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31 Cards in this Set
- Front
- Back
structure of valvular cusps: differences of AV valve and SL valve (2). Name dense and loose c.t.
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AV: inner dense c.t.; SL: outer dense c.t.; dense c.t. = valve fibrosa; loose c.t. = valve spongiosa
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common reason of development of valvular disease
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mechanical injury (leads to fibrosis on preserved architecture), inflammation (fibrosis and visualization), degenerative (deposit of chol and Ca)
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pathophysiology: describe how mitral valve stenosis and aortic valve stenosis lead to heart failure
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https://www.dropbox.com/sh/7pmuqwim8sq7n6e/E8tPkiOnMR/cvs_flashcard1.png
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Calcific aortic stenosis: symptoms and signs for CAS (11pts)
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asymptomatic, angina, visual disturbance, congestive heart failure, synope during exertion, fatigue, palpitation, apex beat change, dyspnea, systolic ejction murmur, small amplitude pulse, systolic thrill,
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Mitral annular calcification (MAC):
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source of thrombi & emboli leading to stroke, infective endocarditis
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Mitral valve proplapse: etiology (2) and predisposition (1)
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Mitral valve: myxomatous (mucus in c.t.) in the mitral valve, anomaly of c.t., predisposition: Marfan's Syndrome
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Mitral valve proplapse: Features of histology (2)
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ballooning, thickened rubbery valve, mucoid material deposit on the valve
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signs and complications of mitral valve prolapse (9)
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usually asymptomatic, angina, palpitation, migraine headache, CHF, stroke, IE, anxiety
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Aschoff bodies appears in acute state of Rheumatic fever. what is Aschoff bodies?
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foci of fibrinoid degeneration surrounded by lymphocytes
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Pancarditis which three?
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pericarditis, myocarditis, verrucae vegetations
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in infective endocarditis, ___________ vegetation is formed? what is it?
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friable vegetations: destruction of underlying cardiac tissue.
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complications of infective endocarditis
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sepsis, sepsis emboli, abscess formation, death, destruction of the valve result in sudden hemodynamic disturbance
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Libman Sacks endocarditis: predisposition
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Systemic Lupus Erythematosis (SLE): autoimmune disease in which the body's immune system mistakenly attacks healthy tissue.
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complications of hypertension at four sites:
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heart: LVH, vessels: atherosclerosis, hypertrophy, fibrinoid necrosis, aneurysm formation, atherosclerosis, brain: haemorrhage, infarction and stroke, kidney: nephrosclerosis
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hypertension: MULTIfactorial (3)
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imbalance between renin activity & salt conc., Overactive sympathetic system (hyperkinetic), peripheral resistance
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Secondary Hypertension causes (4)
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endocrine diseases, kidney disease (renal artery stenosis), pheochromocytoma, adrenal adenomas
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Loop diuretics: site (1) and mechanism (3)
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Loop of Henle, inhibit Na-K-2Cl co-transporter, reabsorption of Ca and Mg, K+ and H+ excretion
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Loop diuretics adverse effects (4)
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electrolyte disturbances, hypokalemia, alkalosis, hypovolemia, hypersensitivity, skin rash
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thiazide diuretics: site (1) and mechanisms (3)
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act on early stage of distal convoluted tubules, inhibit Na-Cl cotransporter, stimulate Na/Ca exchanger, K+ and H+ excretion
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Potassium-sparing diuretics: site (1) and mechanisms (3) (spironolactone and apiloride)
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site: collecting tubule, spironolactone inhibits the effect of aldosterone (which decrease K+ and H+ excretion), apiloride blocks epithelial Na channel
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statin: mechanism (2)
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inhibitor of HMG CoA reductase ie. decrease syn. of chol. in liver; increase synthesis of LDL Receptors
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Bile acid binding resins mechanism (4)
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reabsorption of chol decrease, increase syn,; increase syn,. of LDL receptor; increase hepatic TG synthesis
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digoxin mechanism 3pt
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Inhibit Na/K ATPase; Sensitize baroreflex; increase vagal effect
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β-stimulants (dopamine) mechanism 3pt
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Activate β-receptors, increase syn. cAMP, increase Ca channel opening
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Nitrates (nitroglycerin) mechanisms (2)
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venodilation to lower venous return, relax smooth muscle to restore flow; final: decrease cardiac work
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ivabradine mechanism mechanism (2)
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decrease funny current, decrease SA node packmaker rate, decrease HR
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β-blockers (propanolol) mechanism (2)
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Block β receptor in heart => low HR, contractility, BP, ...
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Ca channels blockers which two drugs?
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dihydropyidine, verapamil
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dihydropyidine mechanism (2)
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Vascular effects (dihydropyidine) low Ca entry => relax coronary, spasm => store flow; Relax vessel => low BP, Cardiac work
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verapamil mechanism (1)
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Cardiac effects (verapamil) low Ca entry =>low contraction, Cardiac work
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describe the renin-agiotensin-aldosterone system and its final effects (4+3)
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http://www.ganfyd.org/images/1/1f/Neurohormonal.JPG
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