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USMLE Step 1 > Cardiovascular Questions > Flashcards

Cardiovascular Questions Flashcards

(73 cards)

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1
Q

CO equation

A

HR * SV

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2
Q

Ficks Principle of CO

A

CO= rate of consumption /
/arterial O2 content - venous O2 Content

“ROS” / (a O2)- (v O2)

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3
Q

MAP (mean arterial Pressure)

A

CO * TPR (total resistance)

2/3 diastolic pressure + 1/3 systolic pressure

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4
Q

Pulse pressure=

A

Systolic Pressure- Diastolic Pressure

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5
Q

PP (pulse pressure) proportional to:

A

SV

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6
Q

PP (pulse pressure) inversely proportional to:

A

Arterial Compliance

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7
Q

SV=

A

EDV - ESV

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8
Q

How is CO maintained during Early & Late stages of exercise?

A 
Early= ^HR, ^SV
Late= ^ HR only (SV plateaus)
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9
Q

What happens typically to Diastole with ^ HR

A

Shortened, less filling time –> decreased CO (e.g. ventricular tachycardia)

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10
Q

Increased PP

A
  1. Hyperthyroidism
  2. Aortic Regurgitation
  3. Aortic Stiffening (isolated systolic hypertension in elderly)
  4. Obstructive sleep apnea (^ sympathetic tone)
  5. Exercise (transient)
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11
Q

Decreased PP

A
  1. Aortic Stenosis
  2. Cardiogenic Shock
  3. Cardiac Temponade
  4. Advanced HF
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12
Q

SV affected by which 3 factors?

A

SV ( CAP)

  1. Contractility. ^
  2. Afterload (decrease)
  3. Preload ^
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13
Q

Catecholamine stimulation via B1 Receptors

  1. pathway
  2. affect of Contractility
A
  1. Ca2+ channels phosphorylated
  2. ^ Ca2+ entry, Ca2+ induced release of Ca2+
  3. ^ storage of Ca2+ in Sarcoplasmic Reticulum
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14
Q

Increase Intracellular Ca2+
Decrease Extracellular Na+ ( dec activity of Na+/Ca2+ exchanger)

effect on contractility?

A

Increase Contractility (SV)

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15
Q

Digitalis is used to treat:

A

congestive heart failure (CHF) and heart rhythm problems (atrial arrhythmias)

can increase blood flow throughout your body
reduce swelling in your hands and ankles

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16
Q

Digitalis

  1. pathway
  2. effect of Contractility
A
  1. blocks Na+/K+ pump
    ^ Intracellular Na+
    dec Na+/Ca2+ exchanger activity
    ^ intracellular Ca2+
  2. Increase Contractility
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17
Q

Acidosis affect on contractility

A

Decrease

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18
Q

HF w. Systolic dysfunction affect on contractility

A

Decrease

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19
Q

B1- Blockage (decrease cAMP) affect on contractility

A

Decrease

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20
Q

Hypoxia/ hypercapnia (dec Po2/ inc PCo2 affect on contractility

A

Decrease

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21
Q

Non-dihydropyridine Ca 2+ Channel Blockers affect on contractility

A

Decrease

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22
Q

myoCARDial o2 demand in increase by?

A

increased:
Contractility
Afterload (proportional to arterial pressure)
HR
Diameter of Ventricule (increased wall tension)

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23
Q

Wall Tension follows Laplace’s Law:

A

Wall tension= pressure x radius

Wall stress= (pr)/ (2wall thickness)

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24
Q

vEnous vasodilators (e.g. nitroglycerin) effect on Preload

A

decrease preload

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25
Approximated by EDV
PRELOAD
26
Approximated by MAP
AFTERLOAD
27
Preload depends
1. venous tone | 2. circulating blood volume
28
Increased Afterload leads to?
Increased Pressure | Increased wall tension per Laplace's law
29
LV compensates for increased after load by
thickening (Hypertrophy) in order to decrease wall tension
30
Arterial vasodilators (e.g. hydrAlAzine) effect on Afterload
Decrease afterload
31
decrease both preload & afterload
ACE inhibitors ( inhibit angiotensin converting enzyme) (Hypertension, CHF; decrease BP, bv) ARBS (angiotensin II antagonists)
32
Chronic Hypertension (increase MAP) results in
LV Hypertrophy
33
Index of ventricular contractility
Left ventricular EF
34
EF=
sv/edv (edv-esv)/edv
35
Preserved ejection fraction
EF normal HFpEF
36
Systolic HF (EF?)
Decreased EF
37
dilated cardiomyopathy affect on Contracility
Decrease contracility
38
Catecholamines, Positive inotropes (digoxin) affect on contracility
Increase contracility
39
? highest total cross sectional area
capillaries
40
? lowest flow velocity
capillaries
41
? accounts for TPR
Arterioles
42
? provide most of blood storage capacity
Veins
43
Viscosity depends mostly on
hematocrit
44
``` hyperproteinemic states (e.g. multiple myeloma) polycythemia affect on viscocity ```
Increase Viscosity
45
Anemia affect of viscosity
decrease viscosity
46
Preload 3 variables inc/dec
1. volume 2. heart rate (filling time) 3. veins. constrict or dilate (storage)
47
Other than Stress & Drugs | Contractility is stimulated by
SNS 1. B1 receptors 2. Release of Epinephrine/ Norepinephrine
48
Heart Pressure > Resistance | leads to:
push blood out of Aortic Valve
49
After load depends on:
1. Blood Pressure (resistance) | 2. Obstruction (stenosis; abnormal narrowing of Lumen)
50
Average pressure in Aorta during Cardiac Cycle
MAP
51
Increase CO ? blood concentration in aorta
Increase
52
Vasoconstriction of Arterioles ? TPR
TPR
53
How do you Maintain MAP
control Hormonal & Neural
54
Short term regulation of MAP (seconds to minutes)
Baroreceptors & Chemoreptors (respect to respiration)
55
Long term regulation of MAP (minutes to days)
Kidneys , which regulate Blood Volume
56
Where are Baroreceptors located?
Carotid Sinuses | Aortic Arch
57
Baroreceptors are ? type of Receptors?
Stretch Receptors
58
Stretch Receptors (baroreceptors) are able to detect "stretch" and send
Action Potentials to the Medulla Oblangata
59
Cardiovascular Control Center
Medulla Oblangata
60
The "stretch" (baroreceptors detect) is altered by
Pressure
61
Myosin- Actin proteins in the heart require
Ca2+
62
Ca2+ binds to
Troponin C
63
if you are "scared" which ion floods the cell from the SNS
Ca2+
64
Myosin head binding can depend on :
correct polarity of Actin
65
for any given Volume, pressure Increase
more vertical slope ESPVR
66
"How many Myosin Heads are working, at End of Systole"
Contractility
67
Contractility altered by:
1. Ca 2+ (Sympathetic Nerves) 2. pH 3. Temperature
68
End Diastolic Volume
Volume of Blood in VENTRICLES before Contraction
69
Preload
End Diastolic Pressure, stretching walls of ventricles to greatest dimensions
70
Volume of Blood Ejected from blood per Heart Beat
Stroke Volume
71
SV directly proportional to:
Preload
72
at a greater EDV - -> ? strength of contractility of ventricles - ->? SV
Increase Contractility of Ventricles | Increase SV
73
Increase in Myocardium stretch - -> ? sacromere length - -> ? sensitivity to Ca2+
increase sarcomere length increase sensitivity to Ca2+ Increase contractility

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