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FCM Physiology > CVS part 2 > Flashcards

CVS part 2 Flashcards

1
Q

How do you decrease heart rate?

A

By inhibiting calcium channels using calcium channel blockers (CCBs) like verapamil and If channels using lvabradine

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2
Q

What does “heart rate” mean

A

number of heart beats per min

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3
Q

What does “stroke volume” mean

A

volume of blood ejected from the heart per beat

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4
Q

What does “cardiac output” mean

A

Volume of blood ejected from the heart per min (ml/min)

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5
Q

What does “blood flow” mean

A

Volume of blood circulating per min

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6
Q

What does “blood pressure” mean

A

Pressure of circulating BF on blood vessel walls

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7
Q

What does “total peripheral resistance” mean

A

Resistance of blood vessels to blood flow

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8
Q

How do you calculate “cardiac output”

A

heart rate x stroke volume

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9
Q

What leads to heart failure?

A

A drop in stroke volume leads to poor cardiac output

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10
Q

how do you calculate arterial blood pressure

A

cardiac output x total peripheral resistance

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11
Q

What causes hypertension

A

high total peripheral resistance leads to high blood pressure - hypertension

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12
Q

How do you decrease heart rate?

A

By inhibiting calcium channels using calcium channel blockers (CCBs) like verapamil and If channels using lvabradine

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13
Q

What is angina?

A

Angina is where you have attacks of chest pain caused by reduced blood flow to your heart.

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14
Q

What reduces irregular heart rate and regulated electrical activity?

A

Anti-arrhythmic drugs, e.g., Na channel or K channel blockers

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15
Q

Heart sounds are a result from

A
  • Vibrations induced by closure of cardiac valves
  • Vibrations in ventricular chambers
  • Turbulent blood flow through valves
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16
Q

S1 - “lubb”

A

Closure of tricuspid/mitral values at beginning of ventricular systole

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17
Q

S2 - “dupp”

A

Closure of aortic/pulmonary valves at beginning of ventricular diastole

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18
Q

S3 – occasional

A

Turbulent blood flow into ventricles, detected near end of first 1/3 diastole – common in young

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19
Q

S4 - pathological in adults

A

Forceful atrial contraction against a stiff ventricle – potentially abnormal

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20
Q

aortic stenosis

A

It is a murmur heard between S1 and S2, due to reduced ejection of blood through aortic valve

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21
Q

Consequences of dilated heart like heart failure:

A
  • ↑ Afterload
  • Decreased SV/CO
  • poor blood flow to end organs
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22
Q

Consequences of chronic high arterial blood pressure

A
  • ↑ Afterload
  • Increased energy expenditure to maintain SV
  • Ultimately decreased SV/CO
  • poor blood flow to end organs
  • High blood pressure is bad for the heart!
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23
Q

Hypovolemic shock

A

an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.

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24
Q

What type of drugs increase heart rate and contractility?

A

Drugs that mimic sympathetic activity (sympathomimetics)
or activate β1 adrenoceptors (β agonists)

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25
Q

What type of drugs reduce heart rate and contractility?

A

Drugs that inhibit β1 adrenoceptors (β antagonists)
reduce heart rate and contractility

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26
Q

Beta adrenergic agonists or beta agonists

A

medications that relax muscles of the airways, causing widening of the airways and resulting in easier breathing. They are a class of sympathomimetic agents, each acting upon the beta adrenoceptors.

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27
Q

When are β adrenoceptor agonists used?

A

Cardiac arrest, anaphylaxis, cardiogenic shock (v. high mortality) caused by infection/inflammation (e.g., sepsis) and/or haemorrhage
i.e. Conditions where CO is compromised

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28
Q

When are β adrenoceptor antagonists used?

A
  • Used for angina, hypertension, arrhythmias, chronic heart failure
  • Conditions where you want to ↓ HR, contractility, the excitability of the heart
    and when ↓ O2 demands
29
Q

Examples of β adrenoceptor antagonists

A

Bisoprolol, Atenolol (β1 antagonist)
Propranolol (non-selective β1 & β2 antagonist)

30
Q

Pilocarpine

A

Relieves intraocular pressure (IOP) in glaucoma

31
Q

Glaucoma

A

It is a common eye condition where the optic nerve, which connects the eye to the brain, becomes damaged. It’s usually caused by fluid building up in the front part of the eye, which increases pressure inside the eye

32
Q

Bethanechol

A

It relieves urinary retention

33
Q

urinary retention

A

a condition in which you cannot empty all the urine from your bladder

34
Q

bradycardia

A

a slow heart rate

35
Q

What are Atropine and Hyocine used for?

A

Used for sinus bradycardia induced after myocardial infarction

36
Q

Ischemia

A

a condition in which the blood flow (and thus oxygen) is restricted or reduced in a part of the body. Cardiac ischemia is the name for decreased blood flow and oxygen to the heart muscle.

37
Q

Why is total peripheral resistance important?

A

it controls Blood Flow and Blood Pressure

38
Q

Vasodilation

A

This increases blood flow and decreases blood pressure.

39
Q

Vasoconstriction

A

This decreases blood flow and increases blood pressure

40
Q

EXCESSIVE CONSTRICTION

A

causes e.g., Hypertension and as a result you will have poor blood flow to end organs

41
Q

Hypotension

A

It is low blood pressure, a blood pressure under 90/60 mm/Hg.

42
Q

EXCESSIVE VASODILATATION

A

(e.g., sepsis, very low BP, no drive for blood flow) you also have poor blood flow to end organs

43
Q

Vasodilation

A

It is the widening of blood vessels as a result of the relaxation of the blood vessel’s muscular walls.

44
Q

Angiotensin II receptor (AT1) antagonists (ARB) e.g., Losartan - helps:

A

Hypertension, heart failure
(they are Vasoconstrictor Receptors blockers)

45
Q

Angiotensin-converting enzyme inhibitors (ACEi) e.g., Enalapril - helps:

A

Hypertension, heart failure
(they are Vasoconstrictor Receptors blockers)

46
Q

α1-adrenoceptor antagonists e.g., Prazosin - helps:

A

Drug-resistance hypertension
(they are Vasoconstrictor Receptors blockers)

47
Q

ETA receptor antagonists e.g., Bosentan - helps:

A

Drug-resistance hypertension
(they are Vasoconstrictor Receptors blockers)

48
Q

VGCC blockers (CCB) e.g., Amlodipine

A

Hypertension angina
(Ca influx blockers)

49
Q

Nitrates e.g., Glyceryl trinitrate (GTN)

A

Angina
(Contractile mechanism relaxants)

50
Q

Nitrates e.g., Glyceryl trinitrate (GTN)

A

Angina
(Contractile mechanism relaxants)

51
Q

PDE5 inhibitors e.g., Sildenafil

A

Erectile dysfunction
(Contractile mechanism relaxants)

52
Q

Oedema

A

It is a build-up of fluid in the body which causes the affected tissue to become swollen.

53
Q

Deep vein thrombosis (DVT)

A

It is is a blood clot that develops within a deep vein in the body, usually in the leg.

54
Q

What is hypertension?

A

Persistently raised arterial blood pressure (BP)

55
Q

Hypertension risk factors:

A

Age
Sex - up to 65 M>W, 65-74 W>M
Ethnicity
Genetic factors
Social deprivation
Lifestyle – smoking, alcohol, salt, obesity, lack of exercise
Stress and anxiety

56
Q

Arteriosclerosis

A

Arteriosclerosis is a broader term for the condition in which the arteries narrow and harden, leading to poor circulation of blood throughout the body.

57
Q

Atherosclerosis

A

a condition that involves the hardening/stiffening of the artery walls because the arteries become clogged with fatty substances called plaques, or atheroma.

58
Q

hypertension diagnosis

A
  1. check the pulse manually
  2. if pulse is irregular, measure blood pressure
  3. if BP ≥ 140/90, take a 2nd reading
  4. if 2nd reading is substantially different take a 3rd reading
  5. you then take lower of the last 2 = as the clinic blood pressure.
  6. Suspect HTN if the BP ≥ 140/90
  7. If clinic systolic BP at least 180 mmHg or clinic diastolic BP at least 120 mmHg:
    - Same day referral for accelerated HTN (retinal haemorrhage +/- papilloedema or suspected phaeochromocytoma or life threatening symptoms (new onset confusion, chest pain, signs of heart failure, AKI)
    - If no symptoms  carry out investigations for target organ damage asap.
    - Target organ damage = start treatment immediately
    - No target organ damage = repeat BP within seven days
59
Q

White coat HTN

A

Suspect a ‘white coat effect’ in people with persistently raised clinic blood pressure readings whose home or ambulatory blood pressure monitoring readings are lower, with a discrepancy of > 20/10 mmHg.

60
Q

What signs do people with white coat HTN exhibit

A

They may also exhibit signs in clinic such as tachycardia, sweating, or palpitations.

61
Q

Masked hypertension

A

This is when patients’ blood pressure is classed as normal in the clinic or office (<140/90 mmHg), but they have an elevated BP when taken outside the clinic using ABPM or HBPM (ambulatory daytime BP or home BP>135/85 mmHg).

62
Q

Why does APBM need to be carried out?

A

because of masked HTN and white coat HTN diagnosis should be confirmed with ambulatory BP monitoring (APBM). Home BP monitoring (HBPM) if ABPM not tolerated.

63
Q

What is APBM and what does it involve?

A

Ambulatory Blood Pressure Monitoring (ABPM) is when your blood pressure is measured as you move around, living your normal daily life. 2 measurements are taken per hour during person’s usual waking hours. Average of 14 measurements used as BP.

64
Q

What is HBPM and what does it involve?

A

2 measurements are taken 1 minute apart when person seated. Recorded twice daily, morning and evening. 4-7 days. Discard measurements taken on first day. Average of all remaining measurements.

65
Q

What is left-ventricular hypertrophy (LVH)

A

a term for a heart’s left pumping chamber that has thickened and may not be pumping efficiently. This is as a result of aortic stenosis or high blood pressure which overwork the heart muscle.

66
Q

What is aortic stenosis?

A

It is a type of heart valve disease (valvular heart disease). The valve between the lower left heart chamber and the body’s main artery (aorta) is narrowed and doesn’t open fully. This reduces or blocks blood flow from the heart to the aorta and to the rest of the body.

67
Q

Diagnosis for hypertension:

A
  1. Target organ damage:
    - ECG for left-ventricular hypertrophy (LVH)
    - Renal function tests (U&Es) for renal impairment.
    - urine tests (proteinuria or albuminuria, haematuria) for renal impairment.
    - Eye screening/ fundoscopy for hypertensive retinopathy
  2. Assess cardiovascular risk:
    measure Hba1C and cholesterol levels
  3. Calculate person’s 10-year risk of developing cardiovascular disease (CVD) using QRISK3 assessment tool
68
Q

What is Hypertensive Retinopathy

A

it is retinal vascular damage caused by hypertension. It

FCM Physiology (11 decks)

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