironolactone toxicity

hyperk
gynecomastia
impotence
decreased libido

35

What is Milrinone

-one in a million donkey campaign (digoxin dance)

-works via PDE block (no cAMP-->AMP)
poster reads: do not foster disinterest

-↑ cAMP--> ↑ Ca--> ↑ Contractility (strong donkey)

-s/e: vasodilation, bad in hypotension

36

What is myocardial hibernation

state seen in chronic myocardial ischemia

myocardial metabolism ↓ to match ↓ blood

37

What are the consequences of myocardial hibernation

LV systolic dysfunction from reduced blood flow

can be fixed or partially fixed by giving back better blood flow

38

What is the vasa vasorum

small blood vessels that supply large blood vessels

syphilis destroys these

39

What leads to varicose veins

incompetence of venous valves

40

What does persistent lymphedema predispose to

lymphangiosarcoma- malig neoplasm of endothelial lining of the lymph

often seen in arms after breast cancer removal

41

What are some of the less obvious reasons to avoid OCPs

Hx of estrogen tumor, ↑ triglycerides, or liver disease (steroid metabolism)

PLUS all the stuff I know you know

42

What is a good specific sign for left heart failure

Orthopnea (trouble breathing laying, good when standing)

43

What is the S3 heart sound

rapid passive ventricular filling sound
abnormality ONLY in people 40+

Heard best at the end of expiration

44

Risks for liver hemangiosarcoma

arsenic
thorotrast
polyvinyl chloride