Flashcards in DVTs & PEs & Sleep Physiology Deck (67)
What are 3 major cardiovascular causes of death?
Ischaemic heart disease
more chance of DVT if you're older or younger?
Risk factors for Venous Thrombosis?
Slowing of flow
Hypercoagulability causes?8 things
Genetic Hypercoagulability causes?
Factor V Leiden mutation (most common)
What happens in Factor V Leiden mutation?
Activated protein C(anticoagulant) can no longer bind to Factor V cause it's mutated
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
Homozygotes of Factor V Leiden mutation have how many fold increase of DVT?
Prothrombin mutation does what for hyper coagulability?
increase circulating plasma level
Thrombophilia happens more arterial? or venous
Thrombophilia would suspected if 3 things happen:
Is post-surgical state considered Thrombophilia?
Nope, it's transient. Thrombophilia is more long term/chronic
deep and superficial veins, they connect, which way do they flow?
proximal or distal DVTs likely to embolize?
common site of DVTs?
symptoms of DVT?
subtle: swelling, redness, warmth, pain, tenderness
Do most people with DVT have symptoms?
Pulmonary thrombo-embolism, how many people die within first hour? how many from subsequent recurrent embolism?
Pleuritic pain in Pulmonary thrombi-embolism could indicate what?
Pulmonary thrombo-embolism symptoms
haemoptysis, cough, syncope
What happens once a Pulmonary thrombi-embolism gets into a local pulmonary artery?
If a large one of 60% of vascular bed occluded in Pulmonary thrombi-embolism, what happens?
sudden death and collapse
medium sized Pulmonary thrombo-embolism, what happens?
acute for pulmonale
Are pulmonary infarcts common?
nope, only if has CVD or preexisting lung condition
Small Pulmonary thrombi-embolism features?
multiple small emboli = chronic cor pulmonale
What is saddle Pulmonary thrombi-embolism?
near beginning of pulmonary artery near heart
fate of Pulmonary thrombi-embolism?
What happens in Pulmonary thrombi-embolism organization?
recanalization, complete or partial
What could happen to valves in DVT?
long term DVT consequences?
chronic venous insufficiency
prevention of DVTs: 5 things:
When do you thrombosis of upper limbs?
catheritizations or thrombophilia
When would you be likely to get thrombosi in cerebral venous sinus
Defining characteristic of sleep?
capability of returning rapidly to wakefulness. Accumulation of debt
sleep for energy preservation?
eh, not really, only 10% less than fully awake
sleep to keep out of trouble
nah. more older theory.
What seems to be the ideal amount of sleep vs. mortality?
Kids who are sleep deprived are tired? or hyper?
83% increase in risk of complications with sleep deprivation in what professionals?
Does nap help with degradation of cognitive performance?
yes, sleep is sensitive to beef amount of sleep
what will get you over 0.05 for sleep?
awake for 18-24 hours
5 hours of sleep for 4-5 nights
return trans-atlantic flight
What's the objective vs. subjective reports of people with sleep deprivation?
objective: performance worsens consistently
subjective: ppl get used to it
What are the 3 most common sleep problems in Aus?
4.7 sleep apnoea
3% primary insomnia
1.2% restless legs syndrome
What increased breathing when you exercise before chemoreceptors?
What 3 drives to breath are stopped completely during sleep?
higher brain centers
wakefulness drive to breath
What 3 drives to breath are partially stopped completely during sleep?
lung stretch receptors
upper airway resistance increases with inspiration or expiration?
What happens to minute ventilation as soon as you fall asleep?
sharp decreases minute ventilation
What is the major regulator of breathing during sleep?
What sleep phase is worst for OSA?
What is normal pCO2 during sleep?
How is movement during REM sleep?
commanded but inhibited
Which muscles are not paralyzed during REM?
breathing and eyes
How many sleep cycles per night? How long do each cycle last for?
each between 90-120min
what happens to slow wave/deep refreshing sleep as you get older?
decreases in time and frequency
Circadian rhythms cues include?
body temp Warmer at night or day?
during day, cooler at night varies ~1 degree
Where is the suprachiasmatic nucleus? what does it do?
in hypothalamus governs some circadian rhythms
How does suprachiasmatic nucleus work?
receives light from retina (esp. blue light) projects to paraventricular nucleus>pineal gland and secretes melatonin
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)
2 times of day where there's the most MVAs?
If you take away light, what is the biological clock set to?
What is advanced sleep phase type sleep disorder?
bed at 6
up at 3am
2 ways sleep is generated:
2. His, NA, Ache affecting thalamus/cortex
VLPO does what to sleep system?
inhibits all other activating systems
What causes disinhibition of VLPO in sleep?
ATP depletion/accumulation of adenosine in basal forebrain