pharma test cardio 2.txt

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pharma test cardio 2.txt
2012-07-07 19:14:13
pharma cardio

Pharma cardio 2, questions 5-8
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  1. Cardiac construction disorders
    • Condition in which the normal heart rhythm is disrupted (cardiac disrhythmias)
    • Two categories: supraventicular dysrhytmias, ventricular dysrhythmias
  2. Two types of cardiac construction disorders
    • Tachycardia: sustained rapid heart beat >100 bpm
    • Bradycardia: sustained slow heart beat <50 bpm
  3. Patterns of cardiac construction disorders
    • Flutter (fast but regular)
    • Fibrillation (fast but irregular)
  4. Supraventicular dysrhythmias
    Electrical abnormalities arise from sinoatrial (SA) node, atrial tissue and atrioventricular (AV) node
  5. Ventricular dysrhythmias
    Electrical abnormalities arise from Bundle of His, Purkinje fibers, ventricular tissue
  6. Interruption of cardiac impulse conduction
    • Heart block
    • Ectopic pacemaker
    • Atrial fibrillation
    • Ventricular fibrillation
  7. Heart block
    May cause atria and ventricles to contract independent of each other (not in a coordinated manner)
  8. Ectopic pacemaker
    • May appear in regions of the heart other than the SA node
    • Drives the heart at abnormally high rates
    • Observed as premature contractions
  9. Atrial fibrillation
    • Very fast electrical discharge patterns causing atria to contract very rapidly
    • Electrical impulses may reach ventricles causing faster and less efficient ventricular contractions
    • Blood is still pumped less efficiently
  10. Ventricular fibrillation
    • An uncoordinated series of very rapid, ineffective ventricular contractions
    • Ventricles merely quiver and do not contract in a coordinated way
    • No blood is pumped from the heart, so ventricular fibrillation is a form of cardiac arrest
    • Fatal unless treated immediately
  11. Potential triggers of cardiac conduction disorders
    • Coronary artery disease (atherosclerosis)
    • Electrolyte imbalances (Na+ and K+)
    • Heart muscle changes
    • Injury from myocardial infarction
    • Heart valve disease
    • Metabolic disorders
  12. Treatment of cardiac conduction disorders
    • Antidysrhythmics
    • Electrocardioconversion
    • Catheter ablation
  13. Antidysrhythmics
    • Alter the physiological properties of the cardiac conduction system or the effective refractory period
    • Five classes: Class I, II, III, IV A and IV B
  14. Class I antidysrhythmics
    • Sodium channel blockers
    • Three further classes, not detailed in handout
  15. Class II antidysrhythmics
    Beta-adrenergic receptor agonists
  16. Class III antidysrhythmics
    Potassium channel blockers
  17. Class IV A antidysrhythmics
    Calcium channel blockers
  18. Class IV B antidysrhythmics
    Adenosine receptors agonists
  19. Electrocardioconversion
    Delivers electrical shock to re-establish normal heart rhythm
  20. Catheter ablation
    • Nonsurgical preocedure where catheter is inserted into groin or neck vein and threaded to the heart
    • Radio frequency energy or intense cold is used to destroy a small amount of tissue to restore normal heart rhythm
  21. Congestive heart failure
    • A condition in which the heart can no longer pump enough blood to the rest of the body
    • Usually a complication of heart disease
  22. Diagnosis of congestive heart failure
    • History and physical exam
    • Lab tests
    • ECG
    • Chest radiography
    • Echocardiography
  23. Treatment of congestive heart failure (to improve heart rate)
    • Diuretics
    • ACE inhibitors
    • Angiotensin II receptor antagonists
    • Cardiac glycocides
    • Vasodilators
    • Dopamine
    • Specialized implantable pacemakers
  24. Shock
    • A life-threatening medical condition caused by insufficient blood flow throughout the body
    • Requires immediate treatment since symptoms can worsen rapidly
    • Five types
  25. Causes of shock
    • Severe hypotension
    • Severe injury or illness
    • Medical emergencies (hypoxia, myocardial infarction, organ damage)
  26. Five types of shock
    • Septic
    • Anaphylactic
    • Cadiogenic
    • Hypovolemic
    • Neurogenic
  27. Septic shock
    • Caused by bacteria multiplying in the blood and toxins due to infections
    • Treatment: antibiotics for underlying infection and fluids to treat dehydration and maintain or increase body fluids
  28. Anaphylactic shock
    • A type of severe hypersensitivity or allergic reaction
    • Treatment: Histamine1 receptor agonists (H1-receptor), epinephrine, glucocorticosteroids
  29. Cardiogenic shock
    • Caused by heart damage preventing sufficient blood supply to the body
    • Treatment for heart attack: cardiac catheterization, coronary artery bypass graft surgery
    • Treatment for congestive heart failure: medications to increase cardiac contracile force, heart transplantation
  30. Hypovolemic shock
    • Caused by severe blood and fluid loss due to traumatic bodily injury
    • Treatment: fluid replacement such as saline, blood transfusion
  31. Neurogenic shock
    • Caused by spinal cord injury due to traumatic accident or injury
    • Treatment is difficult, due to often irreversible spinal cord injuries
    • Supportive treatments of body regulatory functions: airway control, immobilization of the spine, fluids to maintain blood pressure, glucocorticosteroids, surgery
  32. Heart diseases in infants and children
    • Fetal and perinatal circulation: Ductus arteriosus (DA), Foramen ovale (FO)
    • Congenital heart disease (CHD)
  33. Ductus arteriosus (DA)
    • Connects pulmonary artery with the aorta bypassing the fetal lungs
    • Normally closes at birth
  34. Foramen ovale (FO)
    • An opening in the septum between the two atria that is normally present in the fetus
    • Normally closes at birth
  35. Congenital heart disease (CHD)
    • Refers to abnormal functional and/or structural heart problems that develop before birth
    • About 35,000 babies born each year have some type of congenital heart defect
    • Responsible for more deaths in the first year of life than any other birth defect
    • Some resolve over time while others require treatment
    • Causes include environmental factors or chromosomal abnormalities
    • Two types: cyanotic and non-cyanotic
  36. Cyanotic CHD
    • Tetralogy of Fallot: refers to a group of four types of heart defects: narrowing of pulmonic valve, right ventricular wall hypertrophy, displacement of the aorta, ventricular septal defect
    • Transposition of the great arteries: pulmonary artery connected to the left ventricle, aorta connected to the right ventricle
  37. Non-cyanotic CHD
    • Septal defects: atrial septal effect (hole in the wall separating L from R atria), ventricular septal defect (hole separating L and R atria)
    • Patent ductus arteriosus (getting its own flashcard)
    • Coarctation of the aorta (also getting its own flashcard)
  38. Patent ductus arteriosus (non-cyanotic CHD)
    • Ductus arteriosus connects the fetal pulmonary artery and aorta
    • Allows blood to bypass nonfunctioning fetal lungs
    • Oxygenated blood comes from the mother via the placenta
    • Usually closed within a couple of days after birth
    • Leads to abnormal blood flow between the aorta and pulmonary artieries if it remains open
  39. Coarctation of the aorta
    • Congenital narrowing of part of the aorta
    • Narrowing of aorta leads to increased resistance in the left ventricle
    • Increased resistance in the left ventricle can eventually lead to congestive heart failure