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199 Cards in this Set
- Front
- Back
What is the site of highest vascular resistance?
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Arterioles
|
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What structures have alpha 1 receptors?
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artioles of the skin, splachnic, and renal circulations, veins
|
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where a B2 adrenergic receptors found?
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artioles of skeletal muscle
|
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Cardiac output = ?
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(mean arterial pressure - Rt atrial pressure) / TPR
|
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When an artery is added in parallel ( as seen in the system blood flow system), what happens to total resistance?
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It decreaes
|
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what increases Reynold's number (measure of turbulent blood flow)?
2 things |
Decrease blood viscosity (anemia)
Increase blood velocity (narrowed vessel) |
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why is more blood contained in veins than arteries?
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Veins are more distensible than arteries
Veins have higher compliance (C= V/P) sine they have a decrease amount of elastic tissue |
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where does the largest decrease in pressure occur in the system circulation?
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acros arterioles (site of highest resistance)
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What is the major determinant of pulse pressure?
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stroke volume (because of decreased capacitance of arteries, an increase in stroke volume will cause an increase in systolic pressure)
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what does aging due to pulse pressure?
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it increases pulse pressure because it decreases the capacitance of the arteries
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how do you measure left atrial pressure?
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pulmonary wedge presure, with a catheter making almost direct contact with pulmonary capillaries
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What sets resting membrane potential in cardiac cells?
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conductance to K; resting membrane potential approaches K equilibrium potential
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what determines conduction velocity?
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the size of the inward current during the upstroke
increase inward current causes a higher conduction velocity |
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what fibers have the fastest conduction velocity?
which have the slowest? |
the purkinje fibers have the fastest
slowest in AV node (allows time for ventricles to fill) |
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What is the absolute refractory period?
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no AP can be generated, no matter the size of the inward current
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What is the effective refractory period?
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no CONDUCTED AP could be transmitted
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What is the Relative refractory period?
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an AP can be elicited, but more than the usual inward current is required
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What maintains cell to cell cohesion at the end of muscle?
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intercalated disks
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name them: low-resistancepaths between cells that allow for rapid electrical spread of AP
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Gap junctions, allows the heart to act as an electrical synctium
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What do T tubules do?
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they are continuous with the cell membrane and carry action potentials into the cell interior
well developed in the ventricles, not so much in the atria |
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what is the site for storage and release of Ca for excitation and contraction coupling?
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the sarcoplasmic reticulum
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How does sympathetic stimulation of the hart cause increase contraction?
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it increases the activity of the Ca pump of the SR (phosphorylates phospholamban) -->more Ca being accumulated and more is available for release
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in the Jugular Venous Pulse, what is the A, C, and V wave?
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A wave = atrial contraction
C wave = RV contraction bulging the tricuspid valve into the atria V wave = filling of the atria against the closed tricuspid valve |
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what is the dicrotic notch?
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a blip in the aortic pressure that occurs after rapid ejection when the aortic valve closes
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What is and what causes Cushing's triad?
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Curshing's triad = hypertension, bradycardia (reflex), repiratory depression
due to increased intracranial pressure causing vasoconstriction--> cerebral ischemia --> HTN (sympathetic response) with bradychardia. |
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why is the action of aldosterone slow?
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it requires new protein synthesis
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name the four effects of Angiotensin II.
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1. Stimulates synthesis and secretion of Aldosterone
2. Increases Na-H exchange in Proximal convoluted tubule 3. Increases thirst 4. Causes vasoconstriction of the arterioles--> increase in TPR and arterial pressure |
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What metabolites regulate coronary circulation?
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O2 levels, adenosine, and NO
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What controls cerebral circulation?
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local metabolic factors
most important vasodilator is CO2 |
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what controls circulation in skeletal muscle?
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extrinsic sympathetic innvervation of blood vessels and local metabolic factors
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HDL and LDL levels to be a risk factor for coronary artery disease
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LDL above 160 mg/dl
HDL below 30 mg/dl |
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What is the cardiac consequence of having thalassemia?
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Treatment for thalassemia involves blood transfussions, therefore, Iron overload can cause Iron deposition in the heart
Also, the anemia can cause a high output cardiac failure |
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What type of parasympathetic receptors are found on the heart?
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M2 receptors
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What type of PARASYMPATHETIC receptors are found on blood vessels?
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non innervated M3 receptors
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What cardiac abnormality is associated with Cri du chat syndrome?
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ventricular septal defect
|
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What are some associative disease/deletions found with VSDs?
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Cri du chat syndrome
Trisomy 13 Trisomy 18 |
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Baby with pink face and blue lower body. What's wrong?
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patent ductus arteriosus
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what do you associate with a boot-shaped heart?
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RV Hypertrophy seen with tetraogy of Fallot
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Kid is cyanotic relieved by squatting. What's going on?
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he has tetralogy of Fallot. When he squats down, he increases system vascular resistance (compresses femoral arteries), which decreases the right to left shunt and directs more blood from the RV to the lungs
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Failure of articopulmonary septum to spiral causes what?
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Transposition of great vessels
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What heart defect is seen with Turner's syndrome?
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infantile type coarctation of aorta
(narrowing between subclavian artery and ductus arteriosus= preductal) |
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Notching of ribs, hypertension in upper extremities, weak pulses in lower extremities. Dx?
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Adult type coarctation of aorta
(narrowing occurs distal to ductus arteriosus) |
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What is a valvular abnormality seen with Coarctation of the aorta?
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bicuspid aortic valve
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Central area of fibrinoid necrosis surrounded by reactive histiocytes.
What is going on? |
Aschoff bodies = central area of necrosis
Anitschkow cells = reactive histiocytes This is seen in myocarditis due to groupd A Beta Hemolytic Strept |
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Most common initial presentation of acute rheumatic fever?
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migratory polyarthritis
occurs in large and small joints; no permanent damage |
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How do you diagnose acute rheumatic fever?
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increases streptolysin O titers
Positive throat culture leukocytosis, increase P-R interval, Increase CRP |
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why can you get dysphagia in rheumatic heart disease?
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rheumatic heart disease causes mitral stenosis, which will eventually increase the size of the left atria.
the enlarged left atria impinges on the esophagus |
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what is the pathophysiology responsible for mitral prolapse?
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myxomatous degeneration of the mitral valve leaflets due to excess production of dermatan sulfate
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what valve is affected in Austin Flint Murmur?
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regurgitant flow from aortic regurgitation hits the anterior leaflet of the mitral valve
|
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what are the complications of infective endocarditis?
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chordae rupture
glomerulonephritis suppurative pericarditis |
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name a drug that can cause myocarditis.
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Doxorubicin
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Name the toxin that can cause myocarditis.
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Diptheria toxin
|
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Name the 2 microbial infections that can cause myocarditis.
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Coxsackievirus
Trypanosoma Cruzi |
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Endocardial biopsy shows lymphocytic infiltrate. What is the likely cause?
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Coxsackievirus infection
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A young woman with pericarditis and effusion. What is the likely Dx?
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SLE
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What is the Kussmaul sign and when is it seen?
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Neck vein distension on inspiration because blood cannot enter the RA
seen in a pericardial effusion (seen with pericarditis) |
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"Water bottle" configuration on chest x-ray.
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Seen in pleural effusion seen with pericarditis
|
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what is the ECG finding seen in pericarditis?
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Elevated ST segment in multiple leads
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What is the finding in the heart of a child with restrictive cardiomyopathy?
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endocardial fibroelastosis (thick fibroelastic tissue in the endocardium)
|
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where do most cardiac myxomas occur?
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Left Atrium
|
|
how does a ball-valve lesion present?
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multiple syncopal episodes due to blockage of diastolic filling by myxoma ball
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what are rhabdomyomas often associated with?
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Tuberous sclerosis
|
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In a pressure vs volume cardiac cycle graph, how do you approximate diastolic pressure?
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Diastolic pressure is equal to the pressure at which the aortic valve opens
|
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when do you hear a soft s2?
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Heard in aortic stenosis
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What apolipoprotein is required for chylomicron formation and excretion?
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B-48
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What apolipoprotein is required for VLDL assembly and secretion?
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B-100
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Type II hyperlipoproteinemia definition
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Increase in serum LDL above 190 mg/dl
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What are acquired causes of Type II hyperlipoproteinemia?
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Primary hypothyroidism (decrease LDL Receptors)
Nephrotic syndrome (Increase in LDL correlates with degree of hypoalbuminemia) |
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what is a hereditary cause of Type II hyperlipoproteinemia?
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Familial Hypercholesterolemia - Autosomal Dominant
due to deficiency in LDL receptors |
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Premature coronary artery disease, tendon xanthomas (Achilles and extensor joint surfaces), Xanthelasma (yellow raised plaques on eyelids)
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All symptoms of familial hypercholesterolemia (type II hyperlipoproteinemia)
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What is increased in Type IV hyperlipoproteinemia?
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Increase in VLDL (due to increase in synthesis or decrease in catabolism)
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What causes Type IV hyperproteinemia?
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acquired- excess alcohol, Progesterone (OCP), Diabetes Mellitus
Familial hypertriglyceridemia- AD disorder |
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causes of Type III hyperlipoproteinemia
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Familial dysbetalipoproteinemia
Deficiency of apolipoprotein E |
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What happens when you have a deficiency in apoliprotein E?
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you get decreased liver uptake of chylomicron remnants and IDL
Increase in serum cholesterol and triglycerides |
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What is arteriosclerosis and what does it cause?
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thickening and loss of elasticity of arterial walls
due to dystrophic calcification in the wall of muscular arteries |
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Name some fungi that cause Mycotic aneurysms.
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Aspergillus, Candida, Mucor
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What is arteriosclerosis?
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Hardening of arterioles due to protein deposition (seen in DM and hypertension)
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Name some bacteria that cause mycotic aneursyms.
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Bacteroides fragilis, pseudomonas, Salmonella
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newborn with lymphedema in hands and feet. What is a likely genetic disorder they may have?
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Turner's syndrome causes defective lymphatics
Also see dilated lymphatic channels in teh neck (cystic hygroma) --> webbed neck |
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newborn with lymphedema in hands and feet. What is a likely genetic disorder they may have?
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Turner's syndrome causes defective lymphatics
Also see dilated lymphatic channels in teh neck (cystic hygroma) --> webbed neck |
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How do you treat a capillary hemangioma in a newborn?
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Let it regress with age (DO NOT TREAT)
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How do you treat a capillary hemangioma in a newborn?
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Let it regress with age (DO NOT TREAT)
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What is a cavernous hemangioma?
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Benign tumor of liver and spleen
Can rupture if very large |
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What is a cavernous hemangioma?
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Benign tumor of liver and spleen
Can rupture if very large |
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When do you see Hereditary Telangiectasia?
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Chronic Iron deficiency anemia
seen as dilated vessels on skin an mucous membranes in mouth and GI Tract |
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When do you see Hereditary Telangiectasia?
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Chronic Iron deficiency anemia
seen as dilated vessels on skin an mucous membranes in mouth and GI Tract |
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Describe Kaposi sarcoma.
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malignant tumor arising from endothelial cells
- assoc. with HHV8 - Raised, purple discoloration that progresses to a plaque to a nodule that ulcerates - seen on skin, mouth, and GI tract |
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Describe Kaposi sarcoma.
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malignant tumor arising from endothelial cells
- assoc. with HHV8 - Raised, purple discoloration that progresses to a plaque to a nodule that ulcerates - seen on skin, mouth, and GI tract |
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a woman has a radical mastectomy. There was a hx of chronic lymphedema. What is she at risk for?
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Lymphangiosarcoma due to a malignancy of lymph vessels
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a woman has a radical mastectomy. There was a hx of chronic lymphedema. What is she at risk for?
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Lymphangiosarcoma due to a malignancy of lymph vessels
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what is a pyogenic granuloma?
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Vascular, red, pedunculated lesion that ulcerates and bleeds easily
- seen with pregnancy (high E) and trauma |
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what is a pyogenic granuloma?
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Vascular, red, pedunculated lesion that ulcerates and bleeds easily
- seen with pregnancy (high E) and trauma |
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What causes Spider Telangiectasia?
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Hyperestrinism
they are AV fistulas that disappear when compressed |
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What causes Spider Telangiectasia?
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Hyperestrinism
they are AV fistulas that disappear when compressed |
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Port-wine stain on face with leptomeningeal angiomatosis.
Dx and what vessels does it affect? |
Sturge weber disease
affects Small vessels (capilaries) |
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Port-wine stain on face with leptomeningeal angiomatosis.
Dx and what vessels does it affect? |
Sturge weber disease
affects Small vessels (capilaries) |
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what organs/ parts of body are affected in von Hippel-Landau Disease?
|
it's a cavernous hemangioma in SKIN, mucosa, organs
-affects cerebellum and retina - Increased incidence of bilateral renal cell CA and pheochromocytoma |
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what organs/ parts of body are affected in von Hippel-Landau Disease?
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it's a cavernous hemangioma in SKIN, mucosa, organs
-affects cerebellum and retina - Increased incidence of bilateral renal cell CA and pheochromocytoma |
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What vascular malformation is associated with bilateral Renal Cell Carcinomas?
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von Hippel-Landau syndrome
-hemangiomas in cerebellum, retina -see pheochromocytomas |
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Skin rash on buttocks and legs (palpable).
-arthralgia, intestinal hemorrhage, abd. pain following a URI What type of Hypersensitivity? |
Type III hypersensitivity seen in Heonch-Schonlein purpura (IgA immune complexes)
-usually follows a URI |
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What type of vessels are affected in Henoch-Schonlein purpura and where is it commonly seen?
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small vessel IgA deposits
1. Skin 2. GI 3. Joints |
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What is the pathogenesis of the vasculitis disorders?
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1. Type III Hypersensitivty
2. Type II Hypersensitivity 3. ANCA 4. Microbial invasion |
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what is a muscular association with Temporal arteritis?
|
polymyalgia rheumatica
|
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What arteries are involved in Polyarteritis nodosa?
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1. Renal (renal failure)
2. Coronary (acute MI) 3. Mesenteric (bloody diarrhea) 4. Skin (ischemic ulcers) |
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Acute MI in a young child
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Kawasaki Disease
|
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What is contraindicated in Kawasaki Disease and why?
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Corticosteroids (may cause vessel rupture)
|
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desquamating rash, swelling of hands/feet, cervical adenopathy, oral erythema,
Acute MI in a child. dx? |
Kawasaki Disease
|
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small/medium sized vessel disease in a smoker. causes thromboangiitis oblierans.
|
Buerger's disease
|
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what is associated with Buerger's disease?
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Cold sensitivity (Raynaud's phenomenon) can cause gangrene/autoamputation of digits
|
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Nodular densities in vessels of lungs, upper respiratory tract, and renal arteries.
What autoantibody is associated? |
Wegener's granulomatosis
C-ANCA tx. Cyclophosphamide, corticosteroids |
|
A saddle nose deformity, hematuria, and hemoptysis.
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Wegener's granulomatosis
C-ANCA assciated |
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eosinophilia, vasculitis involving skin, lung, heart vessels. What antibody is it associated with?
|
P-ANCA antibodies
(Churg Strauss Syndrome) |
|
Why do men get a renal cause of hypertension?
Why do women? |
men due to atherosclerotic plaques
women due to fibromuscular hyperplasia |
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A "beaded" renal artery. What is it due to and what does it cause?
|
it is due to fibromuscular hyperplasia (seen in women) causing renal artery stenosis --> Hypertension
|
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What is first line therapy for a pregnant woman with hypertension and how does it work?
|
Hydralazine (given with methyldopa)
-dilates arterioles causing afterload reduction |
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When is hydralazine contraindicated and why?
|
angina/CAD because it causes reflex Tachycardia
also fluid retention, nausea, headache, angina, and lupus-like syndrome |
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How does minoxidil work?
|
opens K+ channels - hyperpolarizes and relaxes vascular smooth muscle
given for severe hypertension |
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a person has really long hair, pericardial effusion, tachycardia, and angina. What drug is at toxicity levels?
|
Minoxidil - what is a K channel opener that relaxes vascular smooth muscle
|
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Name some Ca channel blockers and how do they work.
|
Blcok voltage-dependent L-type Calcium channels of cardiac and smooth muscle (decrease contractility)
Verapamil really decrease contractility Nifedipine - dilates vascular SM |
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which Ca channel blocker does not cause arrythmias?
|
nifedipine
|
|
What is monday disease?
|
seen in industrial exposure to NO or isosorbide dinitrate.
tolerance develops for the vasodilation during the work week and is lost over the weekend causes Tachycardia, dizziness, and headache on reexposure |
|
Fenoldopam. What is it and why is it used?
|
used to treat malignant hypertension .
Dopamine D1 receptor antagonist - relaxes Renal vascular smooth muscle |
|
Diazoxide. What is it and what does it do?
|
used to treat malignant hypertension. Opens K channels--> hyperpolarization and relaxation of vascular smooth muscle
|
|
what do B blockers do Calcium channels?
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they inhibit Ca channels (decrease calcium entry into cells)
|
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How do Beta 1 receptor work on the heart?
|
Gs --> active protein Kinase A which phosphorylates L-type Ca channels and phospholamban (both of which increase intracellular Ca for contraction)
|
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How does Digoxin work?
|
Decrease activity of Na/ K ATPase -->--> increased Ca intracellularly (= positive inotropy). Can also stimulate vagus nerve to decrease conduction through the AV node)
|
|
When do you use digoxin?
|
CHF, atrial fibrillation (due to decreaes AV node conducction)
|
|
EKG changes on Digoxin therapy.
|
Increase PR
Decrease QT Scooping ST Inversted T waves |
|
How is digoxin excreted?
|
via kidneys
excretion decreased if hypokalemic and if quinidine is present (quinidine displaces digoxin from its tissue binding sites) |
|
Therapy for digoxin OD
|
slowly normalize K+
lidocaine Cardiac Pacer Anti-dig Fab fragments Magnesium |
|
How do you treat a digitalis induced arrhythmia?
|
Give them a Class IB Antiarrhythmics
(Lidocaine, Mexiletene, Tocainide) |
|
What drug causes a toxicity of hyper/hypothyroidism, pulmonary fibrosis, and hepatotoxicity?
|
Amiodarone (class III antiarrhythmic)
|
|
What are the side effects of quinidine therapy?
|
Torsades de pointes
Cinchoism - tinnutis, HA thrombocytopenia |
|
what is the EKG changes seen in Class IV antiarryhthmics?
|
Increase in ERP, Increase PR Interval
(used for nodal arrhythmias) |
|
Halo effect and blurry yellow vision is characteristic of what drug toxicity?
|
Digoxin
|
|
whats the difference between prinzmetal variant angina and unstable/crescendo angina?
|
Prinzmetal - constant, due to coronary artery spasm, relieved by nitroglycerin/ Ca channel blockers, vasoconstriction due to TxA2 or endothelin
Unstable/crescendo - thrombosis but no necrosis, causes ST depression, worsening chest pain |
|
What supplies the blood to the SA and AV nodes?
|
The Right coronary artery
|
|
What does hereditary spherocytosis and hyperproteinemic states due to blood viscosity?
|
Increases it
|
|
Where is S2 loudest?
|
Left sternal border
|
|
What does it indicate if A2 and P2 do not increase/ decrease in separation with inspiration and expiration.
|
An ASD
|
|
What does paradoxical splitting of A2 and P2 (P2 prior to A2) mean?
|
Aortic stensosi, left bundle branch block
(delayed LV emptying) |
|
Where does a tricuspid regurg murmur radiate?
|
To right sternal border
|
|
2 causes of RV regurgitation
|
1. Dilated RV
2. Endocarditis |
|
3 Causes of LV regurgitation
|
1. dilated LV
2. Ischemia 3. MV prolapse |
|
How does 1st degree usually present?
|
asymptomatically
|
|
What heart defect does Lyme disease cause?
|
3rd degree atrial block (A and V beat independently)
|
|
In 3rd degree AV block, what happens to the stroke volume?
|
The stroke volume goes up because the intrinsic HR of the ventricles if low
needs to increase stroke volume which increases pulse pressure |
|
What does the carotid sinus respond to?
carotid body? |
Carotid arch (CN IX)- increase/ decrease in BP
Carotid body: 1. Severely low P02 2. Increase in PCO2 3. Decrease in pH |
|
What does the aortic arch respond to?
Aortic body? |
Aortic Arch (Vagus)
1. Increase BP (ONLY) Aortic Body 1. Severely low PO2 2. Increase in PCO2 3. Decrease in pH |
|
How does the Cushing TRiad develop?
|
The brain senses increase intracranial pressure, constricts arterioles; causes cerebral ischemia and hypertension (sympathetic response) and also reflex bradychardia
|
|
What is cushing's triad?
|
1. HTN
2. Bradycardia 3. Respiratory depression |
|
What can cause in increase in capillary permeability (Kf)?
|
1. Toxins
2. Infections 3. Burns causes edema |
|
Why does heart failure cause edema?
|
HF causes increase capillary pressure
|
|
How do you close a PDA?
|
indomethacin
|
|
Why do you get a R to left shunt in Tetrology of Fallot?
|
The pulmonary stensosis causes increased RV pressure
|
|
What cardiac defects is Down Syndrome associated with?
|
Atrial Septal defects
Ventricular Septal defects AV septal defects (endocardial cushion defects) |
|
What is the cause of Tetrology of Fallot?
|
anterosuperior displacement of infundibular septum
|
|
What needs to happen to survive a transposition of great vessels?
|
There needs to be a Left to Right shunt
|
|
What causes a transposition of great vessels?
|
The aorticopulmonary septum's failure to spiral
|
|
What other cardiac abnormality is a coarctation of the aorta associated with?
|
bicuspid aortic valve
|
|
What causes a machine like murmur?
|
Patent ductus arteriosus (Left to right shunt)
|
|
How do you close a PDA?
|
Indomethacin (ENDomethacin ENDs a patent ductus arteriosus)
|
|
What cardiac abnormalities are associated with 22q11?
|
truncus arteriosus
Tetrology of Fallot |
|
What cardiac defect is associated with congenital rubella infection?
|
Septal defects
Patent Ductus artiosus Pulmonary artery stenosis |
|
What cardiac defect is associated with Turner's?
|
Coarctation of the aorta
|
|
What cardiac defect is associated with a diabetic mother?
|
transposition of great vessels
|
|
What cardiac defect is associated with Cri du Chat, trisomy 13, trisomy 18?
|
VSD
|
|
What does a congenital infection with Mumps cause?
|
ENDOCARDIAL FIBROELASTOSIS
-endocardium thickens secondary to fibrous and elastic tissue deposition -most in LV - causes a mural thrombus, flattened trabeculae, abnormally stenosed valves |
|
Monckeberg's arteriosclerosis. What happens?
|
Calcification of the media and arteries
|
|
What is arteriosclerosis?
|
Hyaline thickening of small arteries in essential hypertension (associated with increase protein deposition (DM))
Hyperplastic onion skinning in malignant hypertension |
|
What growth factors are involved in the formation of fibrous plaques in atherosclerosis?
|
Platelet derived Growth FActor,
FGF-beta |
|
What causes prinzmetal's variant angina?
|
coronary artery spasm; see ST elevation on ECG
Transmural ischemia |
|
What causes unstable/crescendo angina?
|
Thrombosis (no necrosis); see ST Depression on ECG
|
|
What is the histological finding of long-standing angina?
|
patchy fibrosis with vacuolization
|
|
What type of inheritance is Hereditary Hemorrhagic Telangiectasia?
What do you see? |
Autosomal Dominant
Discoloaration of skin and mucus membranes Can cause nosebleeds (can cause chronic iron deficiency anemia) |
|
What do the renal vessels look like in Fibromuscular dysplasia?
|
"Beaded appearance"
can cause Renal vascular stensis and bruits |
|
Name two bugs that can cause small vessel infectious vasculitis.
|
Rickettsia rickettsii
N. Meningitis |
|
A small vessel vasculitis causing palpable purpura associated with HCV / type I MPGN. describe it
|
Cryoglobulinemia
Get gelling at cold temperatures. -->cyanosis of NOSE and EARS Raynaud's phenomenon |
|
Saddle nose deformity. What is it?
What is the disease marker. What do you see on x-ray? What do you see in urine? |
Wegener's granulomatosis (small vessels)
C-Anca large nodular densities on x-ray in lung See hematuria and RBC casts |
|
Tx. of Wegener's granulomatosis.
|
Cyclophosphamide (nitrogen mustard alkalating agent) and corticosteroids
|
|
What is like Wegern's but lacks granulomas?
|
Microscopic polyangiitis (P-ANCA)
affects small vessels, precipitated by drugs |
|
Primary pauci-immune crescentic glomerulonephritis
|
Vasculitis limited to kidney
pacui-immune = paucity of antibodies |
|
What is Churg Strauss Syndrome?
What is the disease marker? What are the characteristic findings? |
Granulomatous vasculitis with eosinophilia (allergic granulomatosis and angiitis)
seen in lung, heart, skin, kidney |
|
A person with a port-wine stain on face might have what intracerebrally?
|
AVM (leptomeningeal angiomatosis)
this is Sturge Weber Disease (small vessel) |
|
Buttocks and legs palpable purpura, arthralgia, intestinal hemorrhage, melena, abd. pain. Following a URI.
|
Henoch-Schonlein Purpura, type III hypersensitivity, associated with an IgA nephropathy. See multiple lesions of the same age.
|
|
What is the triad of Henoch Schonlein Purpura?
|
1. Skin (buttocks and legs)
2. Joints 3. GI |
|
What nerve roots are most commonly affected by thoracic outlet syndrome?
|
the inferior roots (ulnar C8-T1)
|
|
Thromboangiitis obliterans in small/med vessels in a smoker.
|
Buerger's disease
- may see cold insensitivity |
|
Kid with an MI
what else would you see? |
(Kawasaki Disease
Small/Medium Vessels) Coronary aneurysms, strawberry tongue, lymphadenitis, DESQUAMATING RASH do not treat with steroids (can rupture vessel) |
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What arteritis is associated with Hep. B?
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Polyarteritis nodosa (medium artery)
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What arteries does Polyarteritis nodosa usually affect?
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renal and visceral arteries causing aneurysms and constrictions on angiogram
fever, wt. loss, malaise, abdominal pain, melena, HA, myalgia, hypertension, neurologic dysfx tx. with steroids |
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Pulseless disease. What happens to the ESR? who get it?
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M/L vessel disease
Increase in ESR Young asian women Fever, arthritis, night sweats, myalgia, skin nodules, ocular disturbance, Weak pulses in upper extremities |
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Focal granulomatous inflammation in elderly females, with unilateral headache and vision loss. What associated disease might they have?
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Temporal arteritis associated with polymyalgia rheumatica.
may progress to involve opthalmic artery -->blindness |
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Carcinoid heart disease
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liver met of a carcinoid tumor can cause increase seratonin causing fibrosis of the tricuspid valve and pulm. valve --> valve defects
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What blocks renin release?
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B-blockers do
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What does Histamine do to vasculature?
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Arterial dilation and venous constriction
-released in response to tissue trauma |
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What does bradykinin due to BV?
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arteriolar dilation and venous constriction -->edema
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What sertanonin do to BV?
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arteriolar constriction, released in response to BV Damage
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How do B1 receptors increase contraction?
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Gs, activates protein Kinase A, which causes an increase in cAMP which phosprylates phospholamban and Ca channels--> intracellular Ca in contraction
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