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Pathophysiology 2 > Cardiology > Flashcards

Cardiology Flashcards

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1
Q

In the cardiac cycle, isovolumetric relaxation is a brief period when volume in ventricle ________ as ventricles ______, pressure ____ and AV valves & semilunar valves are ______

A

does not change
relax
drops
closed

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2
Q

List the minor criterias for Rheumatic Fever

A

Fever
Arthralgia (joint pain w/o swelling)
Increased : ESR, CRP
ECG showing heart block (prolonged PR interval)

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3
Q

Describe conduction system of HT

A

SA Node - cluster of autorhthymic cells in right atrium begins HT activity that spreads to both atria, excitation spreads to AV node
AV node transmits signal to AV bundle of His
AV bundle divides into right & left bundle branches & purkinje fibers

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4
Q

The classic sign of pericarditis is a _________. The classic presentation is ___________. Pericarditis can be misdiagnosed as ____ and vice versa

A

friction rub

sharp/stabbing chest pain radiating to the back and relieved by sitting up forward and worsened by lying down

myocardial infarction

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5
Q

IHD risk increases according to what factors?

A

age, smoking, hypercholesterolemia, diabetes, hypertension, family history or IHD

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6
Q

Explain the presence of troponin in blood when there is myocardial infarction

A

Troponin is released from actin/myosin complex when cardiac muscle dies

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7
Q

Reactive (Dressler’s) pericarditis is due to the following cause:

A

Auto-immune response to myocardial antigens released after myocardial infarction

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8
Q

Clinical presentations of LHF are _____________

A

SOB, orthopnea, paroxysmal nocturnal dyspnea, easy fatigue-ability, exercise intolerance

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9
Q

Describe the difference between chest pain that is ischemic in nature vs. pain that is pericardial in nature.

A

Ischemic pain is a heaving, squeezing pain

Pericardial pain is a stabbing pain, worse in supine position

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10
Q

Buerger’s disease is AKA ___________. It is strongly associated with use of ________

A

Thromboangiitis Obliterans

tobacco products

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11
Q

List common treatments for Rheumatic Fever

A
  • anti-inflammatory medications such as aspirin or corticosteroids
  • antibiotics for patients with positive strep throat culture
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12
Q

T/F AF can produce embolic stroke

A

True

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13
Q

The most common congenital heart defect is _________. This condition results in ________ due to mixing of oxygenated and deoxygenated blood in the ______ via the ventricular septal defect and through the over-riding aorta. This is known as a _______ shunt

A

Tetralogy of Fallot

low oxygenated blood

left ventricle

right-to-left

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14
Q

Pulse pressure is calculated as ____?

A

Difference between the systolic pressure and the diastolic pressure (SP-DP).

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15
Q

Atherosclerosis is commonly promoted by ________

It is characterized by the formation of ______, eventually leading to _______

A

sustained hypertension, high level of LDL, low level of HDL in blood plasma

multiple plaques within the arteries (atheromas)

ischemia

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16
Q

Myocarditis is __________. It often resembles heart attack except that ______________. It is often caused by _____ reaction, triggered by _________. Left untreated, it has the potential to develop into _________ cardiomyopathy

A

inflammation of heart muscle (myocardium)

coronary arteries are not blocked

auto-immune

prior recent infection with streptococcus bacteria or Coxsackie virus

dilated

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17
Q

Rheumatic Fever is believed to be caused by _________ and can involve organs/tissues including __________. It is responsible for many cases of damaged _______

A

antibody cross-reactivity with streptococcal antigens

joints, skin, heart, brain

heart valves

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18
Q

Abnormal blood flow in congenital heart defects such as patent foramen ovale or patent ductus arteriosis start off as a _______ shunt but then reverse after a few decades.

A

left-to-right

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19
Q

List and describe layers of the heart from exterior to interior

A

epicardium - visceral layer of serous pericardium
myocardium - cardiac muscle layer
endocardium - chamber lining & valves

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20
Q

List risk factors associated with aneurysm development

A

diabetes

obesity,

hypertension

tobacco use

alcoholism

copper deficiency

Adult Polycystic Kidney Disease

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21
Q

The phase in the cardiac cycle when the mitral valve is closed and the aortic valve is open is the _______

A

systolic ejection phase

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22
Q

Define Orthopnea. What cardiovascular disorder does its presence indicate?

A

shortness of breath in the supine position

Left CHF

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23
Q

Rheumatic Fever (RF) may develop after a ______ infection.

A

Group A Beta-hemolytic streptococcal infection

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24
Q

In cardiac output, what can influence the Preload?

A

amount of stretching of cardiac muscle

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25
________hypertension indicates that the high blood pressure is a result of another condition. List the possible causes.
Secondary 1) anatomical cause - coarctation of aorta 2) renal causes - renal artery stenosis, adult polycystic KD disease 3) adrenal causes - Cushing's syndrome, Cushing's diease, pheochromocytoma 4) neurogenic / thyroid causes
26
In the normal cardiac cycle, the End diastolic volume (EDV) is about ___ml while the End systolic volume (ESV) is about ___ ml. The stroke volume is defined as ______
130 ml 60ml EDV - ESV
27
T/F AF is most common in the elderly
True
28
1st degree conduction block shows an extended ____ interval in ECG
P-R
29
What are risk factors for atherosclerosis?
- males, age, family history, HTN, High total cholesterol, and LDL with low HDL, smoking, diabetes mellitus
30
List the types of IHD
Stable Angina Pectoris Unstable Angina Pectoris Prinzmetal Angina Myocardial Infarction Sudden Cardiac Death Syndrome
31
Describe systemic blood circulation
left ventricle pumps oxygenated blood into aorta aorta branches into many arteries that travel to organs arteries branch into arterioles in tissue arterioles branch into capillaries deoxygenated blood begins return into venules venules merge into veins and return to right atrium
32
How can Rheumetic Fever be prevented?
- long term antibiotic (e.g. long acting penicillin monthly for 5 years) - in case of carditis, antibiotic treatment for up to 40 years - screening of school-aged children for sore throat
33
Describe the difference between Stable and Unstable Angina Pectoris
Stable Angina Pectoris is ischemic chest pain upon exertion of predictable amount for not more than 15-20 minutes. Unstable Angina Pectoris is ischemic chest pain for not more than 15-20 minutes, occuring either with exertion or at rest
34
What is the difference 1st, 2nd degree conduction block?
Rhythm is still sinus but the propagation is delayed from atria to the ventricles
35
In cardiac output, what can influence contractility?
autonomic nerves, hormones, CA2+ or K+
36
Hypertrophic cardiomyopathy is caused by __________ leading to _________
genetic factors thickening of heart muscle
37
The three types of cardiomyopathy are ________. Describe the effect each has on preload and cardiac output./stroke volume
dilated cardiomyopathy - increased preload, reduced cardiac output hypertrophic cardiomyopathy - decreased preload, reduced cardiac output restrictive cardiomyopathy - decreased preload, reduced cardiac output
38
The most frequent site of aneurysm is in the __________. Most non-intracraneal aneurysms arise distal to the origin of the renal arteries at the __________ Aneurysms can also occur in the _______aorta and in the deep vessels of the legs, e.g. ______
anterior cerebral artery from the circle of Willis infrarenal abdominal aorta thoracic popliteal vessels
39
List the 4 Anomalies/Defects of Tetralogy of Fallot
Pulmonary stenosis - in PA RVH [right ventricular hypertrophy] VSD [ventricular septal defect] Overriding Aorta (dextra-position)
40
Restrictive cardiomyopathy is caused by _________ and leads to __________
depositions of various agents due to inflammatory response stiffening of ventricle walls
41
Ischemic pain is often described as _________ while pericardial pain is often described as ____________
heavy, stone-like crashing pain sharp, stabbing pain radiating to the back and relieved by sitting up forward and worsened by lying down
42
Describe septic shock
bacterial toxins caused dilation of peripheral arterioles
43
In an electrocardiogram, the P wave denotes _____ while the QRS complex denotes ________
atrial depolarization | ventricular depolarization
44
Define pulmonary embolism and where it comes from.
Blood clot that obstructs the pulmonary arteries in the lung. They come from the pulmonary artery.
45
Pericarditis is _________. It can be classified according to ___________________
inflammation composition of inflammatory exudate, duration, causative factor
46
The _______ muscles attach to the atrioventricular valves via the __________ and contract to prevent inversion or prolapse of these valves
papillary | chordae tendineae
47
(T/F) Atherosclerosis is a form of arteriosclerosis
T
48
What is the major cause of pulmonary embolism? List risk factors of pulmonary embolism.
*DVT (deep vein thrombosis) 4 F's (fat forty female fertile) Cancer Prolonged immobility CHF MI Stroke Fracture of long bone/hip Major Surgery Blood disorders - e.g. renal cell carcinoma, polycythemia rubra vera
49
In the cardiac cycle, ventricular systole is the period when ________
ventricles pump blood into pulmonary trunk / ascending aorta
50
Endocarditis is an inflammation of _____. The most common structures involved are __________. It is characterized by prototypic lesion aka __________, which is a mass of _________. This mass has the potential to cause ___________
endocardium - inner layer of the heart the heart valves the vegetation platelets, fibrin, microcolonies of microbes, scant inflammatory cells embolic stroke
51
An aneurysm is ____________ caused by _________
localized, blood-filled dilation of a blood vessel disease or weakening of the vessel wall
52
List general clinical features of shock
hypotension tachycardia altered mental status decreased urinary output cool, clammy skin
53
Cardiac output = ______
Stroke volume (SV) * Heart Rate (HR)
54
Arteriosclerosis is a general term describing ________. | Atherosclerosis is a hardening of an artery due to _________.
any hardening of medium or large arteries an atheromatous plaque
55
Cardiac reserve = _____ In the average person, cardiac reserve is _____ In atheletes, cardiac reserve is _______
maximum output / output at rest 4-5 7-8
56
Cardiomyopathy is very commonly accompanied by what condition? As a result, it may lead to what other conditions?
arterial hypertension end-stage CHF, sudden cardiac arrest
57
List and define influences on Stroke Volume
Preload - affect of stretching Contractility - force of contraction Afterload - amount of pressure created by blood resisting flow
58
In cardiac output, what can influence afterload?
arterial blood pressure in diastole Peripheral vascular resistance
59
Clinical features of systemic hypertension include _______
asymptomatic in mild to moderate HTN, late stage HTN is associated with headache, somnolence, confusion, visual disturbances, nausea, vomiting
60
Pericarditis is a common complication of ________ but can also be caused by ______________
myocardial infarction microbial infection, trauma to heart, malignancy, medications
61
Describe pulmonary blood circulation
right side of HT pumps deoxygenated blood to LU right ventricle pumps blood to pulmonary trunk pulmonary trunk branches into pulmonary arteries pulmonary arteries carry blood to LU for exchange of gases oxygenated blood returns to HT in pulmonary veins
62
Heart rate is regulated by what part of brain stem? Which nervous system?
cardiovascular center in medulla oblongata ANS
63
Ischemic heart disease aka __________ is characterized by ________, usually due to ___________
myocardial ischemia reduced blood supply to the heart muscle coronary artery disease
64
90-95% of hypertension is ________ hypertension. Its etiology is _________
essential aka primary idiopathic
65
In the cardiac cycle, isovolumetric contraction is the period when _____
atria, ventricles are all in contraction and AV/SL valves are closed
66
Describe pathogenesis of systemic hypertension
Kidney receives less blood supply per unit of time and activates secretion of renin --> angiotensin I --> angiotensin II --> aldosterone --> ADH --> increased osmolarity and blood volume along with increased vascular resistance/pressure
67
List the phases of the cardiac cycle
``` Isovolumetric relaxation Ventricular filling Atrial systole Isovolumetric contraction Ventricular systole ```
68
The most common cause of secondary systemic arterial hypertension is:
Kidney disease
69
Lung edema is an expected complication of ____.
Left CHF
70
What are the major types of shock? What are their etiologies?
Hypovolemic - blood/fluid loss Cardiogenic - cardiac tamponade, thrombosis, MI, carditis, CHF Distributive - dilation of peripheral arterioles
71
Clinical presentations of RHF are _____________
peripheral edema, nocturia, ascites, hepatomegaly, jaundice, portal hypertension
72
What are of the most common complications of MI?
Arrhythmias (more specifically VF) and HF.
73
About 40% of cases of dilated cardiomyopathy are ______ in nature. Other causes of dilated cardiomyopathy include ____________
familial pregnancy, alcoholism, toxic, metabolic, or infectious agents
74
Confirmation of MI diagnosis requires ____________
1) ECG 2) cardiac enzymes blood level elevation: troponin, creatine kinase B 3) clinical presentation
75
The most common cause of left CHF is _______ | The most common cause of right CHF is _______
Arterial hypertension Left CHF
76
The most common etiology of ectopic arrhythmia is _______
hypoxia
77
SA node fires spontaneously ____ times per minute | AV node fires at ______ times per minute
60-100 | 40-60
78
The duration of ischemic pain is _______ while duration of myocardial infarction pain is _________
20 minutes | several hours
79
Diagnosis of IHD is based on _________
clinical presentations, ECG, blood tests of MI markers, ultrasound, chest X-ray studies
80
Ectopic pacemakers are _____ and can be caused by stimulants including _____
extra beats forming at other sites of the HT caffeine, nicotine
81
Major diagnostic criteria for Rheumatic Fever are:
Migratory polyarthritis - large joints, starts at legs and migrating up (wind) Carditis Subcutaneous nodules - loc: back of wrist, outside elbow, front of knees Erythema marginatum - rash on trunk, arms Sydenham's chorea (St. Vitus' Dance) - neurological presentation (pop and lock) occurs late
82
The first heard sound ("lub") is associated with the ____
closing of the AV valves | Tricuspid and Mitral Valves
83
Buerger's disease presents with _____________. The main symptom is ___________ which occurs in episodes upon exertion (aka ____________) due to severe obstruction with ischemia.The only proven treatment for Beurger's disease is ________
inflammation and thrombosis of arteries and veins of the hands and feet. pain in the affected areas claudication smoking cessation
84
In the cardiac cycle, ventricular filling is the period when _____
blood flows from full atria into ventricle diastasis - blood trickles into ventricle atrial systole - pumps final 20-25ml blood into ventricle

Pathophysiology 2 (8 decks)

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