DVTs & PEs & Sleep Physiology Flashcards Preview

Jason's Respiratory Block > DVTs & PEs & Sleep Physiology > Flashcards

Flashcards in DVTs & PEs & Sleep Physiology Deck (67):
1

What are 3 major cardiovascular causes of death?

Ischaemic heart disease
stroke
DVT

2

more chance of DVT if you're older or younger?

older

3

Risk factors for Venous Thrombosis?

Slowing of flow
endothelial dysfunction/injury

4

Hypercoagulability causes?8 things

severe burns
post-MI
malignancy/chemo
high oestrogen
autoimmune
nephrotic syndrome
obesity
inflammatory diseases

5

Genetic Hypercoagulability causes?

Factor V Leiden mutation (most common)

6

What happens in Factor V Leiden mutation?

Activated protein C(anticoagulant) can no longer bind to Factor V cause it's mutated

7

Heterozygotes of Factor V Leiden mutation have how many fold increase? what's the prevalence in pop?

4% of pop, 50% in DVT pop
5 fold increase

8

Homozygotes of Factor V Leiden mutation have how many fold increase of DVT?

100-fold increase

9

Prothrombin mutation does what for hyper coagulability?

increase circulating plasma level

10

Thrombophilia happens more arterial? or venous

venous

11

Thrombophilia would suspected if 3 things happen:

young age
recurrent
unusual site

12

Is post-surgical state considered Thrombophilia?

Nope, it's transient. Thrombophilia is more long term/chronic

13

deep and superficial veins, they connect, which way do they flow?

superficial>deep

14

proximal or distal DVTs likely to embolize?

proximal

15

common site of DVTs?

calves

16

symptoms of DVT?

subtle: swelling, redness, warmth, pain, tenderness

17

Do most people with DVT have symptoms?

50% asymptomatic

18

Pulmonary thrombo-embolism, how many people die within first hour? how many from subsequent recurrent embolism?

10%
30%

19

Pleuritic pain in Pulmonary thrombi-embolism could indicate what?

pulmonary infarct

20

Pulmonary thrombo-embolism symptoms

variable dyspnoea
haemoptysis, cough, syncope

21

What happens once a Pulmonary thrombi-embolism gets into a local pulmonary artery?

hypoxaemia
reflex vasoconstriction
V/Q mismatch

22

If a large one of 60% of vascular bed occluded in Pulmonary thrombi-embolism, what happens?

sudden death and collapse

23

medium sized Pulmonary thrombo-embolism, what happens?

dyspnoea
cough
acute for pulmonale

24

Are pulmonary infarcts common?

nope, only if has CVD or preexisting lung condition

25

Small Pulmonary thrombi-embolism features?

clinically silent
multiple small emboli = chronic cor pulmonale

26

What is saddle Pulmonary thrombi-embolism?

near beginning of pulmonary artery near heart

27

fate of Pulmonary thrombi-embolism?

dissolution
organization

28

What happens in Pulmonary thrombi-embolism organization?

recanalization, complete or partial

29

What could happen to valves in DVT?

damaged
varicose veins

30

long term DVT consequences?

chronic venous insufficiency
chronic oedema,
pigmentation/haemosiderin
ulceration

31

prevention of DVTs: 5 things:

drugs
mobilization
exercise
compression stockings
lifestyle

32

When do you thrombosis of upper limbs?

catheritizations or thrombophilia

33

When would you be likely to get thrombosi in cerebral venous sinus
mesenteric veins
portal veins
hepatic veins?

thrombophilia/genetics

34

Defining characteristic of sleep?

capability of returning rapidly to wakefulness. Accumulation of debt

35

sleep for energy preservation?

eh, not really, only 10% less than fully awake

36

sleep to keep out of trouble

nah. more older theory.

37

What seems to be the ideal amount of sleep vs. mortality?

7-ish hours

38

Kids who are sleep deprived are tired? or hyper?

ADHD hyper

39

83% increase in risk of complications with sleep deprivation in what professionals?

surgeon

40

Does nap help with degradation of cognitive performance?

yes, sleep is sensitive to beef amount of sleep

41

what will get you over 0.05 for sleep?

awake for 18-24 hours
5 hours of sleep for 4-5 nights
sleep apnoea
return trans-atlantic flight

42

What's the objective vs. subjective reports of people with sleep deprivation?

objective: performance worsens consistently
subjective: ppl get used to it

43

What are the 3 most common sleep problems in Aus?

4.7 sleep apnoea
3% primary insomnia
1.2% restless legs syndrome

44

What increased breathing when you exercise before chemoreceptors?

muscle/joint receptors

45

What 3 drives to breath are stopped completely during sleep?

higher brain centers
emotion stim
wakefulness drive to breath

46

What 3 drives to breath are partially stopped completely during sleep?

lung stretch receptors
touch/temp/pain receptors
muscle/joint receptors

47

upper airway resistance increases with inspiration or expiration?

inspiration

48

What happens to minute ventilation as soon as you fall asleep?

sharp decreases minute ventilation

49

What is the major regulator of breathing during sleep?

chemical control

50

What sleep phase is worst for OSA?

REM sleep

51

What is normal pCO2 during sleep?

35-45mmHg

52

How is movement during REM sleep?

commanded but inhibited

53

Which muscles are not paralyzed during REM?

breathing and eyes

54

How many sleep cycles per night? How long do each cycle last for?

4-6 cycles
each between 90-120min

55

what happens to slow wave/deep refreshing sleep as you get older?

decreases in time and frequency

56

Circadian rhythms cues include?

Light
endogenous

57

body temp Warmer at night or day?

during day, cooler at night varies ~1 degree

58

Where is the suprachiasmatic nucleus? what does it do?

in hypothalamus governs some circadian rhythms

59

How does suprachiasmatic nucleus work?

receives light from retina (esp. blue light) projects to paraventricular nucleus>pineal gland and secretes melatonin

60

What happens to a rat drinking water after suprachiasmatic nucleus lesion?

drinks randomly through day instead of at night when it's awake (nocturnal animal)

61

2 times of day where there's the most MVAs?

morning
late afternoon

62

If you take away light, what is the biological clock set to?

25.3 hours

63

What is advanced sleep phase type sleep disorder?

bed at 6
up at 3am

64

2 ways sleep is generated:

1. cholinergic
2. His, NA, Ache affecting thalamus/cortex

65

VLPO does what to sleep system?

inhibits all other activating systems

66

What causes disinhibition of VLPO in sleep?

ATP depletion/accumulation of adenosine in basal forebrain

67

What's the role of Orexin in sleep?

stabilizes the on/off switch in sleeping when VLPO is disinhibited