Thurs Wk 2 Cardio 7 Flashcards Preview

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Flashcards in Thurs Wk 2 Cardio 7 Deck (23)
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1
Q

chordae tendinae are tethered to the LV wall via anterolateral and __ papillary muscles
AL papillary muscle has __ supply via the LAD/LCX
PM supplied solely by __
because this muscle has single artery supply, it is __ likely to become ischemic and rupture

CO is \_\_ x \_\_
can be measured w the \_\_ principle
CO is rate of \_\_ consumption over the \_\_ O2 difference
Arterial content measured from \_\_ blood
Mixed venous O2 content from \_\_ blood
rate of O2 consumption via \_\_ meter
A

posteromedial
dual
PDA
more

HR x SV
fick
O2, arteriovenous
arterial
pulm atery
O2
2
Q

Blood O2 content is O2__ x %__ + Dissolved __ (unbound to Hb)

PVST have focus of automaticity __ the ventricles
either the __ or __ node
can be terminated w ___, which dilates coronary arteries
hyperpolarizes pacemaker, blocking conduction via __
AE include F, chest burning via __ and hypoTN

A

binding capacity, saturation, O2

above
atria, AV
adenosine

AV node
flushing, bronchoconstriction

3
Q

Supraventricular tachycardias
Class 1C antiarrhtmics F/P
SE is V__

Class 2 M
SE is B and advanced __

Class 3 A

Class 3 I/D/S SE is T__

Class 4 V/D
SE is B and advanced __
dec ventricular __
C__

also A/D

A

flecainade, propafenone
ventricular arrhythmias

metoprolol
bradycardia, AV block

Amiodarone

Ibutilide, dofetilide, sotalol
TdP

verapamil, diltiazim
Bradycardia, AV block
contractility
constipation

adenosine/digoxin

4
Q

HCM caused LVOT obstruction w systolic anterior motion of __ toward IV septum

may hear pericardial __ w constrictive pericardiits
seen w thick fibrous tissue in the __ space
restricts __ filling, dec CO

Antracyclines D/D are chemo agents resulting in dilated cardiomyopathy
dependent on __

mechanism of anthracycline is to block __ enzyme in cancer cells, resulting in DNA strand breakage
when this occurs in cardiomyocytes, __ containing complexes produce free rads
prevent w D__ to chelate iron and stop

A

mitral valve

knock
pericardial
ventricular

doxorubin, daunorubicin
dose

Topo2
Fe
desroxane

5
Q

Bleomycin induces __ formation
SE is P___

cisplatin cross links __ to inhibit synthesis
SE is N/O/peripheral __

Cyclophosphamide cross links __ to inhibit synth
SE is hemorrhagic __/B__

Methotrexate inhibits __
SE is __ toxicity and __ pneumonitis

Paclitaxel inhibits microtubule __
SE Is __

Vincristine/vinblastine binds b__ to inhibit microtubule formation
Se is ___

A

free rad
PF

DNA
nephrotoxicity, ototoxic, neuropathy

DNA
cystitis, bladder ca

DHFR
liver, hypersensitivity

disassembly
neuropathy

beta tubulin
neuropathy

6
Q

Collateral microvessels form a path for blood flow distal to __
A/D vasodilators of coronary arteries, resulting in coronary steal, in which blood flow from __ areas is reduced due to vasodilation in __ areas

young pt w history of arrhythmias likely has __ syndrome
due to accessory __ leading to a reentry circuit

sinus impulses will reach the ventricle via an __ pathway, and feed back to the AV node
this __ the ventricle, resulting in subsequent arrhytmia

ECG findings include __ PR, __ QRS and __ wave

A

occluded vessel
Adenosine, dipyramidamole
ischemic
nonischemic

WPW
pathway

accessory path
peexcites
short, wide, delta

7
Q

Bicuspid aortic valves result in inc __ stress, accelerating the aging process
leads to premature atherosclerosis and __ of the aortic valve
patients get __ at slightly younger age

tx for heart failure can inhibit the __/__ systems or upregulate __ peptides
BNP has D/N/V effect
normally degraded by N
___ of neprilysn result in augmenting of ANP/BNP

A

hemodynamic
calcification
AS

RAAS/SNS, natriuretic
diuretic, natriuretic, vasodilatory
neprilysin
inhibitors

8
Q

Jervell Lange Neilsen syndrome caused by mutation in K__ and K__ of outward K channels

B__ syndrome is AD
mutation in cardiac __ or __ channels that leads to pseudoRBBB and ST elevation in __
inc risk of __

A

KNQ1, KNE1

brugada
Na, Ca
V1-V3
SCD

9
Q

Path of atherosclerosis
__ injury w inc vasc permeability
accumulation of __
monocytes adhere, transform into LLM aka __ cells
release of __
recruitment of __ cells and __ proliferation

BB can slow __ node condxn
this is seen as a prolonging of the __ interval, as it prolongs the AV refractory period

Myocardial ischemia results in T wave __

A
endothelial
LDL
foam cells
cytokines
T, smooth muscle

AV
PR

inversion

10
Q

the __ has dual blood supply via portal vein and hepatic artery
thus, __ do not normally occur unless liver has been transplanted

K/S are end arterial supply organs

Plasma __ activity is measured as the amount of AT1 created per time
can be inc w low __ diet, D/A/A

A

liver
infarcts

kidney, spleen

renin
Na
diuretics, arb, acei

11
Q

Bc varicose veins involve the __ veins, DVT/PE are unlikely
Phlegmasia alba dolens is massive __ that impairs arterial inflow

Hypertensive crisis is defined as DBP > __
results in __ arterioloscerlosis
see onion like thickening of walls as a result of __ SMC and reduplicated ___

affects kidneys predominantly, leading to drop in __ and activation of RAAS

A

superficial
thrombus

130
hyperplastic
lamellated, BM

perfusion

12
Q

extra low freq sound before S1 is __
always __ in younger pt
due to dec ventricular __
seen in LV __

inferior portion of the heart receives blood from __
found in the posterior __ groove
in most indiv, this supply comes from the ___

women on OCP should monitor __ level, which should be less than 160

A

S4
pathologic
compliance, hypertrophy

posterior desceding artery
interventricular
RCA

LDL

13
Q
absolute contraindications of OCP
prior hx of \_\_/\_\_ event
hx of \_\_ dependent tumor
women > \_\_ who smoke
high \_\_
decompensated/active \_\_ dz
P

Aspirin blocks __ to stop synthesis of TA2
pt w preexisting resp sx like R/A or allergies U/A/A should avoid it
use C a P2Y12 inhibitor of ADP receptors
stops platelet __

LMH like E/D are indirect thrombin inhibs
bind AT3 and convert it to rapid inactivator of T/factor Xa
used for pt w __

A
thrombotic, ischemic
estrogen
35
TG
liver
pregnancy

COX1
rhinits, asthma, urticaria, angioedema, analphylaxis
Clopidigrel
aggregation

enoxaparin, dalteparin
Thrombin
ACS

14
Q

E is platelet Gp2B/3A inhibitor

D is positive inotropic agent for LV systolic dysfxn
inhibition of Na/K ATPase causes dec __ outflow
this inhibits __ exchanger, promoting myocyte contractility

Niacin SE include F/W/I
due to release of __
can be mitigated w __ just prior
also w slow __ preps or when taken w ___

A

eptifibatide

digoxin
Na
Na/Ca

flushing, warmth, itching
prostaglandins
Aspirin
release, food

15
Q

acute MR results from spontaneous __ rupture
sudden inc blood to LA results in __
this leads to inc LV __
incompetent valve allows blood to enter from LV reducing __
overall, EF has inc, but __ stroke volume has dec
this leads to __ TN and cardiogenic shock

W chronic MR, __ enlarges to take in more volume
LV then becomes __ hypertrophied to maintain SV
w extensive remodeling, there is impaired __ SV reducing CO

A
chordae tendinae
pulm edema
preload
afterload
forward
hypoTN

LA
eccentrically
forward

16
Q

most prominent effects of LHF occur in the ___
such as w O

Cardiac asthma occurs w inc __ to heart in exercise
LV is unable to keep up, resulting in inc __ pressure

Bilateral __ edema and congestive __ are specific for RHF

A

lungs
orthopnea

VR
pulm vasculature

LE
hepatitis

17
Q

pt w constipation, AV block and syncope w new med for Afib likely is on ___

D/V used for HTN, Angina, Supraventricular arrhythmias

fxn to block L type __ dec phase 0 __ and conduction velocity

slows __ and conduction, causing bradycardia/AV block

negative __ effect so contraindicated w systolic HF

C__ is major SE

A
NDCCB
diltiazem, verapamil
Ca channels
depolarization
sinus rate
inotropic
constipation
18
Q

AT2 stimulates type __ AT2 receptors on vasc smooth muscle and __ (aldosterone release)

ARBs competitively bind to the __ resulting in SM relaxation and dec aldo release

women w SLE have accelerated __ and inc risk of MI
small arterioles/arteries show vasculitis w __ necrosis
can get pericarditis and __ endocarditis w thick valve leaflets
sterile __ thrombi w fibrin, IC, and mono cells
can dislodge resulting in __

renal involvement is __ GN
proliferative/necrotizing crescents w diffuse thickening of __ walls and __ formation
all due to __ deposition

A

1, adrenal cortex

receptor

atherosclerosis
fibrinoid
libman sacks
platelet
embolization

DP
capillary, wire loops

Immune complex

19
Q

pt w mitral valve replacement are at high risk for __ staph
produces a polysaccharide __ to adhere to devices

most are methicillin __
thus, empirically tx w __ first
addtl use of G/R can be added
if determined susceptible, can switch to N/O

A

coagulase neg
slime

resistant
Vancomycin
gentamicin, rifampin
nafcillin/oxacillin

20
Q

ECG findings of AF
absent _, irregular __ intervals and __ QRS

aberrant impulses typically arise from inc atrial excitablity in the __
this leads to remodeling of _ to form short refractory periods

ventricular response depends on transmission from __ node, as it must pass a __ period when ventricles cannot be stimulated

majority of atrial impluses __ reach the ventricles bc of refractory period

A

P waves, QRS, narrow

pulm veins
atria

AV, refractory

never

21
Q

use __ in pt w AMI to reduce HR, CO, and Myocardial O2 demand
avoid __ bb in pt w obstructive lung disease
IE P/N

Cardioselectve beta blockers include M/A/N/B

B2 blockers can dec gluconeogenesis/glycogenolysis, leading to __ in diabetic pt

also prevents entry of __ into tissues, leading to hyperkalemia

A

BB
noncardioselective
propanolol, nadolol

metoprolol, atenolol, nebivolol, bisoprolol

22
Q

BNP/ANP act via __ second messenger system

class 1 antiarrhythmic drugs bind to Na channel in the __/__ state
only dissociate in the __ state
tissues that have high HR are freq depolarizing, meaning more time is spent as __/__
known as use dependence

Class 1B binds to Na channel the __
dissociation occurs __, w little use dependence
selective for __ myocardium as elevated membrane potential allows for more binding

A

cGMP

activate, inactivated
resting
depolarized, inactive

weakest
fast
ischemic

23
Q

class 1C agents have __ binding to Na channel
slowest to __, thus have high __
effective at terminating __

NE acts on __/__ more so than __ receptors
w drug that noncompetitively/irreversibly blocks the A1 receptor, NE must act on __
this results in profound __
selective noncomp A1/A2 antagonist is P

A

strongest
dissociate
use dependence
tachyarrhythmias

A1/B1, B2

B2, vasodilation
Phenoxybenzamine