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Patho Test 3: 1
Cardiac
| Question | Answer |
|---|---|
| What Causes myocarditis? | Bacteria, fungal, protozoan, and viral infections |
| What can also cause myocarditis? | Rheumatic fever, diptheria, heat stroke, and radiation |
| WHat is myocarditis? | Inflammation of the myocardium, which is the heart muscle |
| Pericarditis? | inflammation of the pericardium |
| What can cause pericarditis? | TB, Mycosis, collagen disease, urmeia, fungi, neoplosms, radiation, traum, MI it has a variety of causes |
| What are the two main clinical manifestations? | Pain, and a friction rub |
| What do you do to diagnose pericarditis? | EKG, Echo CT, MRI |
| In Pericarditis what falls and what rises pressure wise? | Falling arterial pressure and rising venous pressure you also have distant heart sounds |
| How do you treat Pericarditis | Bedrest, Meds-analgesics, NSAID's helps w/ inflammaiton, corticosteroids, ABT, antipyretics |
| Chronic Pericardites | inflammation that has thickened the pericardium, s/s are edema, crackles |
| How do you preven Mycocarditis? | Immunizations, increase physiscal activity, avoid competitive sports,gradually increase activity |
| what is endocarditis? | attack of organism, gets in body and is a bacterial invasion,can get in through mouth or surgery, in blood stream, |
| who is endocarditis common in? | older people and high instance of IV drug use |
| how do you diagnose Endocarditis? | H&P blood culture, echo and CT |
| what is the first s/s of endocarditis? | Flu like symptoms, splinter hemmorages of under fingernails, roth spots in retina, petechiae in conjunctiva |
| Complications of Endocarditis? | Mycardial erosoin, which is bacteria is hanging from heart valves treat with antibiotics before invasive procedures |
| What is Pericardial effusion? | fluid in the pericardial cavity, may accompany CHF, Heart surgery, trauma, also renal failure |
| S/S of pericardial effusion | sudden or gradual, can result in cardiac tamponade |
| What is cardiac Tamponade? | Muffled heart sounds, falling aterial pressure, narrowed pulse pressure, rising venous pressure ect.. these are related to not getting blood out: Dyspnea, pain, anxiety, syncope, distened neck veins, edema |
| Pericardial Effusion assessmetn and dx and management | GET TRAY READY, EKG, examine fluid that is withdrawn |
| Cardiomyopathies: primary and secondary | Primary: Heart muscle diseases of unknown origin, silent onset, so s/s until disease is well advanced Secondary:OUtside of heart, MI and have complications because of another cardiovascular disease |
| There are 3 types of cardiomyopathies list them | dilated, hypertrophic, restrictive |
| Hypertrophic | thickend hyper kinetic ventricular muscle mass, uncoordinated contractions and impaired relaxation |
| s/s of hypertrophic | A fib is precursor to sudden death, dyspnea is most common, chest pain, fatigue, syncope |
| How do you treat hypertrophic? | Beta blockers, ca channel blockers, surgical removal of part of mycardium, have to put in automatic internal defiblilator |
| Dilated cardiomyopathy | Most common, dilation of all 4 chambers, cardiac failure, initation is alcohol, cocaine, genetic, pg, and aging, DM or thyroid |
| Dilated what happens to heart? | Heart becomes enlarged and the wall becomes thinner |
| S/S of dilated | Weakness, fatigue, periphial edema, tachycardia, leads to death |
| TX of dilated | releave heart failure adn work laod with digoxin, diuretics, and afterload, reducing drugs, or heart transplant |
| Restrictive | rarest form, stiff ventricular impaired diastolic feeling, it gets fibroused and rigid adn non compliant, major diff, is restrictive diastolic feeling, low stroke volume and CHF |
| Phase o | rapid depolariztion ions switch side |
| Phase1 | early repolarization peak of the action potential stops sodium channels with decrease in socdium permability |
| phase 2 | the plateau, caused by the slower calcium sodium channels opening, calcium plays a role in the contractility in the cardiac muscle |
| phase 3 | final rapid repolariaztion down slope of action potential, calcium sodium channels close and increase K permebility |
| phase 4 | resting, sodium out potassium in |
| what are the two catagories of dysrythmia | Superventricular and Ventricular |
| EKG | a picture of the electrical conduction of the heart. easy quick 2,3, or 12 leads |
| Ejection fraction | amount of blood % beening pumped in the first quarter of systole normal is 60-80 %. |
| Cadiac reserve | how much an individual can increase CO as needed |
| preload | amount of blood the heart must pump with each beat |
| afterload | the pressure needed for the heart to pump blood into the aorta |
| Cardiac contractility | heart can change the force of contraction without changing resting |
| inotropic | something that can modify the contractility |
| heart rate | the frequency the ventricles contract, the blood is ejected , filling time |
| dopomine | increases blood pressure and contractility |
| arterial circulationq | impairment can lead to echemia and infarction |
| what are the three causes of hypercholestrolemia | genetics, nutrition and metobolic disease |
| Risk factors of coronary heart disease | nonmodifiable risks-less than 45 for men and 55 for womenlipid risk factors- total chlosterol less than 200, LDL cholestorol is less than 130, Tri- less than 150, HDL greater than 40Nonlipid risk factors- hypertention less than 140/90, cig smoking,DM, |
| Probable risk factors | Lipoproteins, small LDL particles, HDL subtypes, apolipoprotein B, Homocysteine, Fibrinogen, High-sensitivity C-reactive protein, Impaired fasting glucose |
| CAD | largest killer in the US, great advances in treatment but no decline in death rate |
| two types of lesions in CAD | stable and unstable |
| stable angina | eschemia r/t athoersclerosis and phasospasms and thrombus |
| what brings on stable angina | activity stress and cold |
| what relieves angina | rest |
| where is the pain located with stable angina | anywhere from the neck to the stomach |
| how do you treat stable angina | prevent MI stop activity beta blocker CABG PTCA |
| CABG | coronary artery bypass-graft |
| Variant angina | caused by vaasospasma with or without the disease looks like Reynolds in heart |
| treatment for variant angina | calcium channel or nitrate |
| Silent mydocaridial eschmeia | ischemia without angina, common in patients with Dm, old MIS, and elderly |
| unstable angina | new angina or recent accelerted angina, caused by plaque distrubtiion or repair |
| Diagnosis for unstable angina | EKG, BP, and Cardiac markers |
| Segment elevation MI | eschmic death of myo tissue, may or may not have a T wave |
| S/S of segment elevation | abrubt onset, extreme pain, SOB, weakness, naseua and vomiting, tachecardia, feelings of impending dome, shock, sudden death due to dysrythmias |
| How long do you have to prevent permanent damage to prevent the segment elevation MI | 1 hour (15-20) min is ideal |
| Myoglobulins (MB) | cardiac marker; O2 carrier, released 1 hour after MI, not the best indicator |
| Creatine Kinese (CK) | released 4-8 hours after MI, |
| What are the most specific cardiac markers for MI? | CK and MB |
| Troponine | Cardiac specific and peaks later, its the best one to tell how long ago the MI happened, once it gets to this level its pass the level of treatment |
| Mitral stenosis | opening being narrowed, obstruction of blood flow from the LA to the LV |
| If Mitral stenosis backs up where does it go? | lungs |
| Diagnosis of Mitral Stenosis | H/P- Echo, heart cath |
| Mitral Regergetation | Rheumatic fever |
| Endocarditis | congenital heart defects, diet pills |
| Mitral regergetation backs up it goes where? | left atrium |
| Aortic Stenosis | calcification of the valves also narrowing of the aortic valve |
| What does aortic stenosis cause the left ventrivcle to do? | thicken |
| Aortic stenosis is most common with what ages? | 70-90 |
| Aortic regergetation | etiology-endocarditis, congenital hear defects, syphllis, aneurysms, aging, Marfins, |
| In aortic regergetation it will back up where | LV |
| S/S of aortic regergettation | most patients do not have smyptoms, water hammer pulse, visible pulses, murmur, angina, fainting |
| Diagnosis of aortic regergetation | Echo, EkG, TEE, Stress test, and heart cath |
| Valve replacement: 2 types | Disk Mechanical valves and Ball and socket |
| How do you treat Aortic Regurgitation? | Treat CHF and dysthrithmias, also can do aortic valve replacement |
Created by:
JoeNLind
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