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Cardio X Flashcards

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1
Q

What is the significance of a ST depression?

A

Ischemia

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2
Q

What does a narrow pulse pressure indicate?

A

Ischemia

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3
Q

Do you use lidocaine prophylactically?

A

No

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4
Q

What is the frank starling mechanism?

A

The more preload there is, the more contractility there is to expell the load

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5
Q

What is the preload?

A

Tension deveoped on the walls of the ventricles before is starts to contract

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6
Q

What is the effect of increasing preload on stroke volume?

A

Increases

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7
Q

What is the effect of increasing afterload on stroke volume?

A

Decreased

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8
Q

What is the anrep phenomenon?

A

Increasing after load, will increase contractility

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9
Q

What is the Bowditch phenomenon?

A

increase in HR will be related with increase contractility

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10
Q

Increases in contractility are reflected on a SV/EDV cure how: shifts along the curve, or shifts of the curve?

A

Shifts of the curve

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11
Q

What is the effect of contractility on the need d(EDV)/dSV?

A

smaller

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12
Q

What is the end result of all hearts diseases?

A

Cardiac remodeling (hypertrophy etc) and heart failure

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13
Q

What are the drugs that are used to counteract the decrease in CO d/t heart failure?

A

Inotropic agents

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14
Q

What are the drugs that are used to stop the SANS activation that is caused by cardiac failure?

A

Beta blockers

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15
Q

What are the two ways in which beta blockers help in heart failure?

A

Decrease SANS activation

Decrease renin secretion

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16
Q

What are the two things in heart failure that leads to elevated cardiac filling pressure?

A

Vasoconstriction

Na and water retention

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17
Q

Which division of the ANS activates renin secretion?

A

SANS

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18
Q

Which of the aldosterone inhibitors prevents cardiac remodeling?

A

Spironolactone

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19
Q

What is the effect or ARBs on vasoconstriction?

A

Decreases

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20
Q

What is stage A of the ACC/AHA classification system for heart failure?

A

High risk for developing HF

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21
Q

What is stage B of the ACC/AHA classification system for heart failure?

A

Asymptomatic HF (pre-HF)

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22
Q

What is stage C of the ACC/AHA classification system for heart failure?

A

Symptomatic HF

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23
Q

What is stage D of the ACC/AHA classification system for heart failure?

A

Refractory, end stage HF

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24
Q

Which stage of HF: HTN

A

A

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25
Which stage of HF: CAD
A
26
Which stage of HF: DM
A
27
Which stage of HF: family h/o cardiomyopathy
A
28
Which stage of HF: previous MI
B
29
Which stage of HF: LV systolic dysfunction
B
30
Which stage of HF: Asymptomatic valvular disease
B
31
Which stage of HF: Known structural heart disease
C
32
Which stage of HF: SOB and fatigue
C
33
Which stage of HF: reduced exercise tolerance
C
34
What are Tran's three groupings of HF pts?
Before the heart (peripheral edema) At the heart (HTN) Decreased CO
35
What are the two drugs that are indicated for stage A HF?
ACEI or an ARB
36
What are the three drugs that are indicated for stage B HF?
ACEI/ARB and beta blocker
37
When and in what stage are diuretics indicated for HF pts?
C, if there is fluid retention
38
When and in what stage are aldosterone antagonists indicated for HF pts?
C | Symptomatic LVD/most MI
39
When and in what stage are hydralazine and nitrates indicated for HF pts?
C | Symptomatic HF
40
When and in what stage are ARB and ACEIs (together) indicated for HF pts?
C | Symptomatic HF
41
When and in what stage is digoxin indicated for HF pts?
Symptomatic HF, atrial fibrillation
42
Why are ACEI and ARBs indicated for all HF pts?
Decrease cardiac remodeling
43
What are the drugs used to treat type B HF pts?
regular meds + positive inotropes
44
What will diuretics do to the ventricular filling pressure needed for each level of stroke volume?
Shift along cardiac output curve to a lower value (decreases volume without increasing contractility)
45
What will Inotropic agents do to the ventricular filling pressure needed for each level of stroke volume?
Shift the curve up (more output at the same ventricular pressure)
46
What will vasodilators do to the ventricular filling pressure needed for each level of stroke volume?
Shift curve up and to the left (more output at less ventricular pressure)
47
What are the two effects of the beta adrenergic receptor activation in the heart on Ca?
Increase release, but also increase sequestration
48
What happens to the pattern of myocardial contraction with Ca release via cAMP from beta adrenergic stimulation?
Increase slope (rate of contraction) Increase peak (max contraction force) Increase rate of relaxation
49
What is lusitropy? What effects do beta receptors activation have on this?
ability of the heart to relax Increases
50
True or false: heart relaxation is an active process
True
51
What is the MOA of amrinone?
Increases myocardial cAMP
52
What is the MOA of milrinone?
Increases myocardial cAMP
53
What is the MOA of isuprel?
B1 receptor agonist
54
What is the MOA of dobutamine?
B1 receptor agonist
55
What is the MOA of dopamine on the heart?
B1 receptor agonist
56
What is the MOA of epi on the heart?
B1 receptor agonist
57
Ca interaction with what protein is responsible for the increased peak and rate of heart contraction?
Trop C
58
What are the four practical approaches to increasing myocardial contractility?
1. Increase cytosolic Ca 2. Increase myocardial cAMP 3 Agonism of B1 4. Increase B1 receptor
59
What is the MOA of digoxin?
Inhibits Na/K exchanger, which inhibits Ca from leaving the cell d/t increase [Na] and subsequent/indirect inhibition of Na/Ca exchanger
60
What is the effect on EDV and ESV with digoxin?
Decreases
61
What is the effect on pulmonary and systemic venous pressure with digoxin?
Decreases
62
What is the interaction of the vagus nerve and digoxin?
Dig increases vagal tone (decreases AV conduction)
63
What happens to the PR interval with dig?
Increases
64
What happens to the QT interval with dig?
Decreases
65
What happens to coronary flow with dig?
Increases
66
Is dig pro or antiarrhythmic?
Pro
67
What is the EKG finding of pts on dig?
ST depression

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