Questions and Answers
What happens to FEV1 and FVC in obstructive lung diseases?
Which of the following lung volumes cannot be forcibly exhaled out under normal circumstances?
What is a common characteristic of restrictive lung diseases?
What is the main physiological effect of asthma on the airways?
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In the context of ventilation/perfusion (V/Q) mismatch, what condition might lead to decreased V/Q ratios?
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Which of the following conditions can lead to increased residual volume?
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What distinguishes asthma from other obstructive lung diseases like COPD?
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In obstructive lung diseases, which of the following statements is true regarding lung volumes?
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What is the primary cell type responsible for gas exchange in the alveoli?
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In terms of V/Q mismatch, a pneumonia infection typically leads to which type of ratio?
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What happens to afterload in patients with hypertension?
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Which of the following substances increases cardiac contractility?
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What occurs during Phase 0 of a cardiac action potential in myocytes?
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What effect do beta blockers have on heart rate and contractility?
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How does atrial fibrillation primarily affect cardiac function?
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What is the primary characteristic observable on an EKG during atrial flutter?
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What role do calcium channel blockers play in the management of tachycardia?
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What is the primary function of the SA node in the cardiac conduction system?
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What happens to heart rate in response to sympathomimetics?
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What is the effect of Digoxin on cardiac contractility?
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What structure does blood enter immediately after the inferior and superior vena cava?
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How is stroke volume (SV) calculated?
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What determines diastolic blood pressure?
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What is the role of preload in cardiac physiology?
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Cardiac output is affected by which of the following variables?
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Which condition can lead to a decreased cardiac output due to increased heart rate?
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What happens to cardiac output when stroke volume decreases?
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What anatomical structure does blood pass through after the right ventricle?
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What is the relationship between heart rate and stroke volume during high physical activity?
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What factor does total peripheral resistance primarily depend on?
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Study Notes
Viridans Group and Endocarditis
- Viridans group streptococci includes: S. mutans, S. mitis, S. sanguis.
- Commonly infects mitral and bicuspid valves.
- Staphylococcus aureus is associated with infections of the tricuspid valve, particularly in IV drug users ("Tri Before You Bi").
Heart Failure
- Left sided heart failure often stems from hypertension (HTN), myocardial infarction (MI), or damage to heart muscle, causing pulmonary congestion and edema.
- Right sided heart failure frequently results from left sided failure, leading to jugular venous distension and hepatosplenomegaly.
Renal Function and Pressure
- Kidneys regulate fluid levels, electrolyte balance, nutrient absorption, and toxin excretion, assisting in blood pressure regulation and pH balancing.
- Effective circulating volume (ECV) affects blood pressure; low ECV activates the sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS).
- Hydrostatic pressure pushes fluid out of capillaries, while oncotic pressure draws fluid in, maintaining proper capillary dynamics.
Glomerular Filtration Rate (GFR)
- GFR measures the rate of blood filtered through the kidneys; influenced by afferent dilation and efferent constriction.
- Inulin is the standard for measuring GFR; creatinine is a practical alternative due to its similar characteristics.
Proximal Tubule Function
- High blood glucose levels in diabetes lead to glucose spilling into urine due to transporter saturation.
- Hartnup disease and Fanconi syndrome show amino acids and bicarbonate/glucose losses, respectively.
Acid-Base Balance in the Kidneys
- The proximal tubule excretes H+ in acidosis and reabsorbs bicarbonate, aided by carbonic anhydrase inhibitors, which weaken renal function and induce diuresis.
Renal Tubule Anatomy
- Thin descending loop is water permeable, while the thick ascending limb reabsorbs NaCl.
- Distal convoluted tubule reabsorbs Na, K, and Ca, while the collecting duct focuses on Na and water reabsorption along with K+ and H+ secretion.
Hormonal Regulation
- Aldosterone promotes Na reabsorption and K+/H+ excretion, stimulated by angiotensin II and hyperkalemia.
- Antidiuretic hormone (ADH) retains free water, mediated by V1 for vasoconstriction and V2 for water reabsorption.
Cushing's Syndrome and Addison’s Disease
- Cushing's syndrome results from excess ACTH and cortisol, leading to hypertension, metabolic alkalosis, and body fat redistribution.
- Addison’s disease indicates adrenal insufficiency, leading to hyponatremia and hyperkalemia; treatment involves corticosteroids.
Hypertensive Disorders
- Conn's disease, or hyperaldosteronism, causes hypertension due to excess sodium retention and potassium loss.
Respiratory Acidosis and Alkalosis
- Acidosis occurs with increased CO2 and decreased pH; compensation through renal bicarbonate release happens.
- Alkalosis involves decreased CO2 and increased pH, with renal adjustments in bicarbonate loss.
Respiratory Anatomy
- Type I pneumocytes are responsible for gas exchange; Type II cells produce surfactant to prevent alveolar collapse.
Lung Mechanics
- Negative intrapleural pressure during inhalation opens the alveoli. Pneumothorax neutralizes this pressure, leading to collapse.
- Lung volumes include tidal volume, inspiratory and expiratory reserve volumes, and residual volume, crucial for understanding lung capacity.
Ventilation and Gas Exchange
- Matching ventilation (air) with perfusion (blood flow) is vital for efficient gas exchange; disparities can lead to diseases like pulmonary fibrosis or obstructive lung disease.
Obstructive vs. Restrictive Lung Diseases
- Obstructive lung diseases (e.g., asthma, emphysema) are characterized by air trapping and reduced airflow rates.
- Restrictive lung diseases (e.g., pulmonary fibrosis) result in lower lung volumes while maintaining normal airflow ratios.
Cardiac Function and Regulation
- Afterload increases with HTN; contractility is influenced by the SNS and various medications.
- The heart's conduction system, starting at the SA node, coordinates muscle contractions, facilitated by pacemaker and myocyte cells.
Arrhythmias
- Atrial fibrillation is the most common arrhythmia, marked by irregular heart rhythms and an increased risk of thrombus formation.
- Atrial flutter is characterized by a saw-tooth pattern on EKG.
Cardiac Output and Blood Pressure
- Cardiac output (CO) is calculated as stroke volume (SV) times heart rate (HR), influenced by preload, afterload, and contractility.
- Systolic pressure is determined by SV, while diastolic pressure is affected by total peripheral resistance.
Path of Blood
- Blood follows a defined route through the heart, lungs, and systemic circulation, as detailed from the vena cava to the aorta.
Cardiac Metrics and Terminology
- Key metrics include end-diastolic volume (EDV), end-systolic volume (ESV), venous return, stroke volume (SV), ejection fraction (EF), and systemic resistance.
Summary of Definitions
- Preload and afterload are crucial for understanding cardiac workload; increased preload correlates with enhanced CO but also greater myocardial oxygen consumption.
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Description
This quiz covers essential topics related to cardiology, including the Viridans group and endocarditis, heart failure mechanisms, and renal function in blood pressure regulation. Answer questions on key concepts such as the impact of different types of heart failure and the role of the kidneys in maintaining homeostasis.
