2-Pathopharm > Module 8 > Flashcards

Module 8 Flashcards

(59 cards)

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1
Q

What are the primary functions of the endothelial layer in the vascular system?

A
  • Lines the surface of the entire vascular system
  • One endothelial cell thick
  • Responds to many factors
  • regulates blood flow
  • Provides selective permeability
  • Regulates homeostasis, vasomotor tone and immune/inflamm response
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2
Q

How do nitric oxide and endothelin affect vascular tone?

A

Nitric Oxide: Promotes dilation of vessels
Endothelin: Promotes constriction of vessels

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3
Q

What type of tissue is endothelium

A

active tissue, it directly controls blood clotting in the case of injury

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4
Q

What is the role of lipoproteins in cholesterol transport

A

move fats through the blood stream

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5
Q

What is LDL and its effects on the cardio system

A
  • Transports cholesterol to tissues where it can be used to build things (stored in vessel walls)
  • More lipids then protein
  • It places cholesterol into arteries and creates atherosclerosis
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6
Q

What is HDL’s effect on the cardio system

A
  • transport cholesterol to the liver for excretion
  • More protein then lipids
  • Helps LDL return to the liver so it can be processed and excreted
  • Protects against atherosclerosis
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7
Q

How do chronic high glucose levels damage the endothelial cells, and what are the downstream effects on cardiovascular health?

A

Precursor to endothelial inflammation and atherosclerosis
- Causes endothelial cells to produce endothelin which causes vasoconstriction
- Predisposes to acute coronary events

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8
Q

What are the common causes of endothelial injury, and how do they contribute to atherosclerosis?

A

smoking, elevated blood pressure, elevated blood sugar, high cholesterol and free radicals

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9
Q

How do free radicals contribute to cardiovascular diseases such as atherosclerosis?

A
  • When the antioxidants cannot keep the radicals in check it results in oxidative stress and causes inflammation
  • Makes the molecules not work as well
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10
Q

What does nicotine do to the endothelial layer

A
  • Vasoconstrictor of coronary artery
  • Increases BP and heart rate
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11
Q

What is the RAAS system, and how does it regulate blood pressure and vascular resistance?

A
  • System that maintains BP
  • Raising vascular resistance through vasoconstriction (angiotensin II).
  • Increasing blood volume through aldosterone and ADH.
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12
Q

What do baroreceptors measure

A

stretch receptors that measure blood pressure

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13
Q

What do chemoreceptors measure

A

chemicals O2, CO2 and pH

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14
Q

What is the important factor that determine resistance in the vascular system

A

vessel radius

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15
Q

How does aldosterone influence sodium and water retention, and what is its role in hypertension?

A

Stimulates sodium (Na⁺) reabsorption in the kidneys.

Causes water to be retained along with the sodium.

Increases potassium (K⁺) excretion

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16
Q

What are the different types of lipids?

A

triglycerides, phospholipids, sterols

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17
Q

What are phospholipids

A
  • Essential for building cell membranes
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18
Q

What are triglycerides

A
  • Common type of lipid
  • Major storage form of fat in the body
  • Only type of lipid that serves as an energy source
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19
Q

What are sterols

A

Molecules strung together into a ring structure, mostly only in the form of cholesterol

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20
Q

What lifestyle and genetic factors increase the risk of hyperlipidemia?

A

Obesity, diabetes, hypothyroidism, making lipoproteins, bad diet

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21
Q

What is and causes atherogenesis

A

the build up of arterial plaque
causes: endothelial injury

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22
Q

What is vulnerable and stable atherosclerosis

A

V: thin fibrous caps, high risk for rupture–> thrombus
S: thick fibrous caps, don’t often rupture

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23
Q

What can atherosclerosis cause

A

Coronary Artery disease
MI
Arrhythmias
Heart failure
Sudden death

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24
Q

What is peripheral artery disease (PAD)

Study These Flashcards
A
  • Not enough blood circulating to the legs and feet caused by peripheral atherosclerosis
  • Associated with smoking, DM, African american
  • Aching cramping leg pain
25
what is coronary artery disease (CAD)
Heart disease caused by impaired coronary blood flow - Due to atherosclerosis and lack of O2
26
What is the ankle-brachial index, and how is it used to assess PAD severity?
- Detects stenosis of 50% or more in major vessels of the legs - Measure systolic pressure in each arm and pedal, divide them to get a difference - Difference says how bad circulation is
27
What is the difference between stable and unstable angina, and how are they managed?
Stable: - Predictable and recurrent pain that occurs on exertion and is relieved by rest or nitroglycerin Unstable: - Symptoms increase in frequency and duration, may not be relieved by rest or nitroglycerin
28
What is Intractable/ refractory angina
severe, incapacitating chest pain
29
what is Variant angina
pain at rest with ST elevation, thought to be caused by coronary artery spasm
30
What is Silent ischemia
evidence of ischemia, but no pain
31
What is an NSTEMI
Type of heart attack caused by partial blockage of a coronary artery - leads to reduced blood flow to specific areas
32
What is a STEMI
severe form of heart attack caused by complete blockage of a coronary artery - More serious then a NSTEMI
33
What diagnostic tools are used to assess myocardial perfusion, and what information do they provide?
- Exercise tolerance test: function under stress - Nuclear stress test: BF at rest and during exercise - ECHO: mvm of valve and heart wall
34
How does the heart compensate for decreased cardiac output in heart failure, and what are the consequences of these compensatory mechanisms?
increase heart rate and stroke volume, constrict blood vessels, and retain salt and water - Can mess with balances in the body
35
What are the differences between systolic and diastolic heart failure
Systolic: caused by increased preload, ventricular dilation and rise in ventricular end- diastolic pressure Diastolic: caused by anything that impedes filling of the ventricle, increases wall thickness, delays wall relaxation or decreased filling time
36
Right-sided heart failure
- Caused by pressure build up in the lungs from chronic pulmonary disease
37
Left sided heart failure
- Impairs mvm of blood from pulmonary circulation into systemic circulation - Causes an accumulation of blood in pulmonary circulation
38
What are the risks and symptoms of cardiac tamponade, and how is it diagnosed?
Symptoms: BECK’S TRIAD Hypotension, Jugular vein distention, Muffled heart sounds Diagnosed: Positive Pulsus Paradoxus (Decrease of >10 mm Hg in systolic BP with inspiration)
39
How do statins work to lower LDL cholesterol levels, and what are their potential side effects?
They inhibit the HMG-CoA reductase which reduces the amount of cholesterol biosynthesis SE: headache, fatigue, myo or joint pain, heart burn
40
What is the relationship between the RAAS system and the progression of heart failure?
Renin converts angiotensinogen (from the liver) into angiotensin I. Angiotensin-converting enzyme (ACE) in the lungs converts angiotensin I into angiotensin II. Angiotensin II causes vasoconstriction and triggers aldosterone secretion from the adrenal glands, leading to sodium and water retention BUT this becomes too much for the heart to handle after a while and it does not help the heart but hinders it
41
What are the three contraindications for ARBs, ACEi and DRIs
- Bilateral renal artery stenosis - Angioedema - Preg Category X
42
What is angioedema
swelling in face, lips, tongue related to the increase in bradykin from decrease in ACE
43
What is +/- chronotropic
has to do with heart rate +: high heart rate -: Low heart rate
44
What is +/- inotropic
todo with heart contraction force +: high force -: low force
45
What are the lifestyle modifications recommended for managing hyperlipidemia and hypertension?
HL: Exercise, Low-fat, high-fiber diet, Weight loss HTN: Dash diet, Na restriction, minimize alcohol, reduce stress and stop smoking
46
How does coronary artery bypass grafting (CABG) address chronic coronary artery disease?
- Indicated for angina that cannot be controlled by PCI or medication - Use the great saphenous vein in the leg to attach to the ascending aorta and the area distal to the lesion.
47
How is pericarditis managed
inflammation of the pericardium, managed with NSAIDs and Corticosteroids
48
what complications can arise from pericardial effusion?
- A big risk from pericarditis - Accumulation of fluid in the pericardial sac, due to infection or inflammation - Cardiac Tamponade: Compression of the heart
49
What are the primary differences between arterial and venous circulation
Veins: DO2 blood Arteries: O2 blood
50
How does hypertension cause damage to organs, and what are the long-term consequences of untreated high blood pressure?
Heart: Cardiomyopathy (especially left ventricular), Heart Failure Retina: Retinopathy, causes blindness Kidney: Renal Failure Brain: TIA or CVA Peripheral Arteries: Aneurysms, Atherosclerosis
51
How does the Frank-Starling mechanism contribute to compensatory changes in heart failure?
- Increase in stretch muscle cells better align the heads of the actin and myosin filaments and increases the force of the next contraction - Problem: Increases muscle wall O2 requirements
52
What is cardiogenic shock, and what are its causes and treatment options?
-Decreased Cardiac output that leads to inadequate tissue perfusion
53
What is ventricular remodeling
- Due to cardiac damage, scar tissue builds up in the heart muscles - Leads to worsening heart failure
54
What are the steps/stages of ventricular remodeling
1. Myocardial ischemia 2. Myocardial damage 3. Scar tissue build up 4. Decrease in functional cardiac tissue
55
What are the clinical goals of treatment for acute coronary syndrome (ACS), and what are the types of ACS
Types are unstable angina and MI
56
What is the role of plant sterols in lowering LDL cholesterol
Plant sterols compete with cholesterol for absorption in the digestive tract--> absorbed the PS and excretes the Cholesterol - Less C in the liver, LDL uptake increases which decreases the LDL levels in the body
57
What are the symptoms and diagnostic tools for diagnosing heart failure, including biomarkers and imaging studies?
Symptoms: - SOB, edema, fatigue Tools: - B-type Natriuretic Peptide (BNP): A hormone released by heart muscle cells when stretched. (High BNP levels indicate heart failure) - Echo and CXR
58
What is the significance of collateral circulation in coronary artery disease, and how does it develop?
- When the larger arteries become occlusive the smaller ones increase size and provide alternate channels for blood flow
59
What is a lipoprotein made of
Apoprotein and lipid - they are soluble
2-Pathopharm
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