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1. Theme 3 > T3 L3: How the CVS fails > Flashcards

T3 L3: How the CVS fails Flashcards

1
Q

What is the opposite of turbulent flow?

A

Laminar flow. Flow is slower at the edges because of friction

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2
Q

Where is NO secreted?

A

Endothelial cells

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3
Q

What is an AMI?

A

An acute myocardial infarction. Onset is within minutes. Large or multiple infarcts like this can cause heart failure

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4
Q

What is the immune action response that causes atherosclerosis?

A

When there is a tear in the endothelium leading to an accumulation of white blood cells and fatty deposits

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5
Q

What is the main symptoms of coronary heart disease?

A

Angina

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6
Q

When do atheroma’s become dangerous?

A

When the fibrous cap bursts and can lead to formations of emboli

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7
Q

What are haemodynamic abnormalities?

A

BP inconsistencies

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8
Q

Name 3 systemic activities that help compensate during heart failure

A

Increased heart rate, increased contractility, and increased peripheral resistance

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9
Q

What is meant by osmotic and hydrostatic pressure in vessels?

A

High hydrostatic pressure causes water to leave the vessels, high osmotic pressure causes water to enter the vessels. Veins should have a higher osmotic pressure than arteries

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10
Q

What type of heart failure causes pulmonary oedema?

A

Let heart failure because water is backing up from the left side

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11
Q

What is orthopoea?

A

Can only breathe when sitting or standing

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12
Q

What is dyspnoea?

A

Difficulty breathing

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13
Q

What is ascites?

A

Accumulation of fluid in the peritoneal cavity. Can be caused by heart failure

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14
Q

What is decompensated heart failure?

A

The failure of the heart to maintain adequate blood flow after long term CVD

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15
Q

What are the 2 types of cardiac remodelling?

A

Hypertrophy and dilation

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16
Q

What 2 drugs can be used to inhibit cardiac remodelling?

A

ACE inhibitors and spironolactone

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17
Q

When is ventricular hypertrophy normal?

A

In athletes

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18
Q

What is the eccentric cause for ventricular hypertrophy?

A

Dilation because of volume overload

19
Q

What is the concentric cause for ventricular hypertrophy?

A

Thickening because of pressure overload

20
Q

What is another name for Vasopressin?

A

Antidiuretic hormone (ADH)

21
Q

What is ADH and what is it’s effect on the body?

A

It’s a peptide secreted by the posterior pituitary gland that causes the kidneys to absorb more water.

22
Q

What is Aldosterone and what is its effect on the body?

A

It’s a steroid secreted by the adrenal cortex that causes the kidneys to absorb more NaCl and therefore more H2O. It directly decreases natriuresis

23
Q

What is natriuresis?

A

Excretion of sodium in the urine

24
Q

What effect does decreased diuresis have on BP?

A

Increased BP

25
Q

What do diuretic drugs do to diuretic hormones?

A

They antagonise them leading to fluid loss

26
Q

What effect does increased fluid retention have on aldosterone and ADH?

A

Increased aldosterone and ADH secretion

27
Q

Where is Renin secreted?

A

Kidneys

28
Q

Where is ACE secreted?

A

Lungs and kidneys

29
Q

Describe the formation of aldosterone including precursor molecules

A

Angiotensinogen (precursor molecule) is converted to angiotensin I by renin. Then ACE converts it into angiotensin II which is active and can develop into aldosterone

30
Q

What type of drug is indapamide?

A

A thiazide-like drug that blocks the reabsorption at the DCT of the nephron

31
Q

What type of drug is furosemide?

A

A loop diuretic that blocks reabsorption in the thick loop of the nephron

32
Q

What type of drug is spironolactone?

A

A K+ sparing diuretic that inhibits aldosterone receptors in the cortical collecting duct

33
Q

What is the difference between chronic low output heart failure and decompensated heart failure?

A

Decompensated heart failure is a medical emergency but people can live with it chronically. Chronic form is a disease of the elderly

34
Q

What are the symptoms of left heart failure and why do they happen?

A

Respiratory symptoms. The right heart pumps into the lungs but the left atrium is full so hydrostatic pressure increases in pulmonary circulation. Also known as congestive heart failure because the pulmonary vasculature is congested. In extreme cases, fluid can leak out of vessels and into the lungs

35
Q

What are the symptoms of right heart failure and why do they happen?

A

Systemic symptoms. The blood can’t return to the right heart because its full. This causes an increase in central venous pressure and therefore peripheral oedema or acites

36
Q

What is paroxysmal nocturnal dyspnoea?

A

Waking up in the middle of the night and not being able to breathe

37
Q

What are the 3 main symptoms of heart failure?

A

Fatigue, peripheral oedema and dyspnoea

38
Q

What is cardiogenic shock?

A

Critically low perfusion due to low cardiac output. Defined as <90 mmHg systolic

39
Q

How is positive feedback involved in cardiogenic shock progression?

A

The heart doesn’t have enough blood so it beats slower

40
Q

How is cardiogenic shock treated?

A

Aggressive IV fluid and oxygen and airway maintained

41
Q

What 3 types of drugs are used for chronic heart failure?

A

ACE inhibitors to prevent heart remodelling, Diuretics to increase the amount of fluid loss, and beta blockers to lower sympathetic activity

42
Q

What is the sympathetic activity for homeostasis for low cardiac output (fast response)?

A

Happens to increase BP. Heart rate and contractility increase and there is vasocontriction

43
Q

What is the slow response of the kidneys for homeostasis for low cardiac outpu?

A

Decreased glomerular filtration rate. Increased central venous pressure, venous return and preload

44
Q

How do the kidneys make decompensated heart failure worse?

A

The kidneys increase plasma volume to compensate for poor perfusion of renal tissue because the kidneys can’t tell the difference between heart failure and haemorrhage. This process leads to fluid overload. The heart can’t pump this extra fluid and this leads to rapid deterioration

1. Theme 3 (19 decks)

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