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24 Cards in this Set
- Front
- Back
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auscultation findings in ASD
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1)fixed, wide splitting of the 2nd heart sound
2)pulmonic systolic ejection murmur |
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consequences of untreated ASD
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pulmonary hypertension
atrial tachyarrythmias systemic emboli recurrent respiratory infections heart failure |
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diagnosis of endocarditis
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A)pathological/microbiological evidence
B)2 major critera C)1 major, 3 minor D)5minor Major: typical microorganisms from 2 diff cultures evidence of endocardial involvement (echiocardiographic vegetaion or abcess or NEW regurgitant murmur) Minor: predisposing heart condition IV drug use fever over 38 vascular phnomena immunologic phenomena microbio or echo evidence not meeting major criteria |
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Neurogenic causes of syncope
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vasovagal, situational, neurologic, carotid sinus, psychiatric conditions, medications, orthostasis, hypoglycemia
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Cardiogenic causes of syncope
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tachyrrhythmias, bradyarrythmias, pacemaker malfunction, prolonged QT syndrome, organic heart disease, cardiopulmonary
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Metabolic syndrome
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3 of 5:
increased waist circumfrence elevated triglycerides reduced HDL elevated BP elevated fasting glucose |
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adipokines
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leptin
TNF-alpha, IL-6 MCP-1, PAI-1 adiponectin |
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TNF-alpha, IL-6
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proinflammatory cytokines associated w/ insulin resistance, endothelial dysfunction, and atherosclerosis
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PAI-1
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plasminogen activator inhibitor-1
potentially atherogenic can contribute to endothelial dysfunction and ultimately atherosclerosis |
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adiponectin
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antidiabetic, anti-inflammatory, antiatherogenic effects
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MCP-1
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monocyte chemoattractant protein -1
potentially atherogenic can attract and promote infiltration of macrophages |
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R2 is goverend by
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metabolic, endothelial, neurohumoral, and myogenic factors
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metabolic factors
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adenosine, PO2, PCO2
predominantly affects arterioles <100um |
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endothelial factors
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Vasodialtors: EDRF (NO), endothelial derived hyperpolarizing factor, prostacyclins
Vasoconstrictor: endothelins |
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neurohumoral factors
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ANS and circulating vasoactive agents
a2 adrenergic vasoconstriction, B2 adrenergic vasodilation |
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myogenic factors
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modulate precappillary pressure
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underbasal conditions _____ factors predominate
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metabolic
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in increased activity ______ factors predominate
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endothelial and neurohormonal
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reactive hyperemia
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the increase in coronary flow, following a breif period of coronary artery occlusion
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during exersize _____ dialate primarily arterioles <100um
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metabolic factors
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during excersize ______ dilate primarily arterioles 100-200um
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endothelial or neurohumoral factors
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organic nitrates and EDDF
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generate NO and vasodialtion via stimulation of guanylate cyclase
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nitrate tolerance
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thiol depletion, increased ROS
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first pass effect of ...
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oral dinitrates (not mononitrates)
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