EXSC 433 > EXAM3 > Flashcards

EXAM3 Flashcards

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1
Q

an active process involving molecular signals that produce altered cellular behavior as well as endothelial dysfunction and a subsequent inflammatory response

A

atherosclerosis

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2
Q

explain the disease progression of atherosclerosis

A
  1. injury to endothelial lining
  2. fatty streak
  3. fibrous plaque
  4. possible disruption of the lesion
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3
Q

ischemia

A

lack of blood flow to the heart

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4
Q

angina pectoris

A

chest pain

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5
Q

myocardial infarction

A

heart attack (death to heart cells; lack of blood flow due to plaque build-up)

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6
Q

causes of atherogenesis

A

chronic injury to endothelial cells from tobacco LDL hypertension etc

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7
Q

endothelial dysfunction in atherosclerosis is dangerous because…

A

endothelial dysfunction leads to:

  • increased adhesiveness [platelets monocytes stick]
  • increased permeability to LDL
  • impaired vasodilation & vasospasm
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8
Q

rupture or fissuring of a plaque formed within the artery in atherogenesis cases is called a

A

thrombus

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9
Q

SBP & DBP in hypertension

A

SBP >140

DBP >90

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10
Q

most commonly diagnosed CV disease?

A

hypertension

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11
Q

hypertension causes constriction of _____ ______ so that blood flow is hindered, increasing workload of the heart

A

peripheral arteries

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12
Q

hypertension can cause ________ damage to large arteries as well

A

endothelial

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13
Q

manifestation of advanced atherosclerosis progression in the coronary arteries

A

coronary heart disease

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14
Q

pain resulting from myocardial ischemia (inadequate blood flow to the heart)

A

angina pectoris

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15
Q

how is angina pectoris characterized?

A

substernal pressure, heaviness, burning, sometimes accompanied by dyspnea (trouble breathing)

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16
Q

angina pectoris is labeled “classic” if..

A

elicited by physical or emotional stress

relieved by nitroglycerin or rest

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17
Q

angina pectoris is labeled “vasospastic” if…

A

it occurs at rest for no reason

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18
Q

angina pectoris is labeled “unstable” if … **

A

new onset, lasts for longer duration then last time, increased frequency, occurs at lower level of exertion than usual, (changing, getting worse)

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19
Q

death of myocardial muscle cells that occur when blood flow through the coronary artery is disrupted & tissues are deprived of oxygen for long periods of time

A

myocardial infarction

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20
Q

what is an acute myocardial infarction

A

sudden ischemia leading to myocardial damage & infarction (lack of blood flow causing a part of the heart to die)

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21
Q

10 complications of MI

A
  1. arrthymias [irregular heartbeat]
  2. conduction disturbance
  3. bundle bunch block
  4. cardiogenic shock
  5. infarct extension/expansion
  6. myocardial rupture [muscle cells killed]
  7. new mitral valve regurgitation
  8. pericardial effusion [fluid collection] & pericarditis [inflamed sac around heart]
  9. post-infarction syndrome
  10. left ventricular mural thrombus [blood not being pumped out sits & clots]
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22
Q

S&S of MI

A
  1. angina pectoris
  2. unusual SOB
  3. profound weakness/fatigue
  4. profuse sweating
  5. loss of consciousness
  6. confusion
  7. dizziness
  8. nausea
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23
Q

death resulting from an abrupt loss of heart function is known as

A

sudden cardiac death

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24
Q

chronic degenerative condition in which the ability of one or both ventricles to fill with or eject blood is impaired

A

chronic heart failure

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25
chronic heart failure is usually due to
poor circulation in the heart
26
chronic heart failure manifestations (S&S)
- dyspnea - fluid retention - exercise intolerance - fatigue
27
two types of chronic heart failure
left ventricle systolic & right ventricle diastolic dysfunction
28
LV systolic dysfunction
- reduced blood put out by heart [ejection fraction] - assessed using echocardiogram, radio-nucleotide test, cardiac catheterization - ejection fraction
29
RV diastolic
- diagnosis less exact | - clinical syndrome of congestive HF in the presence of normal ejection fraction
30
loss of brain function subsequent to the interruption of blood flow
stroke [cerebrovascular accident]
31
causes of stroke
1. ischemic (blockage): decreased blood flow to a portion of the brain 2. intracranial hemorrhage: sudden rupture of an artery in the brain leading to compression of the brain structures (hemorrhage/aneurism)
32
symptoms of stroke
weakness in face arm leg, typically on one side of the body, numbness, sudden confusion, trouble understanding, trouble speaking, etc.
33
4 risk factors for stroke
1. asymptomatic coronary disease 2. atrial fibrilation (beat irregularity) 3. pregnancy (increases chances of blood clot) 4. postmenopausal women (lack of estrogen)
34
a series of disorders in which blood flow through non-coronary arterial beds is inhibited by atherosclerotic plaque
peripheral arterial disease
35
PAD is characterized by what 5 things
1. diminished functional capacity 2. limb dysfunction 3. reduced QOL 4. increased cardiovascular ischemic risk 5. increased risk of death
36
PAD manifestation
intermittent claudication [leg pain that follows physical exertion & is relieved at rest - calf thigh buttocks]
37
how do you diagnose PAD
- palpate peripheral pulse - ankle to brachial index 1-1.29 - resting ABI less than 0.5
38
classifications of PAD
1 - assymptomatic 2 - intermittent claudication 2a - distance to pain onset >200m 2b - distance to pain onset
39
________ is released by the kidneys in response to _______ stimulation or a decline in renal blood flow
Renin; sympathetic
40
Explain the renin-angiotension system
- Renin is released by the kidneys in response to sympathetic stimulation or decline in renal blood flow - renin converts angiotensin to angiotensin I - angiotensin I is modified to angiotensin II - angiotensin II stimulates aldosterone secretion, ADH secretion, thirst, & cardiac output [arteriole constriction]
41
interfere with the coagulation cascade [clotting mechanism]
anticoagulants [warfarin, heparin]
42
anticoagulants are also referred to as ____ ____, & may cause easy bruising & bleeding
blood thinners
43
anti-ischemic agents
beta blockers
44
what do beta blockers do
- reduce ischemia (lower oxygen demand for any work load)
45
beta blockers reduce 1st year mortality rate in patients after MI by ___-____%
20-35%
46
with beta blockers there is a reduced __ respond to exercise and a decreased _____ exercise capacity
HR; maximal
47
what do calcium channel antagonists do
reduce ischemia by altering major determinants of myocardial oxygen supply/demand
48
Calcium channel antagonists cause ______ by inhibiting _____ influx in vascular ___ muscle {HR decreases because of calcium inhibition in conduction tissue}
vasodilation; calcium; smooth
49
what do nitrates do?
reduce ischemia by reducing myocardial oxygen demand with a small concomitant increase in oxygen supply
50
what does a vasodilator do ?
- decreases work load on the heart | - dilates coronary arteries (more blood to heart muscle & pain relief in ischemia--used in acute treatment)
51
you should not use a vasodilator if BP is
52
renin is released by the kidneys in response to what two things
sympathetic nerve stimulation | decline in renal blood flow
53
[medications] | angiotensin-converting enzyme inhibitors
reduce myocardial oxygen demand by reducing systemic vascular resistance [reduce work of heart; may cause cough]
54
[medications] | ARBs
used when ace can't be used | prevent binding of angiotensin II (a vasoconstrictor) to its receptors
55
[medications] | Aldosterone antagonists
blunts SA & AV node conduction resulting in a lower ventricular response [less work for the heart]
56
[medications] digitalis
enhances contractility of myocardium [increased stroke volume]
57
[medications] diuretics
loss of water in urine [decrease blood pressure]
58
nitrates affects on exercise
increase resting HR | decrease ischemia
59
all medications cause a decrease in HR and BP except
nitrates
60
FITT for PAD [peripheral arterial disease]
F: 3-5 days I: moderate - pain score of 3 T: 30-60min. 10 min bouts T: R training recommended [weight & non weight bearing]
61
FITT for hypertension
``` F: aerobic daily; resistance 2-3 I: moderate 40-59% RPE 11-13 T: 30-60min. 1 set 8-12 reps T: any *progress gradually; remember BP meds changes comorbitities ```
62
beta blockers may ______ the chance of hypoglycemia, especially in those on ____ or _______
increase; insulin or secretagogues
63
beta blockers may mask the signs of ________ [tachycardia]
hypoglycemia
64
beta blockers and diuretics may affect the ________ function
thermoregulatory
65
BP medication may cause excess decrease in..
BP post exercise [post-exercise hypotension]
66
those with known ischemia during exercise should keep intensity at least _____ beats per minute below the ______ threshold
10; ischemic
67
5 surgical treatments for hypertension
1. percutaneous transluminal coronary angioplasty 2. stent [balloon catheter] 3. coronary artery bypass graft [pull artery from somewhere else] 4. atherectomy [drill pulls out plaque; common in peripheral] 5. laser angioplasty
68
other treatment options
pacemakers | automatic internal
EXSC 433
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