CP Lecture 2 Flashcards by Chavez Girls

What is the most common cause of pulmonary congestion and edema

Heart failure

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Coronary artery disease is the second most common cause of _____

Cardiac muscle disease

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Scar formation at ischemic areas of the ventricle can cause

Poor compliance, decrease filling and decreased contractility

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What is the main issue with arrhythmias?

Drop in cardiac output

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What is more life threatening? Supraventricular tachycardia or ventricular tachycardia

Ventricular tachycardia is life threatening.

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The principle treatment of renal insufficiency (due to fluid overload) is to…

Reduce reabsorption of fluid at kidneys, maintain electrolyte balance

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During severe renal insufficiency, you will see Azotemia which is….

High blood content of nitrogen compounds such as

Urea

Creatinine

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During severe renal insufficiency, what happens in regard to BUN and Sympathetic nervous system activity

Increased BUN

Increased sympathetic nervous system activity to increase BP

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What are the three types of cardiomyopathies

Dilated

Hypertrophic

Restrictive

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What is a primary cause of cardiomyopathy

Idiopathic mechanisms

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What is a secondary cause of cardiomyopathy

Prolonged HTN

Metabolic Disorder

heart valve problems

Arrhythmia

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What is HFrEF and what is the cause

Dilated Cardiomyopathy: Heart Failure with reduced Ejection Fraction

Due to metabolic problems, toxicity from alcohol abuse, infections, genetic predisposition

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When you have dilated cardiomyopathy how is the left ventricular end-diastolic volume effected

Increased

Note: impaired frank starling mechanism, reduced contractility

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Hypertrophic cardiomyopathies

Mainly a diastolic issue. From an enlarged heart. Heart failure with preserved ejection fraction. Muscle cells are disorganized, inefficient pump

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During hypertrophic cardiomyopathies, you have increased pressure in the….

Left atrium, pulmonary artery, and pulmonary capillaries

(Increased left end diastolic volume)

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What kind of cardiomyopathies are common in young athletes

Hypertrophic cardiomyopathies

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When you have a heart valve abnormality how can it effect the Cardiac muscles

It produces Cardiac muscle disease due to impaired relaxation

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Mitral valve incompetency dilates the _____

Left atria

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Tricuspid valve incompetency dilates the _____

Right atria

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Aortic valve incompetency dilates the ______

Left ventrical

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Pulmonic valve incompetency dilates the _______

Right ventricle

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What is idiopathic/primary pulmonary hypertension

MPAP > 20mmHg

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If pulse pressure is below 40-60 what is likely?

Heart failure

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For every unit of blood transfused, what is the recommended rest period

30 minutes of rest b4 activity

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Heart failure primarily effects what kind of skeletal muscle fibers

Type 1

If a patient has elevated troponin or elevated creatinine kinase are they safe to get up from bed?

What does an ST segment elevation indicate?

A myocardial infarction, or maybe the electrodes are not on the patient well

Arrthmyas cause a _____ in cardiac output

reduction

True or false: If the heart rate is too slow OR too fast, cardiac output drops

True Too fast does not allow for proper filling

True or false: arrythmias can only take place in SA node

False, they can happen to any part of the conduction system

What is supraventricular tachycardia

Arrythmia where the atria is contracting too fast

What electrolytes are important in an arrythmia

Sodium Potassium Magnesium Chloride

What can dehydration cause in regards to electrolytes

Increased sodium Increased risk of an arrythmia

True or false: High OR low potassium is a problem that can cause arrythmias

True

If the heart cannot pump enough blood to kidneys what happens?

GFR rate drops, reduction in renin

What is renin?

Enzyme produced in kidneys that converts angiotensin to angiotensin 1 - > angiotensin 2 -> signals adrenal cortex to release aldosterone -> causes kidney to reabsorb sodium and water

How can renal insufficiency cause cardiac issues?

too much fluid/ blood volume

What is the main issue with diuretic medication

produces release of sodium and potassium which leads to electrolyte imbalances

If someone is taking diuretics, what should you pay attention to prior to getting the patient up?

Electrolyte balance

What is cardiomyopathy?

Disease of heart muscle

Cardiomyopathy can cause difficulty for the heart to contract OR it can cause difficulty ______

for the heart to relax

Drug use can cause ______ cardiomyopathy

secondary

Frank-Starling Law states that

the stroke volume of the left ventricle will increase as the left ventricular volume increases due to the myocyte stretch causing a more forceful systolic contraction

If VO2 falls below a critical level then serum lactate levels will _____

Increase

As one exercises, bloodflow is not only increased to the muscles, but also to the ____ to promote cooling

skin

What is V/Q ratio? What is the ratio in the upper and lower part of the lung?

Ventilation/Perfusion 1:1 is ideal The ratio is higher in the upper lung and lower in the lower lung. Lower lung has more perfusion and upper lung has more ventilation. The average V/Q ratio for the whole lung is 0.8

What VQ ratio is considered deadspace

An infinite V/Q ratio with all ventilation and no perfusion example of deadspace: Trachea ( upper airway) all ventilation but no perfusion

Often times you can correct a low V/Q ratio with supplementary _____

Oxygen

The upper lung typically has ____ V/Q ratio than the lower part of the lung

Higher

Is any shunting or deadspace expected to take place at the level of the alveoli

NO, the V/Q ratio should always be close to 1 at the alveoli (unless there’s an abnormal blockage of the airway or perfusion) Note: for V:Q ratio Shunting: Ratio is 0 Deadspace = Ratio is infinite

The __________ part of the lung shunts blood to other parts the ____ part is a physiological deadspace

Lower part Upper Part (apices)

_____ arteries have more elastic property to accomadate high blood pressure ____ arteries have more smooth muscle to allow for vasodilation and vasoconstriction

Larger Smaller

What happens to the vessels in the lungs when the oxygenation in the blood decreases

Reflexive vasoconstriction

What is BNP enzyme?

Enzyme that is produced by atria or ventricles when they are stretched More stretch= more BNP Enzyme is monitored in patients with heart failure

What do high BNP levels mean

More serious heart failure

What does a swan-ganz catheter measure

Right sided/pulmonary artery pressure

Congestive heart failure happens in what percentage of adults over 40?

20%

Congestive heart failure happens in what percent of adults over 85

65.2%

A full blockage of a coronary artery will cause an ST segment ________ and a myocardial infarction, whereas a partial blockage of a coronary artery will appear as an ST segment ________

| Complete blockage: elevation Partial blockage: depression

Identify

ST segment depression

Identify

ST segment elevation

stable angina

chest discomfort or anginal equivalent that is provoked with exertion and alleviated at rest

Atrial flutter

Myocardia in the atria let off signals that make the atria contract rapidly (but with a regular rythm

Ventricular fibrillation

the lower heart chambers contract in a very rapid and **uncoordinated manner**. As a result, the heart doesn't pump blood to the rest of the body.

atrial fibrillation

Afib stands for atrial fibrillation (AF), which is a type of arrhythmia, or abnormal heartbeat. Afib is caused by extremely fast and irregular beats from the upper chambers of the heart Note: different than atrial flutter because it's irregular

The liver releases _______ in response to low blood pressure or adverse changes in sodium The kidneys produce _______ which helps make the ___________

Angiotensin Renin Angiotensin 1

The lungs release ACE (angiotensin converting enzyme) which turns angiotensin 1 into....

Angiotensin 2 Note: angiotensin 2 causes vasoconstriction by decreasing nitric oxide synthesis ( a vaso dialator)

Angiotensin 2 causes the release of aldosterone which promotes..

Sodium and water retention Note: combined with the vasoconstriction effect of angiotensin 2, this raises blood pressure When the kidney senses raised blood pressure, it reduces the reduction of Renin to stop more angiotensin 2 from being released

What is cardiac tamponade?

enough fluid accumulates in the pericardial sac compressing the heart and leading to a decrease in cardiac output and shock