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108 Cards in this Set

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What are allergy shots?
also called "immunotherapy," are given to increase your tolerance to the substances (allergens) that provoke allergy symptoms.
Why do you not exercise before allergy shots?
Exercise may stimulate increased blood flow to the tissues and promote faster release of antigens into the bloodstream.
What are allergy shots good for?
stinging insects, pollens, dust mites, allergic asthma. Not for hives or food allergies
What is rush immunotherapy?
More rapid build up to the maitenance dos of extract. Given every few hours rather than every few days. Greater risk of body-wide reaction so usually under medical supervision
What is oral immunotherapy?
Increasing doses of allergen but is given as drops placed under tongue and swallowed rather than injections. Helpful to select patient population
What is intranasal immunotherapy?
Controlled studies have shown intranasal administration of grass, birch tree and dust mites effective at reducing rhinitis. May not have the longer lasting benefits of traditional immunotherapy.
What were the results of twenty years of study on Vytorin?
Reduced levels of LDL or bad cholesterol but had little effect on buildup of plaque in the arteries.
What are statins?
they may lower the risk of heart disease by lowering cholesterol and lowering inflammatory factors that can aggravate plaques, causing them to burst and block heart arteries, as well as reduce amounts of triglycerides, a particularly dangerous form of fat for the heart.
What was government concerned of regarding Vytorin?
trial data manipulation
What is vytorin?
Zocor and Zetia
What is the generic statin?
simvastatin
What does your risk of heart disease depend on?
food you eat and genes you inherit
What did the ancient egyptians think in regards to the heart?
thought it was the center of emotions and intellect. When mummifying people, they would take it out of body and put it into a jar to preserve it.
Who was Galen?
a Roman pysician who observed the heart in open cest cavities as he would take care of Gladiators. Thought it made blood and then delivered the spirit to the rest of the body
Who is Mr. Francis Wells?
Developed a new technique to repair heart valves and is performed by robots, surgeon controls arm of robot. Very few incisions compared to open heart surgery
Who was William Harvey?
First to realize that the heart was a pump. Realized that heart would circulate the blood through the lungs, where it would be oxygenated and then to the rest of the body because all parts require a constant supply of oxygen
Where is the heart?
In the center of the cavity.
How big is the heart, how much blood does it pump per minute and through what? How many times does it beat in a lifetime?
Size of the human fist, 5-6 liters of blood per minute through 100,000 km of blood vessels. Beats 2.6 billion times in a lifetime.
What is the largest vein in the body and what does it do?
Vena Cava returns the blood to the heart with two valves (one from lower body and legs and other from head and arms)
What does the right atrium do? Where does the blood then get pumped?
Vena Cava enter in the right atrium and collects the used blood to pump it down through a valve into the right ventricle which pumps the blood to the lungs via the pulmonary artery.
What is the difference between arteries and veins?
Arteries carry blood away from the heart and veins carry to hte heart
What is known about arteries?
they carry oxygenated blood except from the pulmonary artery because blood gets oxygenated in the lungs.
Where does the blood go after it has been oxygenated in the lungs?
Comes back via the pulmonary vein into the left atrium the pumped down to the left ventricle
Where does blood go form left ventricle?
Pumped out through Aorta (biggest Artery) which subdivides into different arteries to spread the blood throughout the body
What are the smallest arteries?
Capillaries (narrow as human hair) so small red blood cells can pass through individually
What can go wrong with the heart?
failure to pump enough blood (cells would be starved of oxygen), impairment of electrical signal (cells on heart that act as pacemaker so heart will not pump without signal) reduced flow of blood through coronary arteries (arteries feed heart constant supply of oxygen) improper functioning of heart valves (hearts pumping efficiency decreases)
What are coronary arteries?
arteries that surround heart like a crown and feed it its constant supply of oxygen.
What are common indicators of heart disease?
downward crease on your earlobe, baldness.
Who are more common to develop heart disease?
men
When are women protected against heart attacks?
before menopause but after the amount of heart attacks even out. Nothing to do with estrogen
What is a huge risk factor for heart disease?
Smoking, bigger risk factor than it is for lung cancer. Carbon Monoxide in cigarette smoke displaces oxygen form hemoglobin so less oxygen in blood
What are common risk factors for heart disease?
obesity (more weight more blood vessels and harder heart has to work) diabetes
What do diabetics not produce enough of? What does this lead to?
Not enough insulin so excess glucose in the blood which broken into compounds that are toxic to muscle cells.
What are the 2 systems to measure blood sugar?
Milligrams per Deciliter and Millimoles per Liter. If blood glucose level of 126 mg/dL or 7 mmol/L after overnight fast then chance you have diabetes
What is an Oral Glucose Tolerance Test?
Give you a fixed amount of glucose in solution to drink and then take your blood later to check levels. Tests if your insulin production is effective (insulin tells your cells to take up Glucose from the blood) If result is over 11 mmol/L have Diabetes
What is the Hemoglobin A1C?
gies you an idea of blood glucose levels over past 2-3 months. Analyzes how much hemoglobin in red blood cells reacted with breakdown products of Glucose. Best way to check if a regimen that a Diabetic is on is actually working
What is cholesterol?
essential biochemical needed for life. Body can make it. used to synthesize a variety of steroidal hormones
What happens when cholesterol ends up inside our coronary arteries?
form deposits called atherosclerotic plaque which blocks flow of blood oxygenating the heart. Caused by high colesterol
What are main cause of high cholesterol?
Saturated fats
What could 1/3 of all heart attacks and strokes be prevented by?
Statins - drugs that reduce cholesterol. Prevent liver from making cholesterol
What is the most popular Statin? What are its side effects?
Lipitor. Muscle aches and elevated liver enzymes and possibly impaired memory
What is homocyteine?
Naturally occuring compound. Said to be a risk factor but not concluded it is a cause of heart disease.
What forms homocysteine and one formed what happens?
Formed by amino acid Methionine and then metabolized by the B Vitamins.
What causes high levels of homocysteine? What does this mean?
Inadequate B Vitamin intake. High levels can be toxic to the cells that line blood vessels.
What is homocysteine in relation to heart disease?
Simply a market whatever elevates the risk of heart disease is elevating Homocysteine levels
What does inflammation include?
Swelling, increase in temperature and pain risk factor for heart disease
What is an inflammatory marker?
C-reactive protein (CRP) hgih levels of this indicate higher risk of heart disease. Says that inflammation is going on somewhere in the body.
What is best way to prevent inflammation?
Diets classified as pro-inflammatory or anti-inflammatory
What type of fats are anti-inflammatory?
Omega 3 fats (fish oils, canola, flax) give rise to prostaglandins that reduce inflammation.
What type of fats are pro-inflammatory?
Omega 6 fats (corn oil, sunflower oil, safflower oil) give rise to prostaglandins that enhance inflammation. Most americans have diets toward pro-inflammatory side
What should proportion be between anti and pro inflammatory fats?
1:1. American diet is 9:1 towrads Omega-6
What can cause inflammation?
Bacterial or viral infections. Immune system rush to area and release chemicals. Sometimes body makes mistake and targets itself and causes autoimmunity.
What does dental health have to do with heart disease?
Poor dental health leads to higher risk of heart disease. When your gums are infected and bleed easy entryway for bacteria. Bacteria can cause infections leading to inflammation
What is hypertension?
Elevated blood pressure. Related to stress but not always. Stress does increase blood pressure though.
What do you measure blood pressure in?
Systolic and Diastolic. S/D (diastolic for denominator) units are millimeters of Mercury (mm Hg) because used Manometers (instrument around arm) that had tube containing mercury but now do not have mercury but use same units
130-135/85-90 is what?
Cutoff blood pressure.
What is White Coat Hypertension?
people tend to stress about their blood pressure being taken so it goes up
What are the two types of hypertension?
Mental stress-caused and essential hypertension (cause unknown)
What are the ways to reduce blood pressure?
Exercise for 30 minutes 5 times a week, Diet of whole grains, fruits, vegetables, low fat dairy and restricted in fat. Closer you are to a vegetarian diet, better of you are.
What is good about bananas?
High in Potassium which is known to reduce blood pressure
What does salt to?
Increases blood pressure
What medication is safest in reducing blood pressure?
Diuretics. Make you urinate more and by removing water from your blood lower the amount of liquid total and lower the pressure of blood. Can cause you to lose Potassium so take supplements
What are ACE inhibitors?
Angiotensin Converting Enzyme Inhibitor. Ex is Vasotec. Block formation of Aniotensin II which increases blood pressure. Blocks the enzyme that makes it. Side effects are that it can lower white blood cell count so increased susceptibility to infection
What are beta blockers?
interfere with activity of adrenaline. Beta Blockers reduced high blood pressure by throttling back the force and speed of the heart.
What are calcium channel blockers?
cause Arteries to relax and dialate. Calcium important for nerve function especially the ones that cause increase in blood pressure by artery contraction
What is Valsertan?
Last drug to be used against high blood pressure if nothing else works. Is Angiotensin II receptor antagonist. Blocks the receptor that Angiotensin would bind to.
What is Angina?
Painful constriction in the chest. Indication something is wrong. When coronary arteries are blocked it slows oxygen supply to the heart causing Angina.
What is early cardiovascular disease?
preliminary buildup of plaque (not yet dangerous)
What are atheromas?
plaques that are significant in size. With large plaque heart may not be able to meet it's own oxygen requirements when exercising because not enough blood flow
What happens when a plaque bursts open?
It forms a blood clot which plugs up the artery complete so all tissues fed by artery die. When plaque bursts open it perceives it as a cut so blood platelets gather to form a clot, if it forms inside of a coronary artery you are in trouble.
What usually induces Angina?
exercise
What is vasospastic angina?
Angina during rest the arteries go into spasm which can choke off the flow of blood. If there are large plaques already deposited in the arteries, less intense spasm can still choke off flow of blood.
What is the stress test?
When someone has Angina put on a treatmill and activity heart is monitored by electrodes.
What can be used to treat the symptoms of Angina?
Nitroglycerine because it dilates the blood vessels but does not remove plaque. Cannot use paddles to shock the heart though because there will be an explosion
What are the side effects of nitroglycerine?
headaches because blood vessels dilated all over the body.
What else other than nitroglycerine can be used to treat angina?
Beta blockers: reduce the force of contraction of the heart, heart won't need as much oxyen. Calcium antagonists: relaxes muscles that constrict arteries which widens the blood vessels. Arginine: Amino Acid that promotes formation of Nitric Oxide which widens the blood vessels.
What is a common treatment for Angina?
Beta Blockers and Calcium Antagonists
What is congestive heart disease?
If angina and high blood pressure are not addressed heart becomes very inefficient. Usually affects left ventricle which is very important. In congest. heart failure blood is not returning to hte heart properly. The serum (liquid in the heart) starts to leak out into surrounding tissues and causes dropsey.
What visible symptoms are there for congestive heart disease?
Water is retained in the tissues and ankles first places to swell.
What are causes of congestive heart disease?
Coronary artery disease, high blood pressure, heart valve problems, abnormal heart rhythms, thyroid problems.
Who is William Withering?
Discovered the first treatment of Dropsy. Made a brew from the Foxglove plant. Worked
What is the active ingredient in the foxglove plant?
digitalis which is a mix of compounds that causes heart to beat more forcefully.
How do they treat congestive heart failure?
Diuretics to reduce fluid build up, beta blockers to improve pumping function, ace inhibitors to relax constriction of blood vessels (none of those CURE it yet though) then coenzyme Q-10 (CoQ-10) which is an OTC that is essential coenzyme that synthesizes ATP. It will make the cardiac cells create more energy. Amount to take is debatable.
What is cardiac arrhythmia?
The heart begins to beat irregularly.
What is used to treat cardiac arrhythmia?
range of drugs but best is pacemaker. Electrical device that tells heart when to beat.
What is a heart attack (myocardial infarction)?
Most severe heart problem . Pain in the arm or chest indivative. Caused by the blockage of a coronary artery. Blood clot is formed when platelets adhere to site of injury and produce fibril "net" that ensnare everything passing by. This makes the blood be choked off to part of heart causing heart attack
How many heart attacks are there per year in north america?
1.5 million. 25% die immediately. 25% don't know suffered heart attack
What is usual treatment for a heart attack at a hospital?
Morphine: to relieve the pain, oxygen: to increase the oxygen content of the blood. Nitroglycerine: to dilate blood vessels. Aspirin: dissolves any blood clots that have formed.
What is ventricular fibrillation?
Caused by blockage of one of the coronary arteries. Hearts begin to fibrillate instead of property pumping, not stopped but inefficient pumps.
What do you do if ventricular fibrillation occuring?
CPR or defibrillator which is a machine with two paddles that delivers an electric shock to patient's chest
What do emergency situations of ventricular fibrillation use?
Adrenaline and Atropine because they will immediately increase the force of contraction of the heart, sometimes they need to be injected directly in the heart.
What do they perform at a hospital to determine what is going on inside the heart?
electrocardiograms (EKG). Can determine if damage to the heart muscle.
What enzymes are released into blood if tissues have been damaged?
Troponin and creatine kinase
What can be used to prevent further blood clot formation?
heparin, a carbohydrate polymer
What do they use to dissolve blood clots?
Thrombolytics and other methods. TPA (Tissue Plasminogen Activator) such as Activase interacts with proteins called Plasminogens to break down into Plasmins and go on to dissolve the cots. Not that common anymore
What is a Cath Lab?
A Cardiologist can physically dissolve the blood clot. They insert a Catheter usually in the leg and sname it up into the heart wile looking through an X-ray device. Then they inflate a balloon at the end of the Catheter to open the site of blockage. Called Balloon Angioplasty. They then put in a Stent which is a metal spring that holds the artery open, it is around the balloon so when balloon inflates it pushes stent into place and when deflates stays in place. Stent not permanent solution and can promote inflammation.
What is Balloon Angioplasty?
Inflating a balloon on the end of a catheter to open an artery
What is a stent?
a metal spring put in place by balloon angioplasty used to hold an artery open
What is a drug eluting stent?
One type of stent that releases anti-inflammatory drugs from the metal frame, but not as useful as hoped. Even with stent in place 15-25% people have re-narrowing of the arteries.
How is radiation used in terms of ventricular fibrillation?
Radiation in the form of a very small pellet is placed inside the artery and the radiation destroys some of the tissue inside the artery which prevents new plaque deposits from forming.
What is laser endarterectomy?
Through a catheter, you can burn the deposit with a laser however it is too sensitive, if you miss you can burn through the artery.
What is bypass surgery?
Used when the condition cannot be solved by diet or lifestyle changes. The chest is opened and heart is exposed. Arteries are taken from the leg and sewn on, bypassing the site of blockage. To do this a heart-lung machine has to take over because heart must be stopped. It sends deoxygenated blood to the lungs and sends it through the rest of the body when heart is operated on.
What two group perform the bypass surgery?
One opens the chest and other harvests artery from the leg.
What must the patient take after bypass surgery?
Anticoagulants because heart tissue has been injured and clots could form.
What are complications of bypass survey?
memory impairment and people don't feel right after
What is valve surgery?
They replace existing faulty valves by pig valves or by simple valve like those in snorkeling masks
What are the important facts about an artificial heart?
It is simple to engineer a pump that will circulate blood but heard to make one that will speed up and slow down when necessary. A power source is hard to find too so people will have to carry around external device to power the heart filled with compressed air.
What are important facts about heart transplants?
First one was done 40 years ago. Survival rates used to be very low and rejection common. Commonly performed now.