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Clinical Medicine 3 > Dr. Houston (Cardio)- Exam 1 > Flashcards

Dr. Houston (Cardio)- Exam 1 Flashcards

(90 cards)

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1
Q

What is the pathway of the heart?

A
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2
Q

What are the different components of heart fibers (histology?

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3
Q
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4
Q

What is cardiomyopathy?
* What is primary and secondary?

A

Cardiomyopathy: Disease of the myocardium

  • Primary Cardiomyopathy – disease manifests directly (idiopathic, genetic, infection, alcohol/drugs)
  • 2nd Cardiomyopathy – develops to compensate for other diseases (e.g. hypertension, valve diseases
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5
Q

Dilated cardiomyopathy:
* What are the causes?

A

Idiopathic, Genetic mutations, Infection, Alcohol/drug abuse

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6
Q

What is the patho behind dilated cardiomyopathy? Txt?

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7
Q

Hypertrophic Cardiomyopathy
* What are the causes?

A

Most commonly - Autosomal missense mutation in sarcomere protein

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8
Q

Hypertrophic cardio
* What is the patho?

A
  • New cardiomyocytes added parallel
  • Causes myocardium becomes thick, heavy, and hypercontractile
  • Usually LV hypertrophy (mostly on interventricular septal wall)
  • New muscle fills chamber = decreased chamber volume
  • New muscle = increased stiffness (less compliant)
  • Both = decreased preload = decreased CO
  • Classified as Diastolic heart failure
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9
Q

Hypertrophic Obstructive Cardiomyopathy
* What does it cause?
* Decreases what?
* What type of mumor?
* What can happen?

A
  • Interventricular septal wall bloc.
  • Mitral valve can be pulled medially (Venturi effect) = decreased SV
  • Crescendo-decrescendo mumor
  • Ischemia (more muscle, but less efficient CO to coronary arteries
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10
Q

txt of hypertrophic cardio?

A

Beta blockers, calcium channel blockers, surgery

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11
Q

Restrictive Cardiomyopathy
* What are the causes?

A

Misfolded cardiac proteins (amyloidosis) – either genetic or w/age, sarcoidosis (granulomas), fibrotic deposits (fibroelastosis), hemochromatosis, ROS-induced inflammation

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12
Q

What is the patho and txt of restrictive cardio?

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13
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14
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15
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16
Q

What are the stages of the slow action potential?

A
  • 4: Na+ funny channels open = Na+ influx = RMP to threshold
  • 0: Ca2+ channels open, Ca2+ influx = depol
  • 3: K+ channels open = K+ efflux = repol
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17
Q

What are the steps of the fast action potential

A

4: Na+ influx = RMP to threshold

0: rapid Na+ influx = rapid depol, Na+ channels close

1: K+ (voltage gated) channels open, K+ efflux = repol

2: Ca2+ influx maintains plateau

3: Ca2+ channels close,
K+ channels open = repol

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18
Q
  • What is fibrillation?
  • What are the causes?
A
  • Fibrillation – quivering or twitching contraction – inefficient for pumping blood
  • Causes: Not fully understood. Risk factors - Inflammation of atria via CV disease (hypertension, coronary artery disease, valvular disease). Poor diet/lifestyle. Possible genetic factor.
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19
Q

What is the patho of afib

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20
Q
  • What is heart block?
  • What are the causes?
A

Heart block: arrhythmia where electrical signal delayed or blocked

Causes
* Damage or fibrosis to conduction system; Lev’s disease – idiopathic scarring
* Ischemic heart disease - heart attack = hypoxia = cardiomyocyte scar tissue
* Cardiomyopathies, Myocarditis, Medication

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21
Q

What is Atrioventricular block?

A
  • delay/interruption of electrical signal from atria to ventricles
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22
Q

What is first degree, second degree (type 1+2) and third degree?

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23
Q

Bundle branch block
* What is it?
* What are the causes?

A
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24
Q

What is the patho of bundle branch block?

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25
Paroxysmal supraventricular tachycardia (PSVT) * What is paroxysm? * May last how long? * What are the causes?
* paroxysm = sudden, violent, Tachycardia = rest >100bpm, Supraventricular = in Atria * may last anywhere from a few minutes to a few days, and some people have no symptoms at all. * Causes: Stress, overexertion, Alcohol use, Caffeine use, Illicit drug use, Smoking, hyperthryodism, - medications (Digoxin)
26
What is the patho of Paroxysmal supraventricular tachycardia (PSVT)?
27
Premature beats * What are they? * What are the causes?
* Earlier than normal contraction due to ectopic focus * Causes: Electrolyte imbalance, ischemic damage, drugs, anxiety, or Reenterant loop
28
What is the patho of premature beats (PAC and PVCs)?
29
Sick sinus syndrome (sinus node dysfunction) * What are the causes? * What is the patho?
30
What is first degree, second one and two and third degree SA block
31
Ventricular tachycardia * HR? * What is in a row? * What happens with high HR? * What are the causes?
32
What is the patho for the two types of v tach?
33
Ventricular fibrillation (VF, Vfib) * What is fibrillation? * What are the causes? * What is the txt?
* Fibrillation – quivering or twitching contraction – inefficient for pumping blood. High risk of sudden cardiac death * Causes: stress or damage causes cardiomyocyte heterogeneity - medications, illicit drugs, electrolyte imbalance, ischemia to cardiac tissue * Txt:Defibrillation to depolarize a critical mass of cells back into sinus rhythm
34
Long QT wave and Torsades de pointes * What are the causes? * What is the pahto?
Causes * Genetic abnormality, medications (channel blockers). Pathophysiology * Long QT wave means ventricular repolarization lasts longer than normal in some heart cells * Due to ion channel problems – dysfunctional L-type Ca2+ channels or Na+ & K+ channel problems
35
* PVCs can form causes what? * Can causes polymorphic VT known as what?
* PVCs can form causes reentrant circuits and reentrant tachycardia * Can causes polymorphic VT known as Torsades de pointes (twisting of points)
36
Cardiogenic shock * What are the causes?
MI, obstructive shock – pericadical effusion leading to cardiac tamponade – fluid in pericardial sac - trauma
37
What is the patho of cardiogenic shock?
38
What are the different layes of the heart?
39
* What are the different tropinins? * What happens to damage cells?
40
What are the main braches of the coronary?
41
Coronary Heart Disease * What is the patho?
42
Acute MI: * What are the causes?
* MI mostly due to endothelial (tunica intima) dysfunction * Via atherosclerosis – plaque build up (fat, cholesterol, proteins, calcium, WBC). Take years to fully form
43
What is the patho of MI?
Degree of damage and ECG changes depends on duration of ischemia: * Inner 1/3rd closest to endocardium most damaged by ischemia (farthest from artery and under high pressure from chamber lumen) * If clot suddenly lysis and bloodflow restored damage can be limited to inner 1/3rd – subendocardial infarct nottransomural * ECG of subendocardial infarct shows a ST-segment non elevation (NSTEMI). * If ischemia persists = necrosis to entire heart wall * Called a Transmural Infarct * ECG show ST-segment elevation (STEMI
44
What is the difference in NSTEMI and STEMI on EKG?
45
46
Angina pectoris * What is angina? Pectoris? * What is it? * Causes?
* Angina – “to strangle” * Pectoris – “chest” * Reduced coronary blood flow = tissue ischemia = anaerobic respiration = lactate = pain, but no damage * Causes: same as MI
47
Angina pectoris patho? (3 types)
Different types of Angina depending on whether pain w/ or w/o physical exertion 1. Stable angina – pain during exercise/stress – releveled by rest 2. Unstable angina – pain during exercise/stress – continues during rest (doesn’t go away) 3. Vasospastic angina (Prinzmetal) – can occur anytime (even at rest)
48
Coronary Heart Disease * Unstable vs vasospastic?
49
50
What is the difference bn vein, venule, large/mid artery and arteriole?
51
52
What is the clotting casade pathway?
53
What is the patho of aneursym?
* Aneurysm – abnormal dilation/bulge in vessel * Define as when diameter 1.5x that of normal * Any artery (rarely in a vein) * Due to weakness in vessel wall
54
What are the types of aneurysms?
55
Types of aneurysms: * What are the causes?
56
Aortic aneurysm * What is MC? * What is the MC site?
* Most common - Aortic aneurysms most common (40% thoracic aorta, 60% abdominal aorta) * Most common site between renal arteries and common iliac artery bifurcation (less elastin in walls)
57
what is the patho of aortic aneurysm?
58
What can Aortic aneurysm lead to?
* Ruptured aneurysm = loss of blood delivery = ischemia distally * If aneurysm near aortic valve can cause aortic insufficiency * If in brain = Subarachnoid space bleed * Clots * Syphilis (tertiary) causes inflammation/fibrosis of vasa vasorum – Endarteritis obliterans
59
Aortic dissection * Tear where? * Blood pools where? * What are the causes?
60
What is the patho of aortic dissection? What can it lead to?
61
Arterial embolism/thrombosis * What are the causes? * What is the patho?
62
* What is vasculitis? What is it classified by? * What are the causes?
63
What is the patho of vasculitis?
64
Giant cell arteritis * What is it?
Vasculitis of branches of the carotid arteries
65
Peripheral vascular/artery disease (PVD or PAD) * Affects what? * Narrowing of what? * What are the causes?
66
Peripheral vascular/artery disease (PVD or PAD) * What is the patho?
67
Phlebitis/thrombophlebitis * What is it? * Can be classified as what? * What is it called if infected?
* Thrombus (clot), Phleb (vein), Itis (inflammation) * Blood clot that gets lodged in a vein and causes inflammation * Can be classified either as superficial or deep (DVT) – usually in legs * If infected called septic thrombophlebitis (e.g. Staph at IV site). Can lead to shock
68
Phlebitis/thrombophlebitis * What are the causes?
69
Phlebitis/thrombophlebitis * What is the patho?
* Damage to endothelium * Causes vasoconstriction – limits blood flow * Primary hemostasis – Platelet plug * Secondary hemostasis – Fibrin Clot * Clot grows – decreases blood flow, including blood pressure = reduced venous return * Potentially thromboembolic
70
Venous Thrombosis * What is it? * What are the causes? * What is the patho?
71
Varicose veins * What is it? * What are the causes? * What is the patho?
72
What is variocele? WHat can it cause?
73
Venous insufficiency * What is the tho?
74
What are the stages of chronic venous disease?
75
How are the valves together?
76
* What is stenosis? What is regurg? * What are common causes?
77
What are the common effects of vavular patho?
78
Aortic Valve Stenosis * What are the cuases? * What is the patho?
## Footnote LESS THAN 1 CM2
79
Aortic valve regurg causes?
* 50% Root dilation (mostly idiopathic, some from aortic dissection, aneurysms, or sypillis) * 50% Valvular damage (infective endocartitis, chronic rheutic fever)
80
Aortic Valve Regurgitation * What is the patho?
81
Mitral Valve Stenosis * Causes? * What is the patho?
82
Mitral valve prolapse causes?
83
Mital regurg causes?
84
Mitral Valve Regurgitation & Prolapse * What is the patho?
* LA experiences increased volume on ventricular systole * Then subsequent increased LV preload as blood drains form LA * Thus, LA and LV volume overload = Eccentric hypertrophy * Eventually heart becomes overwhelmed = Left sided heart failure (congestive heart failure) * Pulmonary edema
85
Tricuspid Valve Stenosis * What are the causes? * What is the patho?
## Footnote * RA dilation can compress esophagus = dysphagia
86
Tricuspid Valve Regurgitation What are the causes?
87
# [](http://) What is the patho of Tricuspid Valve Regurgitation ?
88
Pulmonary Valve Stenosi * What are the causes? * What is the Patho?
89
Pulmonary Valve Regurgitation * What are the causes?
* Valvular damage (infective endocarditis), bacterial infection * Rheumatic heart disease * Previous surgeries (e.g. on stenotic valve) * Malfunctioning prosthetic valve
90
Pulmonary Valve Regurgitation * What is the patho?

Clinical Medicine 3 (27 decks)

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