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Cardiovascular Disease I
Pathophysiology Exam 2
30
Pathology
Graduate
06/18/2016

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Cards

Term
What is the most common disorder in the United States?
Definition

CV Disease.  5% at age 20, 75% for those > than 75, 20% of the population overall.

 

Also the most common cause of death in the US.  About 1 million deaths per year.

Term
What is the equation for BP?
Definition

BP = CO x PVR

 

Blood pressure = cardiac output x periphreal reistance

Term
What effects blood pressure?
Definition

CO:  Heart rate, contractility (how well the myocardium is working), filling pressure (tone and volume)

 

PVR:  arterial diameter is the biggest factor in determining BP!!!!, arterial length, and elasticity

Term
How do you reduce CO?
Definition
Reduce the HR, reduce the contractility (via beta blockers), and reduce the venous blood volume (diuretics)
Term
How do you reduce PVR?
Definition
Vasodilation...which cna be achieved by direct action on the vessel walls, or through central control action of the CNS
Term
What do angiotensin II and Aldosterone do?
Definition

Angiotensin II:  active form of angiotensin, causes vasoconstriction, triggers aldosterone production and release

 

Aldosterone:  most potent natural mienralcorticoid, helps with sodim and fluid retention, also a cardiac growth factor

Term
What are the treatments for hypertension?
Definition
Use sympathetic receptor blockers, renin-aldosterone inhibitors, orreduce the blood volume via diuretics
Term
What is atherosclerosis and what does it do?
Definition
Formation of lipid deposits just under the intema of the blood vessel, decreases diamtere size therfore incresaing vascular resistance, potentially occurs in the aorta or the coronary arteries.  This is usually the number one cause of cardiovascular disease.  Closely related to lipid metabolism.
Term
What are the two sources of cholesterol?
Definition

Exogenous:  dietary consumption and absorption

 

Endogenous:  Production of cholestrol in the liver

Term
What are Lipoproteins, HDL's and LDL's?
Definition

Lipoproteins:  Macromolecule consisting of lipid and specialized

 

LDL:  transporter of endogenous cholesterol, the higher your LDL, the greater your risk of heart disease

 

HDL:  "reverse cholestrol transport," removes LDL cholestrol and triglycerides.  The more HDL you have, the better, because it gets rid of plaque build-up

Term
What is the HDL paradox?
Definition
Increasing your HDL alone, does not reduce your risk for heart disease.  You have to lower your LDL's as well as raise your HDL's.
Term
What is a fatty streak? What is a Foam cell?
Definition

Fatty Streak:  LDL-cholestrol accumulates under the endothelium.  MOnocytes collect in the fatty streak, LDL is oxidized

 

Foam Cells:  monocytes become macrophages which ingest the oxidized LDL.  This damages the endothelium and permits more LDL to accumulate. Creates an inflammatory response as well...

Term
What is the role of inflammation in artherosclerosis?
Definition
Provides a unifying theme in the pathogenesis of the disease.  in the process, it causes the release of a C-reactive protein.  This is what is normally scanned for in the blood to give an indication of the disease
Term
What increases the risk of arthresclerosis?
Definition
Cigarette smoking, hypertension, diabetes, family history, lipid abnormalities, age, lifestyle choices such as obesity and diet
Term
Why do women tend to develope artherosclerosis in earlier stages in life?
Definition
Women have higher levels of HDL, estrogen also is known to raise HDL levels.
Term
What are the chronic effects of Atherosclerosis?
Definition
Angina pectoris, congestive heart failure, renal artery stenosis, femoral or popliteal stenosis, aorta aneurysm formation
Term
What is the most common mechanism for myocardial infarctions?
Definition
Plaque ruptures
Term
What are the most common lipid lowering agents we use?
Definition
HMG-CoA reductase inhibitorrs, Statins, and Fibrates
Term
What are the adverse effects of the Statins?
Definition
Liver damage, muscle damage, don't use it when you are pregnant, childrean and teens (all are normally pretty rare cases).  But muscle weakness can be a big indicator for us!
Term
What is our treatment for hyperlipidemia?
Definition
PCSK9 inhibitors and other drugs to lower levels of LDL other than using statins via subcutaneous injections every 2 weeks
Term
What are systolic and diastolic readings?
Definition

Systolic:  pressure at which flow first resumes in a occluded artery

 

Diastolic:  pressure at which flow returns to normal in an occluded artery

Term
Define hypertension.
Definition
Persistent elevation of blood pressure to 140.90 or above, 50 million americans have hypertension and only about 70% are actually aware of it (around 1930 is when we figured out how to measure it)
Term
What is pheochromocytoma?
Definition
Rare tumor of adrenal medulla or sympathetic ganglia, secretes high levels of norepinephrine...main symptoms occur periodically with sever headaches, severe diaphoresos, palpitations, tremor and anxiety
Term
What are the symptoms of hypertension?
Definition
Usually none! That's why they call it the "silent killer."  Occasionally will see headaches, malaise/fatigue, and symptoms of complications
Term
What is white coat hypertension?
Definition
Increase in blood pressure due to being in a doctor's office or a medical facility which increases the blood pressure due to stress, not actual hypertension.
Term
What are the two major treatment strategies for hypertension?
Definition
Reduce cardiac output (block beta1, increase venous capacitance, reduce peripheral vascular resistance) Reduce peripheral vascular resistance
Term
What are the drug groups used for treating hypertension?
Definition

Diuretics:  lower blood volume

 

Adrenergic Blockers:  BLock alpha 1 and beta 1 action

 

Direct vasodilators:  reduce peripheral vascular resistance

 

Inhibit Renin System:  Reduce volume and periphreal resistance

Term
What is the Limbo Goal and what are the possible side effect of it?
Definition
The Limbo Goal is the idea of how low you can possibly drop your blood pressure, but, the lower you make your blood pressure, the greater the side effects of the BP medication you are on
Term
What orthostatic hypotension?
Definition
When you stand up too fast and you get dizzy because the blood rushes from your brain toward your lower body.
Term
What is the step down strategy for treating hypertension?
Definition
Slowly knocking down the BP to normal stable pressure levels through lifestyle changes in combination of the medications.
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