Ettinger Cardiology 1

Front 1

What type of heart failure causes pleural effusion in small animals?

Back 1

bilateral

Front 2

What is systolic failure

Back 2

inability to eject blood properly

Front 3

What is diastolic failure

Back 3

inadequate ventricular filling

Front 4

Equation for cardiac output (CO)

Back 4

CO= SV x HR

Front 5

What is preload

Back 5

degree of ventricular filling just before contraction

AKA End diastolic filling

Front 6

What is afterload

Back 6

force opposing ventricular ejection

Front 7

What is the largest influence on peripheral resistance?

Back 7

small arteries and arterioles

Front 8

What is the most common reason for pressure overload (increased resistance of the ventricles to eject blood)

L heart disease

R heart disease

Back 8

subaortic stenosis (LH)

systemic arterial hypertension (LH dz)

HWD (R side)

Front 9

How does the cardiac myocyte adapt to sustained pressure overload (secondary to pressure overload)

type of hypertrophy

Back 9

concentric hypertrophy

Front 10

What diseases cause volume overload

Back 10

valvular insuffiency
PDA/septal defects
high output states (hyperthyroidism)

Front 11

volume overload causes the cardiac myocyte to adapte to a larger chamber size by

hypertrophy

Back 11

eccentric hypertrophy

Front 12

What are three different mechanisms diastolic failure can occur

Back 12

abnormal relaxation

abnormal compliance

external constraint by the pericardium

Front 13

What is the MOA of how the body responds to HF? (in general - CO, BP etc)

Back 13

- fall in CO causes a decrease in BP

- activation of compensatory mechanisms to restore and maintain blood pressure

Front 14

What are the two prioriteies of the cardiovascular system during HF?

Back 14

maintain BP

Maintaine plasma volume

Front 15

Changes of BP/plasma volume are sensed by these organs & where?

Back 15

high pressure baroreceptos/mechanoreceptors/volume receptors:

- aortic arch

- carotid sinus

- ventricular myocardium

- atria and great veins

- juxtaglomerular apparatus - kidney's

Front 16

How is the RAS system activated?

Back 16

Decrease in renal blood flow cause the release of renin and activation of the RAS system

Front 17

renin increases ___ concentration

Back 17

Ang I

Front 18

ANg II is a potent ___

Back 18

vasocontrictor

Front 19

With Ang II increasing vasoconstriction, this helps to normalize ___ and but will also increase ___

Back 19

normalize blood pressure

afterload of the heart

Front 20

ANG II stimulates the release of

Back 20

ADH

aldosterone

Front 21

ADH causes

Back 21

vasoconstriction

water resorption from the distal tubules

Front 22

aldosterone causes

Back 22

Na/Water retention

postassium/Mg excretion

Front 23

This is the most potent vasoconstrictor for vascular smooth muscle cells

Back 23

endothelin

Front 24

These are counter-regulatory hormones involved in volume homeostasis and cardiovascular remodeling.

Back 24

natriuretic peptides (vasodilatory agents)

Front 25

Examples of natriuretic peptides (4)

Back 25

ANP: atrial natriuretic peptide

BNP: brain natriuretic peptide

CNP: C-type natriuretic peptide

DNP: dendroaspis natriuretic peptide

Front 26

What do natriuretic peptides do in general

Back 26

promote:

natriuresis

diuresis

peripheral vasodilation

inhibition of RAS

Front 27

What happens to the bennificial effexts during CHF with natriuretic peptides

Back 27

They are over ridden by agents that cause vasoconstriction and water retention

Front 28

Why are dogs tachycardic with HF?

Back 28

increase in sympathetic tone and decrease in parasympathetic tone.

Front 29

In RHF, ascites will always preeced ____

Back 29

subcutaneous edema

Front 30

This is a common finding (PE finding) with HF, and is more prominent in RHF and those with DCM

Back 30

cardiac cachexia

Front 31

If an obese dog presents with coughing, it is most likely due to

Back 31

respiratory issues. Rare for CHF dogs to be obese

Front 32

What are the dogs presenting with main stem bronchus like

Back 32

obese/normal weight

dry hacking coughs

worse during the day

normal HR

Front 33

What are the dogs presenting with CHF (vs. main stem bronchus)

Back 33

thin/weight loss

more subtle cough worse at night

pink nasal or sputum

Front 34

This is an important negative prognostic factor in patients with CHF

Back 34

arrhythmia

Front 35

What do gallop rhythms suggest

Back 35

ventricular dysfunction

Front 36

Fourth heart sounds suggest

Back 36

atrial contraction

Front 37

Splitting of a heart sound suggest

Back 37

pulmonary hypertension

Front 38

Distended and pulsating jugular veing can suggest

Back 38

RHF

Front 39

What does CVP estimate (heart disease)

Back 39

R ventricular end diastolic pressure

Front 40

Systolic function is best assessed by

Back 40

SV (preload, afterload, and contractility)

Front 41

Preload is best evaluated by

Back 41

L ventricular end diastolic volume

Front 42

After load is measured by

Back 42

aortic impedance or arterial elastance (femoral artery)

Front 43

What is the best technique for evaluating diastolic function noninvasively

Back 43

echo

Front 44

cTnT

Back 44

cardiac troponin T

Front 45

cTnI

Back 45

cardiac troponin I

Front 46

What causes the release of cTn

Back 46

cell necrosis and loss of membrane integrity

Front 47

In general, increased concentrations of cTnI or cTNT reflect

Back 47

myocardial dammage

Front 48

first heart sounds corresponds to

Back 48

closing of the AV valves (mitral and tricuspid)

Front 49

What is isovolumetric contraction

Back 49

relates to the same volume, but just an increase in pressure. As when the ventricles contract

Front 50

What is end systolic volume

Back 50

After the ventricles contract 40-50% of the blood remaines in the ventricles

Front 51

What corresponds to the second heart sound?

Back 51

closure of the aortic and pumonic valves

Front 52

What is the third heart sound

Back 52

S3

not normally heard

rapid ventricular filling in volume overload

Front 53

What is the fourth heart sound

Back 53

S4

not normally heard

begining of atrial systole with pressure overload and non-compliant ventricles or with 3rd degree AV block

Front 54

SV is

Back 54

the amount of blood ejected out of the L ventricle with each beat

Front 55

What causes the heart to increase HR and myocardial contractility?

Back 55

increase sympathetic tone

increase catecholamines bind to B receptors in the heart

Front 56

How does sympathetic tone increase HR?

Back 56

release of NE which binds to to B1 receptors in the heart.

also increases conduction through the AV node

(B antagonists such as atenolol and propanolol decrease HR through this mechanism)

Front 57

This is the ion required for myocardial contraction

Back 57

Ca

Front 58

Frank Starling Law

Back 58

greater the cardiac volume, the stronger the contraction

Front 59

eccentric hypertrophy

Back 59

chamber size gets larger but the thickness stays the same

occurs due to volume overload

Front 60

concentric hypertrophy

Back 60

cardiac chamber stays the same size but the walls get thicker

occurs due to pressure overload (increase in afterload)