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Med Path Fall 2020 > Things I cannot Remember Test 1 > Flashcards

Things I cannot Remember Test 1 Flashcards

1
Q

Blood pressure extrinsic factors

A

Disease

Obesity

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2
Q

HTN is a key risk factor for

A

Stroke

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3
Q

Primary HTN has what kind of etiology

A

Heterogenous, unknown

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4
Q

Risk factors for secondary HTN in women due to hormones

A

Smoking*
History of HTN during pregnancy
Family history

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5
Q

Symptoms of hypertensive urgency

A

Severe headache and anxiety

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6
Q

HTN emergency symptoms and potential complications

A

End organ damage
Chest pain
SOB
Difficulty speaking

Complicaitons:
Stroke
Pulmonary edema- blood leaks out of heart into lungs.

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7
Q

CVD

A

Disease of the heart and vessels that affect the efficient functioning of the cardiovascular system.

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8
Q

How many adults have CVD? What are the 4 types of CVD

A
  1. Hypertension
  2. Coronary heart disease
  3. Stroke
  4. Heart failure
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9
Q

Leading cause of mortality in the US from CVD

A
  1. Heart disease

2. Stroke

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10
Q

Primary form of CVD

A

Coronary heart disease- disease of blood vessels that supply the heart.

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11
Q

Hyperlipidemia levels

A

Tg 150+
HDL less than 40
LDL over 100
Cholesterol over 200

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12
Q

Secondary Hyperlipidemia due to what

A

Polygenic. Due to high fat diet and sedentary lifestyle. Much more common than primary/genetic.

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13
Q

Most common chronic disease in the US

Responsible for 80% of CVD

A

Atherosclerosis

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14
Q

CHD risk factors (4)

A

Smoking, HTN, hyperlipidemia, diabetes.

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15
Q

What causes MI

A

Thrombosis

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16
Q

Elevated blood indicators for MI

A

myoglobin
Troponin
Creatine kinase

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17
Q

Pericardium tamponade

A

Pericardium fills with blood. Decrease CO- swells. Less room in heart for blood.

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18
Q

Percutanous coronary intervention PCI for CAD

A

Angioplasty

Intracoronary stents

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19
Q

Heart failure causes

A

MI*
HTN
Valvular disease
Cardiomyopathy- muscle heart disease

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20
Q

Heart failure

A

Inability to increase cardiac output as needed

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21
Q

Left side HF

A

Pulmonary edema
Tachypnea- rapid breathing
Cyanosis

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22
Q

Right side HF

A

Most commonly caused by left sided failure
Peripheral edema
Hepatomegaly- enlargement of liver
Ascites- Excess venous pressure drains into abdomen.

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23
Q

Main cause of cardiac arrhythmia

A

MI- most common side effect of MI is arrhythmia.

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24
Q

Two forms of cardiomyopathy

A
  1. Ischemic due to thrombosis
  2. Non-ischemic
    - Toxic: Alcohol
    - Metabolic disease: hyperthyroid disease, amyloidosis,
    - Infection: HIV, COVID. Post viral myocarditis.
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25
Primary cause of cardiomyopathy myocyte injury
MI
26
Hypertrophic cardiomyopathy is what type of genetic defect
Autosomal dominant | AA men most likely to have
27
Mitral valve regurgitation may be due to
Mitral valve prolapse | backflow from left ventricle to circulation
28
Mitral valve prolapse
Degeneration of connective tissue in the valve. | May lead to mitral valve regurgitation.
29
Acute pericarditis is caused by what
Neoplasm
30
chronic pericarditis is caused by what
Idioparthic
31
Systemic associations to pericardial disease
Uremia- excessive ammonia in blood
32
Ocular manifestations of infective endocarditis
Roths spots
33
The defining feature of diabetes
Hyperglycemia
34
Primary pathology of Diabetes due to hyperglycemia
Vascular damage happens all over body
35
Normal blood glucose levels
F 70-99 R less than 140 A 5.7 or below O Less than 140
36
Diagnostic criteria for diabetes
F 126+ R 200+ A 6.5 + O 200+
37
Average patient with diabetes has what A1C
8.5%
38
Predicts likelihood of disability and death
AIC
39
eAG
6% AIC = blood sugar 125 | For every 1% increase in AIC, add 30 mg/dl
40
Most common endocrine disorder in the US
Diabetes 9-11% of population.
41
2 main risk factors of Diabetes
Overweight, sedentary life style
42
diabetes is the number __ cause of death
7
43
3 major diabetes complications
Retinopathy Cerebrovascular disease- stroke Neuropathy- palsy
44
Diabetic is the leading cause of
Kidney failure non traumatic lower limb amputation New cases of blindness in adults due to retinopathy
45
Diabetes is a major contributor to
coronary heart disease | Stroke
46
Prediabetic stats
F 100-125 R 140-199 A 5.7-6.5 O 140-199
47
Prediabetic risk factors
Overweight, sedentary lifestyle History of high BMI, gestational diabetes, having a baby over 9 pounds
48
Two causes of type 1 diabetes
Immune mediated - molecular mimicry, altered beta cells. | Idiopathic
49
What is type 2 diabetes mellitus
Insulin resistance
50
Risk factors of type 2 diabetes
Sedentary lifestyle, obesity
51
Gestational diabetes increases risk of type
2 by 50%
52
DOC for gestational diabetes
insulin
53
Metabolic syndrome | Percentage of people it affects
Cluster of conditions that occur together | Affects 23-25% of population
54
Diagnosis of metabolic syndrome
3 or more of the following - TG over 150 - Fasting glucose over 100 - HDL less than 40 - Large waistline - Blood pressure 135/85
55
3 main effects of chronic hyperglycemia
1. Glycation of proteins causes abnormal crosslinking 2. PKA levels increase 3. Sorbital causes edema
56
Macrovascular results due to diabetes
Coronary artery disease Peripheral artery disease - Amputations= ulcerations Cerebrovascular disease - transient ischemic attack, stroke. Other- hearing loss and immunosuppression
57
DM is the number 1 cause of
Lower leg amputation
58
Microvascular Diabetes mellitus side effects
Retinopathy Neuropathy Nephropathy
59
What damages endothelium in microvascular DM
Endothelial glycation. Basement membrane thickens and reduces O2 transmission. Loss of pericyes = microaneursyms leak Glycated platelets cause thrombosis- blood leakage and ischmia
60
prevalence of diabetic retinopathy
28-33%
61
Leading cause of renal failure
Diabetic nephropathy due to glomerulosclerosis
62
Risk factors of diabetic nephropathy
Hyperglycemia and HTN
63
Most common cause of death in type 1 diabetse
Diabetic nephropathy
64
Diabetes is the number 1 cause of
ESRD
65
Most common diabetic neuropathy
Peripheral Other: Autonomic Proximal Focal (cranial nerve palsies)
66
Incidence of diabetic retinopathy increases with ____
Duration of DM
67
How does diabetes contribute to cataract formation
40% increase in risk | Sorbital in lens fibers causes swelling, apoptosis, and increased free radical formation
68
DKA triad
Hyperglycemia Acidic blood High ketones
69
Diabetic ketoacidosis sugar level
200 mg/dl
70
Hypoglycemic shock sugar level
70 | Severe is 50-55
71
Most common neurological disorder
Headaches
72
3 types of primary HA
TTN (80%) Migraines (20%) Cluster (0.4%)
73
Secondary HA are associated with what
``` Fasting Sinus inflammation Infections Stroke Trauma Refraction Medication over use ```
74
TTH are due to what?
Persistent myofascial input- constantly contracting muscle somewhere Causes pain and sterile inflammation.
75
Migraine neurovascular theory
Lower threshold to stimuli leads to cortical hyper excitability followed by cortical spreading depression (CSD). CSD activates trigeminal nerves and causes pain in dural blood vessels. starts in occipital lobe
76
54321 Migraine criteria | 24321 for classic migraines
5 or more attacks 4 hours - 3 days 2 of the following: Unilateral, throbbing, severe pain, activity worsens 1 of the following: photophobia, photophobia, vomitting, nausea
77
Childhood periodic syndromes
Migraines in kids. Car sickness
78
Probable migraine
Hasn't met 54321 critera, but on their way.
79
What primary HA causes conj injection and tearing due to neuromuscular problems?
Migraines and cluster
80
Migraines without aura (common) has what percentage of risk for what
25% increased risk for stroke and MI
81
Migraines with aura "classic migraine" has what risks associated?
2x risk of MI in women | 2x risk of stroke in men= women
82
Retinal migraines
Transient, monocular visual disturbance. Vascular spasm causes ischemia = visual disturbances. Send to neuro
83
What kind of primary headache causes projectile lacrimation
Cluster HA
84
Ophthalmodynia Periodica
Shooting eye pain | Prob occurs along CN V ophthalmic branch
85
HA work up
``` History CN eval Sinus eval Blood pressure Refraction Bino testing Health asses VF screening Consider brainscan Refer to neuro ```
86
Thrombosis causes
Endothelial damage due to atherosclerosis. Collagen exposed and pro clotting factors cause thrombosis. Blood flow irreg due to immobility or anything that causes turbulent blood flow hypercoaguability due to predisposition towards clotting. Congenital or acquired.
87
Thrombosis is more frequent when
During sleep when blood is static + decreased blood pressure (no pressure to push blood along)
88
Arterial thrombosis cause Effects Risk factors
Cause: Endothelial damage- atherosclerosis Effects: MI, Stroke Risk factors: Smoking, HTN, hyper cholesterol, diabetes
89
Venous thrombosis 1. Associations 2. Location 3. Effect 4. Risk factors
1. Associations- venous stasis and hypercoaguabiltiy 2. Location- deep veins 3. Effect- thromboembolism, DVT, pulmonary embolism 4. Risk factors- Immobilization
90
DVT tests
D Dimer test | Angiography ultra sound
91
Pulmonary embolism symptoms
Shortness of breath Hemoptysis - cough up blood Sharp chest pain
92
Venous thrombosis ocular manifestations
Papilledema due to venous sinus thrombosis, BRVO/CRVO
93
Aneurysm risk factors
Tobacco use
94
Location of aneurysms
Cerebral arteries | Brain stem
95
3 Aneurysm complications
Rupture- hemorrhagic stroke Dissecction-- ischemia Thrombus due to turbulent flow causes ischemia
96
Ocular manifest of aneurysm
Posterior communicating artery out pouching causes CN III palsy
97
Shock shared feature
Inadequate tissue perfusion leads to anaerobic metabolism
98
3 shock MOA
1. Inadequate oxygen delivery - respiratory failure, heart failure, fluid loss, hemorrhage or anemia. 2. Inadequate oxygen uptake- poisoning 3. Inadequate nutrients
99
Final common pathway of shock
Metabolic acidosis and cell death
100
5 types of shock
1. Hypovolemic - loss of blood volume due to injury, child birth, or dehydration. 2. Cariogenic- heart damage. Unable to pump blood. MI, HF. 3. Septic - bacterial infection. Causes fever and peripheral thrombus formation. May lead to hypovolemic or cardiogenic shock. 4. Anaphylactic/hypotonic - Type I hypersensitivity. Widespread vasodilation. 5. Neurogenic - damage to brain or spinal cord.
101
three phases of shock
Compensatory Progressive Refractory
102
presentation of compensatory phase of shock
Decreased skin perfusion

Med Path Fall 2020 (20 decks)

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