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55 Cards in this Set
- Front
- Back
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What are the forward/backward effects of right heart failure
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Foward: decreased blood spply to the lungs
Backward: systemic edema ascites, dependent edema |
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What are the forward/ backward effects of Left hear failure?
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Forward: decreased CO, decreased tissue perfusion, Acidosis
Backward: Pulmonary edema orthopnea, dyspnea, frothy sputum |
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Name some things that increase Preload
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Fluid overload
Valve stenosis |
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Name some things that increase afterload
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HTN, Aortic valve stenosis
Drugs (Norepinephrine, Dopamine) |
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What does automacity mean?
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Has an intrinsic rate; pumps on its own
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What is Starling's Law?
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As increase preload will increase CO up to a point and hten it will not increase CO bc heart will be overstretched
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What does the electricla signal in heart do?
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Causes mechanical events
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what is cardiac cycle?
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P Wave:depolarization of Atria
PR: Entire Atria event QRS: ventricle depolarization (systole) T wave: Repolarization (rest) |
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what does CO=?
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SV X HR
5-6 L |
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What is are theories about etiology of HTN?
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1. Insulin resistance
2. Pressure-Natriuresis relationship: kidney requires higher pressure to initiate diuresis 3. RAAS system |
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What is insulin resistance associated with?
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decrease NO release from iendothelium
decrease production of Angio II in lungs SNS activity |
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What is RAA System?
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Kindey releases renin
Reni changes to angio I in presence of angiotensinogen Angio I changes to angio II in the lungs Angio II stimulates release of aldosterone in adrenal cortex Aldosterone causes Na and water retension Angio II also go to arterioles and causes vasoconstriction |
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What is causes Cyanosis in Tetralogy of Fallot?
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right ventricular outflow tract obstruction (RVOTO)- blood unable to flow to lungs, so deoxygentaed blood go thru foramen ovale and to body
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What is the Bainbridge Reflex?
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Neural reflex; volume receptors respond to volume changes
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What are the 4 abnormalties in tetralogy of fallot?
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Ventricular sptal defect
Aortic Overriding Pulmonic Stenosis (RVOTO) Ventricular Hypertrophy |
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What is the Patho of Long QT Syndrome?
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Mutations in the genes that code for ion channels in the heart (Na and K channels)
Causes fatal arrythmias (Torsades de Ponts) |
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What is the patho of Hypoplastic Left heart syndrome?
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congenital cardiac defect. Underdeveloped left side of heart
blood returning from lungs must go thru atrial septal defect to right side) and then is pushed into plmonary artery. gets to aorta by the patent ductus arteriosus and goes to body |
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What is the patho of Hypertrophic Cardiomyopathy?
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Hypertrophy of left ventricl in absence of other conditions (ie HTN, stenosis)
Most common cause of sudden death in age < 30 years old |
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What are the goals of Dialysis (substances moved)?
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Remove: water, urea, potassium
Replace: bicarb |
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What are the Hormonal influences on the Nephron?
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ADH: resorption of water
Aldosterone: resorption of Na secretion of K Renin secretion of angio II and aldosterone Peptides secrete Na |
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what is normal specific gravity of urine?
Disease that increase and decrease? |
1.015-1.022
Increased: Dehydration, SIADH Decrease: DI, Diuretics, infants, CRD |
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What is Nephrotic Syndrome?
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Cluster of symptoms that result from loss of protein and increased glomerular permeability
Hypoalbinumia, orbital edema, hyperlipidemia (liver is compensting for low proteins) |
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What is AGN?
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Kidney disease from inflammation in glomeruli;
Most often an immune response (usually to Streptococcal A) Treat underlying cause |
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What is ATN?
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Acute Tubular Necrosis
Results from toxic ischemic insult ot tubules 3 Phases Onset Maintenance: oliguria and increasing Cre and BUN Recovery: Cre andBUN coming down; may take up to 1 year for 100 % recovery |
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What are the etiologies of Pre, Inrea and Postrenal failure?
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Pre: Azotemia: impired blood flow to nephrons
Intra:tissue damage to kidney from immunologic or inflammaotyrr response to prolonged hypotension Post: obstruction of urinary collecting system anywherre from calyces to urethral meatus |
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What is the most common typ eof ARF pre-, intra, or post?
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Pre Azotemia (accumulation of nitrogenous wastes)
usually from shock, CHF, Sepsis |
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What are common causes of Intra-renal failure?
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ATN (most common)
nephrotoxic drugs (Aminoglycosides) AGN, HUS Vasculitis |
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What are some cause of post renal failure?
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Urethral or Bladder Ca
BPH Urethral Strictures |
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What is VUR
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Vesicoureteral Reflux
Bacteria able to go up into kindey |
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What cause increase V/Q retio?
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Dead Space
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What cause decrease V/Q?
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Shunt; atelectasis
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What are the main characteristics of obstructive pulmonary diseases?
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decreased FEV1
Dyspnea wheezingV/Q mismatch |
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what is the best indicator of lung disease
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FEV and FVC
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what is the normal V/Q ratio?
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0.8-0.9
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In asthma treatment what are the reliever and what are the controllers?
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Relievers: Bronchodilators
beta2 adrenergic agonists Anticholinergics Controllers: corticosteroids leukotriene inhibitors, cromoylyn longacting beta 2 |
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What are the basic characteristics of ARDS?
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indirect of direct injury to lung
endothelial damage cause systemic inflammatory response *Inflammation of Lung Parenchyma* Increase permeability of capillaries |
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What are the underlying mechanisms of Lupus
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B- cell hyperactivity and production of autoantibodies and nonself antigens
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What does estrogen do to production of autoantibodies?
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Estrogen increases it (increased SLE in women) and Androgens protect against SLE
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what is the mechanism in CF
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Autosomal Recessive Exocrine Glands secrete estra amount of thick mucus
affect lungs and pancreas |
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What is cause of RDS in newborns
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insufficient surfactant and structural immaturity of lung
Hyaline Memebrane forms from increased capl permeability and blocks gas exchange |
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What are the basic underlying mechanisms of MODS?
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Dysfunction of 2 or more organ systems caused by inflammatory porcess
Endothelial damage cause NO release and complement, kinin, coagulation systems to be activated |
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How is RDS prevented or treated?
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give corticosteroids to mom
give surfactiatnt via ETT Inhaled Nitric oxide |
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What is a common cause of MODS?
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gram-negative bacteria
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Wha tis Patho of GERD
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decreased resting tone of LES causes backflow of gastric contents into esophagus
Pain, ulcers, esophagitis, obstructions |
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what are common causes of GERD?
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smoking, fatty foods, hiatal hernia, infants (normal), alcohol, delayed gastric emptying (meds, neurological), obesity
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What are the 3 complications of PUD
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Obstructions
Hemmorrhage Peritonitis |
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Name some things that can cause PUD
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NSAIDs, H Pylori, stress, smoking, corticosteroids, ETOH
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What are Cursling's Ulcer's
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Burns
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What are Cushing's Ulcer's?
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Neurologic
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Name some causes of Ischemic bowel
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Poor perfusion
(anesthsia, shock, mesenteric artery thrombus) Paralytic Ileus (post-op complication from narcotics, Premature Newborns with NEC |
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What is NEC?
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Necrotizing Enterocolitis
Preterm infants thought to be from intestinal ischemia, oral feedings, and bacterial flora |
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What is the most common diagnostic sign of NEC?
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air in the intestinal wall seen on Xray
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What is patho of Celiac disease?
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T-cell mediated response against alpha-gliadin
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What is kernicterus?
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brain damage seen in liver failure from bilirubin crossing blood-brain barrier
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What is Cullen's Sign?
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gra-blue discolorization of periumbilical area seen in acute pancreatitis
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