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

DVTs & PEs & Sleep Physiology Flashcards

1
Q

What are 3 major cardiovascular causes of death?

A

Ischaemic heart disease
stroke
DVT

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2
Q

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

A

older

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3
Q

Risk factors for Venous Thrombosis?

A

Slowing of flow

endothelial dysfunction/injury

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4
Q

Hypercoagulability causes?8 things

A 
severe burns
post-MI
malignancy/chemo
high oestrogen 
autoimmune
nephrotic syndrome
obesity
inflammatory diseases
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5
Q

Genetic Hypercoagulability causes?

A

Factor V Leiden mutation (most common)

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6
Q

What happens in Factor V Leiden mutation?

A

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

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7
Q

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

A

4% of pop, 50% in DVT pop

5 fold increase

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8
Q

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

A

100-fold increase

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9
Q

Prothrombin mutation does what for hyper coagulability?

A

increase circulating plasma level

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10
Q

Thrombophilia happens more arterial? or venous

A

venous

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11
Q

Thrombophilia would suspected if 3 things happen:

A

young age
recurrent
unusual site

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12
Q

Is post-surgical state considered Thrombophilia?

A

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

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13
Q

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

A

superficial>deep

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14
Q

proximal or distal DVTs likely to embolize?

A

proximal

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15
Q

common site of DVTs?

A

calves

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16
Q

symptoms of DVT?

A

subtle: swelling, redness, warmth, pain, tenderness

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17
Q

Do most people with DVT have symptoms?

A

50% asymptomatic

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18
Q

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

A

10%

30%

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19
Q

Pleuritic pain in Pulmonary thrombi-embolism could indicate what?

A

pulmonary infarct

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20
Q

Pulmonary thrombo-embolism symptoms

A

variable dyspnoea

haemoptysis, cough, syncope

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21
Q

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

A

hypoxaemia
reflex vasoconstriction
V/Q mismatch

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22
Q

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

A

sudden death and collapse

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23
Q

medium sized Pulmonary thrombo-embolism, what happens?

A

dyspnoea
cough
acute for pulmonale

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24
Q

Are pulmonary infarcts common?

A

nope, only if has CVD or preexisting lung condition

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25
Q

Small Pulmonary thrombi-embolism features?

A

clinically silent

multiple small emboli = chronic cor pulmonale

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26
Q

What is saddle Pulmonary thrombi-embolism?

A

near beginning of pulmonary artery near heart

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27
Q

fate of Pulmonary thrombi-embolism?

A

dissolution

organization

28
Q

What happens in Pulmonary thrombi-embolism organization?

A

recanalization, complete or partial

29
Q

What could happen to valves in DVT?

A

damaged

varicose veins

30
Q

long term DVT consequences?

A

chronic venous insufficiency
chronic oedema,
pigmentation/haemosiderin
ulceration

31
Q

prevention of DVTs: 5 things:

A 
drugs
mobilization
exercise
compression stockings
lifestyle
32
Q

When do you thrombosis of upper limbs?

A

catheritizations or thrombophilia

33
Q

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

A

thrombophilia/genetics

34
Q

Defining characteristic of sleep?

A

capability of returning rapidly to wakefulness. Accumulation of debt

35
Q

sleep for energy preservation?

A

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

36
Q

sleep to keep out of trouble

A

nah. more older theory.

37
Q

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

A

7-ish hours

38
Q

Kids who are sleep deprived are tired? or hyper?

A

ADHD hyper

39
Q

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

A

surgeon

40
Q

Does nap help with degradation of cognitive performance?

A

yes, sleep is sensitive to beef amount of sleep

41
Q

what will get you over 0.05 for sleep?

A

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

42
Q

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

A

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

43
Q

What are the 3 most common sleep problems in Aus?

A

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

44
Q

What increased breathing when you exercise before chemoreceptors?

A

muscle/joint receptors

45
Q

What 3 drives to breath are stopped completely during sleep?

A

higher brain centers
emotion stim
wakefulness drive to breath

46
Q

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

A

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

47
Q

upper airway resistance increases with inspiration or expiration?

A

inspiration

48
Q

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

A

sharp decreases minute ventilation

49
Q

What is the major regulator of breathing during sleep?

A

chemical control

50
Q

What sleep phase is worst for OSA?

A

REM sleep

51
Q

What is normal pCO2 during sleep?

A

35-45mmHg

52
Q

How is movement during REM sleep?

A

commanded but inhibited

53
Q

Which muscles are not paralyzed during REM?

A

breathing and eyes

54
Q

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

A

4-6 cycles

each between 90-120min

55
Q

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

A

decreases in time and frequency

56
Q

Circadian rhythms cues include?

A

Light

endogenous

57
Q

body temp Warmer at night or day?

A

during day, cooler at night varies ~1 degree

58
Q

Where is the suprachiasmatic nucleus? what does it do?

A

in hypothalamus governs some circadian rhythms

59
Q

How does suprachiasmatic nucleus work?

A

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

60
Q

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

A

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

61
Q

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

A

morning

late afternoon

62
Q

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

A

25.3 hours

63
Q

What is advanced sleep phase type sleep disorder?

A

bed at 6

up at 3am

64
Q

2 ways sleep is generated:

A
  1. cholinergic

2. His, NA, Ache affecting thalamus/cortex

65
Q

VLPO does what to sleep system?

A

inhibits all other activating systems

66
Q

What causes disinhibition of VLPO in sleep?

A

ATP depletion/accumulation of adenosine in basal forebrain

67
Q

What’s the role of Orexin in sleep?

A

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

Jason's Respiratory Block (20 decks)

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