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60 Cards in this Set
- Front
- Back
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What are the three non-modifiable risk factors for atherosclerosis?
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Age
Sex Dyslipoproteinemia |
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What are the five modifiable risk factors for atherosclerosis?
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Dyslipidemia
Diabetes Obesity Smoking Hypertension |
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Where are LDL receptors located
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Hepatocytes
Adipocytes Adrenal cells |
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How fast is LDL endocytosed?
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3 minutes
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What are the roles of Ox-LDL?
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Cause endothelial cells to produce MCP-1 (monocyte transmigration)
Promote monocyte differentiation Initiate M-CSF generation from endothelial cells (Express scavenger receptors on macrophage surface) Phagocytosed by macrophage to form foam cells |
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What is released by macrophages and what do they do
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TNF-alpha
IL-1 Induce endothelial cells to express VCAM-1, P-selectin |
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What is the optimal LDL
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< 100 mg/dL or 2.59 mM
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what is considered high LDL
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> 160 mg/dL or 4.14 mM
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Limb leads
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Lead I, II, III, aVF, aVR, aVL
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Chest leads
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V1-6
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Symptoms of cardiac arrythmias
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Palpitations, dizziness, fatigue, loss of conciousness, shortness of breath, blood stasis
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What phase of the miocardial action potential is affect by change in automaticity
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Phase 4 slope increases and allows for threshold potential to be reached more rapidly
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Common cause of increased automaticity arrythmia
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ischemia results in anaerobic metabolism (decreased activity of Na/K ATPase)
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three conditions that cause re-entry
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pathways longer than normal (dilated heart)
perkinje fibre transmission is slow decreased refractory period (often due to drugs) |
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How is atrial flutter distinguished from atrial fib. on an ECG
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defined P wave
slower atrial beat |
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How long before V. fib. causes death
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1-3 minutes
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What is natriuretic factor
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released by atrial/ventricular myocardium to inhibit Na reabsorption in distal tubules - diuresis
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clinical hypertension
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≥140/90 mm Hg in ≥2 doctor visits
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What proportion of HTN patients are controlled?
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16%
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What is pheochromocytoma
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excessive production of adrenaline
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major risk factors for hypertension
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obesity, smoking, hyperinsulinemia, high salt, high fat, stress, genetic factors
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What are the components of bone
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Bone cells
Type 1 collagen (Protein matrix) Hydroxyapatite Growth factors (TGFb, IGF-1) Other matrix proteins (fibronectin, osteocalcin, osteopontin) |
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What are osteocytes?
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Machanoreceptors/effectors emedded in bone
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What increases RANKL/OPG ratio
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PTH
Vitamin D Some cytokines |
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What decreases RANKL/OPG ratio
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Estrogen
TGF-b Mechanical force |
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How does osteoclast initially dissolve minerals
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H+ pumped out by H+ ATPase
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How does osteoclast dissolve organic matrix
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Cathepsin K
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Molecular activators of bone remodeling
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PTH, vitamin D, thyroid hormone, I/TNFa
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Inhibitors of bone remodelling
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Calcitonin
Estrogen |
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At what age does bone resorption=fromation
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25-35
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what happens to bone as you age
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remodeling cycles increases in frequency
imbalance of osteoclast/blast activity loss of estrogen in women with menopause cortical bone thins and becomes porous trabecular bone weakens due to decreased bone density, increase # and depth of resorption pits, loss of trabecular connectivity and perforation of trabecular plates |
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effect of estrogen
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neg - osteoclast precursors
neg - osteoclast pos. lifespan, anabolic activity |
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two functions of kidneys
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rid of waste
volume and composition control |
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why do we care about sodium
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predominant ion of ECF
movement of sodium controlled by transport mechanisms |
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what proportion of CO does kidneys filter
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20%
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how fast does kidney filter
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180 L/day
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what is moved in proximal tubule
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nutrients
Na/K ATPase Na/H exchanger Carbonic anhydrase Organic acid secretors |
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what crosses at the loop
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descending thin is freely permeable to water
sodium, chloride, potassium reabsorption |
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what crosses at distal
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Na/Cl transporter
Hydrogen |
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What crosses the collecting duct
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water
Na channel - resorption preferred K channel - secreted |
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Blood clot
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platelet, trapped RBCs, fibrin
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Virchow's Triad
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Blood stasis
Hypercoagulability Endothelial injury |
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Mortality rate due to heart failure
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50% at 5 years
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Role of inflammation in myocardial ischemia
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release of TNF, IL-6 and IFN-gamma stimulate endotherlial cells and activate macrophages that fill with Ox-LDL
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What is prinzmetal or variant angina
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uncommon episodic angina that happens at rest due to coronary vasospasm
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factors that determine infarct size
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severity and duration of ischemia
size collateral coronary circulation spontaneous lysis of cornary thrombus effects of therapy |
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two cardiac enzyme tests
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troponins T and I (rise for 10 days)
creatine kinase (elevated for 72 hours) |
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how do you detect silent MI
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exercise stress test
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pericarditis
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inflammation of pericaridum
fibirinous or fibrohemorrhagic 2-3 days post-MI |
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Chronic IHD with heart failure
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progressive heart failure
enlarged heart secondary to left ventricular hypertrophy and dilation gray-white scars of healed infartcs |
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sudden cardiac death
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within 1 hour of symptoms (or without)
most common mechanism is lethal arrhythmia |
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erythropoiesis during second trimester
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liver, spleen, lymph nodes
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major type of fetal Hb
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HbF
2 alpha, 2 gamma chains |
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decreased proliferation/differentiation of stem cells
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aplastic anemia, renal failure, endocrine disorders
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decreased maturation of erythroblasts
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B12 deficiency, folic acid deficiency
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decreased Hb synth
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iron deficiency (decreased heme)
decreased globin synth (thalassemia) |
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folic acid/B12 deficiency
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Macrocytic normochromic anemia
decrease in RBC, WBC, platelets large hypersegmented neutrophils bone marrow hypercellular ineffective hematopoiesis and RBC destruction |
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Thalassemia
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microcytic hypochromic anemia
erythroid hyperplasia in bone marrow extramedullary hematopoiesis (liver, spleen) increased iron absorption increase in HbF/A2 to compensate |
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Iron deficiency
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microcytic hypochromic anemia
decreased erythroid progenitors mimics chronic disease anemia |
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aplastic anemia
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bone marrow failure
decreased WBC, RBC, Platelets suppression of myeloid stem cells due to infections, chemicals, radiation, drugs hypocellular bone marrow reversible or irreversible |
