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cv questions 2 Flashcards

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1
Q

features of coagulation disorders?

A

DEEP BLEEDING
DELAYED ONSET
SPORADIC BLEEDING INTO JOINTS
BLEEDING AFTER SURGERY

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2
Q

tests for coagulation disorders?

A

APTT, PT
BLOOD COUNT
CF ASSAYS

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3
Q

Which 3 conditions see a raised SPTT and normal PT?

A

HAEMOPHILIA A AND B

FACTOR 11 AND 12 DEfICIENCY

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4
Q

when is a normal APTT and raise PT seen?

A

factor 7 deficiency

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5
Q

which conditions see a normal APTT and raised PT

A

factor 7 deficiency

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6
Q

in which conditions are both aptt and pt raised?

A

liver failure
transfusion
dic
anticoagulant

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7
Q

what is seen in cryoprecipitate?

A

wvf
factor 2
factor 8
factor 13

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8
Q

what 2 new therapies could be used for haemophilia?

A

gene therapy

bispecific antibodies which bind to f9a and f10 and mimics the procoagulant function of 8

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9
Q

how does thrombophilia present?

A

YOUNG AGE,
THROMBOSIS DESPITE
ANTICOAGULATION

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10
Q

what do proteins c and s do

A

prevent clotting by inactivating 5a and 8a

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11
Q

what does antithrombin do?

A

inactivates 2a and 10a

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12
Q

how does warfarin work?

A

vit k inhibitor

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13
Q

what are the 3 layers of blood vessels?

A

ADVENTITIA - VASA VASORUM, NERVES
TUNICA MEDIA - SMOOTH MUSCLE
LAMINA INTIMA - ENDOTHELIUM

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14
Q

how are capillaries and venules supported?

A

1 cell thick

suppoted by matrix and mural cells

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15
Q

what 5 functions does the endothelium regulate?

A 
ORGAN REGENERATION 
INFLAMMATION 
PROLIFERATION 
VASCULAR TONE AND PERMIABILITY 
HAEMOSTASIS AND THROMBOSIS
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16
Q

outline how an atheroscleroma form?

A 
increased vascular permiability due to endothelial activation 
more LDLs in, bind to proteoglycan 
more immune cells macrophages in
foam cells release metalloproteinases
angioneogenesis
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17
Q

roles of no on endothelium?

A

VASODILATES
REDUCES PROLIFERSTION
LESS WHITE CELL ADGESION
LESS OXIDATION OF LDL

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18
Q

what does laminar flow promote?

A

antiinflammatory
antiproliferative
antithrombotic

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19
Q

what are the 3 laters of the heart?

A

endocardium
myocardium
epicardium

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20
Q

what is the tetrology of fallot

A

pulmonary stenosis
overriding aorta
VSD
rv hypertrophy

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21
Q

what is heard on ascultatino of aortic stenosis?

A

systolic murmur moving towards s2

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22
Q

risk factors of aortic stenosis?

A 
rheumatic fever 
age 
elevated CRP 
hypertension
ckd 
ldl
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23
Q

outline the pathophysiology of aortic stenosis

A

STIFFENING OF VALVES - MORE DIFFICULT TO GET BLOOD OUT -
REDUCED CARDIAC OUTPUT AFTER COMPENSATION MECHANISMS FAIL.
LEFT SIDED HYPERTROPHY.
SYSTOLIC HEART FAILUTE

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24
Q

how does aortic stenosis present?

A

tachynpoea, chest pain, ejection murmur

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25
5 investivgations for aortic stenosis?
``` echo ecg cardiac mri cxr cardiac catheterisation ```
26
primary treatment for aortic stenosis?
valve replacement | beta blockers, alpha blockers, bp control, statins
27
2 things which may cause aortic vavle insufficiency
rupture due to infection or dilation of aortic root
28
sequelae of chronic aortic regurgitation
congestive heart failure | oedema
29
sequelae of acute aortic regurgiation?
acute decompensation, cardiogenic shock, pulmonary oedema
30
5 causes of aortic regurgitation?
infective endocarditis rheumatic fever marfans trauma
31
outline the pathophysiiology of acute AR?
RUPTURE OF VALVES, REDUCED CARDIAC OUTPUT, REDUCED DIASTOLIC PRESSURE, BACKFLOW TO PULMONARY VEINS LEADING TO PULMONARY OEDEMA HYPOPERFUSION TO ORGANS AND SHOCK
32
outline the pathophysiology of chronic ar?
SAME BUT INSIDIOUS WITH COMPENSATION MECHANISMS. | LV HYPERTROPHY, DYSNPNOEA, LOW CORONARY PERFUSIUON
33
how does acute ar present?
austin flint murmur tachycardia pulmonary oedema
34
how does chronic ar present
wide pulse pressure | pistol shot pulse
35
how is chronic ar treated?
ASYMPTOMATIC - BETA BLOCKERS AND BP MEDICATIONS SEVERE ASYMOTOMATIC - REPLACEMENT SYMPTOMATIC - REPLACEMENT
36
how is acute ar treated?
valve replacement and vasodilators
37
how does mitral stenosis cause pulmonary hypertension?
STIFFENING OF MITRAL VALVE, BACKFLOE INTO PULMONARY VEINS AND PULMONARY HYPERTENSION
38
3 causes of mitral stenosis?
theumatoid fever sle carcinoid syndrome
39
how does mitral stenosis present?
dyspnoea, haemoptysis, chest pain, diastolic murmur
40
when is a balloon valvectomy offered in mitral stenosis/
severe asymptomatic | severe symptomatic
41
pathophysiology of mitral tegurgitation?
BACKFLOW, PROLONGED VOLUME OVERLOAD, VENTRICULAR DYSFUNCTION, LV FAILURE
42
how does mitral regurgitation present?
murmur, deminished s1 atrial fibrilation
43
how is acute mitral regurgitation treated?
replacement intraaortic balloon counterpulsation preop diuretics
44
how is chronic asymptomatic ar treated?
ACEi | drugs and surgery if EF<60
45
what is the first line treatment for mr if ef is low?
intraaortic balloon counterpulsation
46
pathyphysiology of dilated cardiomyopathy?
``` enlargemet of lv low ef increase in esv and wall stress compensation fails hf ```
47
presentation of dilated cardiomyopathy
displaced apex beat
48
treatment of dilated cardiomyopathy
``` councelling diet modification treat underlying condition ace i b blockers diuretics heart transplant ```
49
hypertrophic cardiomyopathies
``` abnormal diastolic function as small cavity increased ventricular pressure ventricular failure ischaemia t ocoronary vessels myopathy death ```
50
investifations for hypertrophic cardiomyopathy
``` hb level (low) bnp troponin (higher levels of these indicate higher risk) echo chest xray cardiac mri ```
51
management of hypertrophic cardiomyopathy?
beta blockers veramapril (ccb) pacemaker septal ablation
52
what is restrictive cardiomyopathy?
characterised by diastolic dysfunction and normal systolic function volume and thickness of ventricles usually normal the muslce is stiffened so cant contract properly in diastole
53
some causes of restrictive cardiomyopathy?
familial (troponin muttion) sacoidosis fabrys disease scleroderma
54
outline the pathophysiology of restrictive cardiomyopathy
muscle is stiff so cant relax or contract properly in diastole - reduced compliance increased stiffness leads to increased ventricular pressure, reduced compliance, cant fill properly lower co
55
presentation of restrictive cardiomyopathy
``` comfortable in sitting pos hepatomegaly weight loss easy bruising low sv and co ```
56
investigations for restrictinve myopathy
``` cbc serology, amyloidosis check xray ecg cho catheterisation ```
57
management
heart failure medication (acei and arbs, diuretics) anti arrhythmia steriods for immunosuppression pacemaker cardiac transplantation
58
what is the equation for ph?
[H+]= 10(-pH)
59
what is the role of macrophage scavenger receptors a and b?
A - BINDS TO OXIDISED LDL AND DEAD CELLS AND BACTERIA B - BINDS TO OXIDISED LDL AND MALARIA
60
what free radicals do macropgages release?
METALLOPROTEINASES NADPH OXIDASE MYELOPEROXIDASE
61
what does il 1 do to vcam
upregulates it
62
what 3 other things do macrophage do to cause atherosclerosis
CYTOKINES IL1 CHEMOKINES - MCP UP EXPRESS CHEMOATTRACTANTS FREE RADIACS
63
what does nuclear factor kappa b do?
MASTER REGULATOR OF ATHEROSCLEROSIS MATRIX METALLOPROTEINASES NO SYNTHASE IL1

GI cancers (18 decks)

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