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Flashcards in CV Resp Deck (43)
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1

How does the ductus arteriosus normally close?

when baby takes first breath theres an increase in O2 which causes a decrease in prostaglandin production > closure of DA

2

What are the energy sources of the heart?

1. Fatty oxidation (60%)
2. Glucose oxidation
3. Glycolysis

3

what is the most posterior part of the heart?

left atrium

4

calculate CO using rate of o2 and such

= rate of O2 consumption/arterial O2 content - venous O2 content

5

What happens when theres a wide splitting of A2/P2?

seen in conditions that delay RV empyting: pulmonic stenosis and right bundle branch block

6

What happens when theres a paradoxical splitting of A1 and P2?

seen in conditions that delay LV emptying (aortic stenosis, left bundle branch block), normal valve closure is reversed since LV is trying to empty for a longer period of time

7

When can you hear an S3 the best?

left lateral decubitus position during exhalation

8

What murmurs are heard better w valsalva?

MVP and hypertrophic cardiomyopathies
(it decreases preload and afterload)
- decreases the intensity of most other murmurs

9

How does hand grip affect murmurs?

it increases afterload: increases intensity of MR, AR, VSD, MVP

10

How does the murmur of MVP change w position?

Standing up: decreases preload, click closer to S1
Lying down: increases preload, click and murmur closer to S2

11

Marfans pt dies slowly bc of a heart issue, what is it?

MVP- leading to conductive issue

12

left infraclavicular murmur loudest at S2

PDA: congenital rubella or prematurity

13

what phase of the cardiac AP does cardiac muscle contractoin occur?

phase 2

14

How do ACh and adenosine act on the pacemaker AP?

they decrease the rate of diastolic depolarization and decrease HR

15

Speed of conduction?

purkinje, atria, ventricle, AV node

16

how do T waves relate to K?

Hyperkalemia = peaked T waves
Hypokalemia = flat T waves

17

how do you treat A flutter?

1. Class IA, IC, or III antiarrhythmics
2. Rate control: betal blocker or Ca channel blocker

18

What can cause a first degree AV block?

lyme disease- but more likely causes third degree heart block if not treated

19

where does ANP act in the kidney?

causes decreased Na reabsorption at the medullary collecting tubule
- constricts efferent arteriole and dilates afferent arteriole via cGMP
- contributes to the escape from aldosterone

20

delta wave on ECG

wolf parkinson white syndrome: acessory conduction pathway that bypasses the AV node leading to early ventricle depolarization
- also see a slurred upstroke of QRS
tx: Procainamide or amiodarone

21

where do the aortic arch and carotid sinus receptors send their info?

to solitary nucleus of medulla

22

What happens in supine hypotension?

supine or right lateral decubitus position > compression of IVC > reduced venous return, reduced preload, reduced CO and hypotension

23

Tricuspid atresia: what is it?

absence of tricuspid valve and hypoplastic RV
- requires both ASD and VSD for viabiliity

24

boot shaped heart

tetrology of fallot

25

how do pts with tetrology of fallot relieve cyanotic spells?

they squeat to increase PVR and decrease the right to left shunt

26

why are beta blockers the drug of choice for aortic dissections?

decrease the slope of rise in BP

27

how do you diagnose prinzmetals angina?

ergonovine challenge!

28

how do you reverse a hibernating myocardium?

CABG revascularization!

29

Time course microsopically of MI: contraction bands from reperfusion injury, release of necrotic cell content into blood, beginning of neutrophil migration

12-24 hrs

30

Time course of MI: early coagulative necrosis, wavy fibers

4-12hrs