CV Resp Flashcards

(43 cards)

1
Q

How does the ductus arteriosus normally close?

A

when baby takes first breath theres an increase in O2 which causes a decrease in prostaglandin production > closure of DA

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2
Q

What are the energy sources of the heart?

A
  1. Fatty oxidation (60%)
  2. Glucose oxidation
  3. Glycolysis
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3
Q

what is the most posterior part of the heart?

A

left atrium

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4
Q

calculate CO using rate of o2 and such

A

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

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5
Q

What happens when theres a wide splitting of A2/P2?

A

seen in conditions that delay RV empyting: pulmonic stenosis and right bundle branch block

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6
Q

What happens when theres a paradoxical splitting of A1 and P2?

A

seen in conditions that delay LV emptying (aortic stenosis, left bundle branch block), normal valve closure is reversed since LV is trying to empty for a longer period of time

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7
Q

When can you hear an S3 the best?

A

left lateral decubitus position during exhalation

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8
Q

What murmurs are heard better w valsalva?

A

MVP and hypertrophic cardiomyopathies
(it decreases preload and afterload)
- decreases the intensity of most other murmurs

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9
Q

How does hand grip affect murmurs?

A

it increases afterload: increases intensity of MR, AR, VSD, MVP

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10
Q

How does the murmur of MVP change w position?

A

Standing up: decreases preload, click closer to S1

Lying down: increases preload, click and murmur closer to S2

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11
Q

Marfans pt dies slowly bc of a heart issue, what is it?

A

MVP- leading to conductive issue

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12
Q

left infraclavicular murmur loudest at S2

A

PDA: congenital rubella or prematurity

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13
Q

what phase of the cardiac AP does cardiac muscle contractoin occur?

A

phase 2

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14
Q

How do ACh and adenosine act on the pacemaker AP?

A

they decrease the rate of diastolic depolarization and decrease HR

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15
Q

Speed of conduction?

A

purkinje, atria, ventricle, AV node

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16
Q

how do T waves relate to K?

A
Hyperkalemia = peaked T waves
Hypokalemia = flat T waves
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17
Q

how do you treat A flutter?

A
  1. Class IA, IC, or III antiarrhythmics

2. Rate control: betal blocker or Ca channel blocker

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18
Q

What can cause a first degree AV block?

A

lyme disease- but more likely causes third degree heart block if not treated

19
Q

where does ANP act in the kidney?

A

causes decreased Na reabsorption at the medullary collecting tubule

  • constricts efferent arteriole and dilates afferent arteriole via cGMP
  • contributes to the escape from aldosterone
20
Q

delta wave on ECG

A

wolf parkinson white syndrome: acessory conduction pathway that bypasses the AV node leading to early ventricle depolarization

  • also see a slurred upstroke of QRS
    tx: Procainamide or amiodarone
21
Q

where do the aortic arch and carotid sinus receptors send their info?

A

to solitary nucleus of medulla

22
Q

What happens in supine hypotension?

A

supine or right lateral decubitus position > compression of IVC > reduced venous return, reduced preload, reduced CO and hypotension

23
Q

Tricuspid atresia: what is it?

A

absence of tricuspid valve and hypoplastic RV

- requires both ASD and VSD for viabiliity

24
Q

boot shaped heart

A

tetrology of fallot

25
how do pts with tetrology of fallot relieve cyanotic spells?
they squeat to increase PVR and decrease the right to left shunt
26
why are beta blockers the drug of choice for aortic dissections?
decrease the slope of rise in BP
27
how do you diagnose prinzmetals angina?
ergonovine challenge!
28
how do you reverse a hibernating myocardium?
CABG revascularization!
29
Time course microsopically of MI: contraction bands from reperfusion injury, release of necrotic cell content into blood, beginning of neutrophil migration
12-24 hrs
30
Time course of MI: early coagulative necrosis, wavy fibers
4-12hrs
31
Time course of MI: extensive coagulative necrosis, tissue shows acute inflammation, neutrophil migration
1-3days
32
Time course of MI: macrophage infiltration followed by granulation tissue at the margins
3-14 days
33
when is an MI pt most at risk for fibrinous pericarditis?
1-3days
34
when is an MI pt most at risk of free wall rupture or papillary muscle rupture?
3-14days
35
When is an MI pt most at risk for Dresslers syndrome?
~6 weeks
36
tx of dresslers syndrome?
nonsteroidals
37
treatment of MI?
``` MONA morphine oxygen nitrates Aspirin ```
38
inheritance of hypertrophic cardiomyopathy?
Autosomal dominant
39
mutation of hypertrophic cardiomyopathy?
beta myosin heavy chain mutation
40
What drugs reduce mortality in CHF?
1. ACE inhibitors 2. Beta blockers 3. Angiotensin receptor antagonists 4. Spironolactone
41
how does syphilis affect the heart?
it disrupts the vasa vasorum, leading to atrophy of the vessel wall and dilation fo the aorta
42
electrical alternans: alternating amplitude of QRS segment
cardiac tamponade
43
most common heart tumor?
metastases from melanoma or lymphoma