CV Flashcards
1
Q
what is neointima?
A
growth of new vessel walls
2
Q
what is stage 1 of atherosclerosis?
A
fatty streaks
3
Q
what is syncope?
A
loss of consciousness
4
Q
what should the speed and gain of an ECG be set at?
A
speed 25mm/s
gain 10mm/mV
5
Q
what is the order of conduction in the heart?
A
SA-AV-bundle of his-bundle branches-purkinje fibres
6
Q
above what is considered high BP?
A
140/90mmHg
7
Q
in hypertensive patients what does pharmacology target?
A
peripheral resistance
8
Q
what can ECGs identify? (6)
A
arrhythmias ischaemia and infarction chamber hypertrophy pericarditis electrolyte imbalance drug toxicity
9
Q
what is the dominant pacemaker of the heart?
A
sinoatrial node
10
Q
what is the intrinsic rate of the SA node?
A
60-100bpm
11
Q
what are the backup pacemakers?
A
atrioventricular node and ventricular tissue
12
Q
what is the intrinsic rate of the AV node?
A
40-60bpm
13
Q
what are tachycardia and bradycardia?
A
tachy-fast heart beat
brady-slow heart beat
14
Q
what is dextrocardia?
A
heart on the wrong side of the chest
15
Q
what is stroke volume?
A
volume ejected from each ventricle during systole
16
Q
what are risk factors for atherosclerosis?
A
age obesity smoking diabetes cholesterol hypertension family history
17
Q
what are 4 components of atherosclerotic plaque?
A
lipid, necrotic core, connective tissue, fibrous cap
18
Q
what initiates atherosclerosis?
A
endothelial damage
19
Q
what are 3 inflammatory cytokine found in plaques?
A
IL-1 ***
IL-6
IFN gamma
20
Q
what is angina?
A
chest pain caused by ischaemia
21
Q
what is characteristic of stable angina?
A
induced by effort
relieved by rest
22
Q
what is characteristic of unstable angina?
A
continues at rest
23
Q
what is the first line for treatment of angina?
A
GTN spray
24
Q
how does GTN spray help relieve angina?
A
- causes systemic veno-dilation meaning the venous return to the heart is less and hence preload is lower. This means the demand on the heart is less.
- causes coronary arteries to dilate
25
what does PCI stand for?
percutaneous coronary intervention
26
what are positives of PCI?
less invasive
short recovery
repeatable
27
what are the negatives associated with PCI?
risk of stent thrombosis
infection
not good for complex cases
28
what does CABG stand for?
coronary artery bypass graft
29
what are the negatives associated with CAGB?
invasive
stroke and bleed risk
long recovery time
one off treatment
30
what are the positives with CABG?
good prognosis
| deals with complex disease
31
which conditions make up acute coronary syndromes?
STEMI
N-STEMI
unstable angina
32
what are the characteristics of a patient with STEMI in:
a) coronary artery
b) heart muscle ?
a) full occlusion of coronary artery
| b) full thickness damage to muscle
33
what are the characteristics of a patient with NSTEMI in:
a) coronary artery
b) heart muscle
a) partial or complete occlusion
| b) partial thickness damage to muscle
34
what is the detectable difference between NSTEMI and unstable angina?
high serum troponin or creatine kinase MB
35
what are 5 stages of atherosclerosis leading to MI/stroke?
1. fatty streak
2. fibrotic plaque
3. atherosclerotic plaque
4. rupture and thrombus
5. MI/stroke
36
what test can be used to check for cardiomegaly, pulmonary oedema or widened mediastinum due to aortic rupture?
chest xray
37
what is the target range for oxygen sats in a normal individual?
94-98%
38
what is the target range for oxygen sats in someone with COPD?
88-92%
39
what type of drug is aspirin and how does it work?
antiplatelet
| COX1 inhibitor- blocking formation of thromboxane A2
40
what are the consequences of hypertension?
'cerebrovascular events'- stroke
IHD
peripheral vascular disease
41
what level is considered hypertension?
140/90 mmHg
42
at what level, in clinic, does hypertension reach stage 2?
160/100mmHg in clinic
43
how is severe hypertension quantified?
systolic 180mmHg+
| diastolic 110mmHg+
44
what causes of hypertension make up primary hypertension?
primary cause unknown but any combination of:
- genetics
- sympathetic activity
- high salt
- faulty membrane transporters
- RAAS abnormalities
45
what are the causes of secondary hypertension?
renal disease
| pregnancy
46
what is the most common cause of secondary hypertension?
chronic kidney disease
47
what is the most common cause of chronic kidney disease?
diabetes
48
which drugs can cause hypertension?
```
corticosteroids
erythropoietin
contraceptive pill
alcohol
ecstasy
cocaine
```
49
what are risk factors of hypertension?
```
age
race
family history
obesity
lack of exercise
smoking
salt intake
alcohol
diabetes
stress
```
50
what is malignant hypertension?
high blood pressure with life threatening side effects, risk to one or more organs
51
what are the consequences of malignant hypertension?
cardiac failure
blurred vision
renal failure
severe headache
52
what are the treatments for hypertensives?
-lifestyle changes
-ACD
ace inhibitors
calcium channel blockers
diuretics
53
what is treatment goal for BP in hypertensives?
140/90mmHg
54
how do hypertensives usually present clinically?
asymptomatic unless malignant hypertension
55
what tests can be done in a hypertensive do detect LV hypertrophy?
ECG, echocardiography
56
what is infective endocarditis?
infection of the endocardium or vascular endothelium of the heart
57
what type of endocarditis is common in IVDU?
right sided endocarditis
58
which type of virulent organisms commonly infect normal valves?
streptococcus pneumoniae
| staphylococcus aureus
59
what are risk factors for infective endocarditis?
```
IV drug use
poor dental hygiene
dental treatment
IV cannula
pacemaker
cardiac surgery
```
60
how does poor dental hygiene increase risk of infective endocarditis?
gum disease causes bleeding gums and therefore bacteria is able to enter bloodstream
61
what are the 4 valvular heart diseases?
mitral stenosis
aortic stenosis
mitral regurgitation
aortic regurgitation
62
what type of valve is the mitral and where does it sit?
bicuspid valve
| between left atrium and ventricle
63
what is heart failure?
inability of the heart to deliver blood (o2) at equivalent rate to requirement of metabolising tissue
64
what is the main cause of heart failure?
IHD
65
what are causes of heart failure?
```
IHD
cardiomyopathies
valvular diseases
cor pulmonale (pul hypertension causes)
hypertension
alcohol
arrhythmias
pregnancy
etc
```
66
risk factors for heart failure
```
65+
African descent
male
obesity
previous MI
```
67
what are the 2 types of acute MI?
STEMI and NSTEMI
68
what is an acute myocardial infarction?
necrosis of cardiac tissue due to prolonged ischaemia from occlusion of artery by thrombus
69
what are the risk factors for MI?
```
age
male
CHD
premature menopause
diabetes
smoking
hypertension
high lipids
obesity
family history
```
70
what are clinical presentations of someone suffering MI?
```
chest pain- radiating left arm, jaw, neck
breathlessness
fatigue
anxiety
pale, clammy. sweating
hypotension
brady or tachy
```
71
what type of valve is the aortic valve and where is it located?
tricuspid valve
| separates left ventricle from aorta
72
how big is the aortic valve in normal adult heart?
3-4cm2
73
what is the most common valvular disease in the western world?
aortic stenosis
74
what are the 3 types of aortic stenosis?
supravalvular
valvular
subvalvular
75
which type of aortic stenosis is most common?
VALVULAR
76
what type of aortic stenosis is common in elderly?
CAVD- calcific aortic valvular disease
77
what type of aortic stenosis is a common congenital disease?
BAV- bicuspid aortic valve
| calcification of BAV
78
which congenital disease predisposes to aortic stenosis?
congenital bicuspid aortic valve
79
from which cells do platelets form?
megakaryocytes
80
what is menorrhagia?
heavy periods
81
what are possible causes of macrocytic anaemia?
b12/folate deficiency
liver disease/alcoholism
hypothyroidism
82
what is anaemia?
reduced red cell mass
83
what are consequences of anaemia?
reduced o2 transport
| tissue hypoxia
84
what are the compensatory changes as a consequence of anaemia?
increased tissue perfusion
increased O2 transfer to tissues
increased red cell production
85
what is the normal range roughly for erythrocyte volume in humans?
80-100 fl
86
what are the 3 categories for anaemia clinically?
macro, normo and microcytic
87
what are 3 causes of microcytic anaemia?
iron deficiency
chronic disease
thalassaemia
88
what are 3 causes of normocytic anaemia?
acute blood loss
anaemia of chronic disease
combined haematinic deficiency
89
how long does a normal red cell survive?
120days
90
how can a small decrease in red cell numbers be compensated for?
increased erythropoietin
| decreased apoptosis
91
what are the 3 classifications of B thalassaemia clinically?
major, intermedia, carrier
92
at what age does a patient with B thalassaemia major commonly present~?
6-12 months, baby
93
what is the lifespan of platelets?
7-10days
94
what are possible causes of low platelets?
```
congenital
marrow problems
drugs
splenomegaly
autoimmune
haemorrhage
```
95
what is the name given to the condition of low platelet count?
thrombocytopenia
96
where are platelets produced and destroyed?
bone marrow
| spleen
