First Year

• #deck column:1
• #tags column:13
• First year::Cardiology What is the vaso vasorum? Small blood vessel which supplies blood to the tunica adventita of larger blood vessels
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels Where does the primary heart field come from? migration of progenitor heart cells through the primitive streak to the visceral lateral plate mesoderm
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels At what stage in foetal development does the establishment of the primary heart field occur? around 3 weeks after conception
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels What effect on the heart does lateral folding of the embryo cause? Both lateral plate mesoderms make contact and fuse to form one heart tube
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels What effect does cranial-caudal folding of the foetus have on the developing heart tube? It positions the heart tube ventral to the foregut in the thoracic cavity
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels What is the dorsal mesocardium? the connection between the heart tube and the foregut of an embryo
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels Where does the primary heart field come from? migration of progenitor heart cells through the primitive streak to the visceral lateral plate mesoderm
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels At what stage in foetal development does the establishment of the primary heart field occur? around 3 weeks after conception
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels What effect on the heart does lateral folding of the embryo cause? Both lateral plate mesoderms make contact and fuse to form one heart tube
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels What effect does cranial-caudal folding of the foetus have on the developing heart tube? It positions the heart tube ventral to the foregut in the thoracic cavity
• First year::Cardiology::Physiology of the heart::Embryology of the heart and great vessels What is the dorsal mesocardium? the connection between the heart tube and the foregut of an embryo
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What are the main anticoagulant drugs given for a deep vein thombrosis? Apixaban or rivaroxibam first lineLMWH followed by warfarin second line
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What is the mechanism of action of warfarin? Vitamin K antagonist which blocks clotting factors sticking together
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What is the mechanism of action of heparin? Enhances function of anti-thombrin III
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What is the mechanism of action of Xa inhibitors? block the generation of thombrin
• First year::Cardiology::Pharmacy::Anti-coagulant drugs what is the mechanism of action of thombrin inhibitors? block conversion of fibrinogen to fibrin
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What is the mechanism of action of tissue plasminogen activator? activates plasmin which breaks down fibrin clots
• First year::Cardiology::Pharmacy::Anti-coagulant drugs Is tissue-plasminogen activator (TPA) a coagulant or fibrinolytic? fibrinolytic
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What is the most common anti-platelet drug? aspirin
• First year::Cardiology::Pharmacy::Anti-coagulant drugs How many days before surgery should aspirin and other anti-platelet drugs be stopped? 7 days
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What is the mechanism of action for aspirin? inhibits COX1 and COX2, stopping aggregation of platelets
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What are the common uses of aspirin? treating unstable angina and secondary prevention of MI
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What is the common use of heparin? Preventing progresson of DVT or PE
• First year::Cardiology::Pharmacy::Anti-coagulant drugs When is heparin preferred to warfarin? in acute needs, as heparin acts faster
• First year::Cardiology::Pharmacy::Anti-coagulant drugs What are the main side effects of thrombolytic drugs? Eg. TPA hemorrhage
• First year::Cardiology::Physiology of the heart::Haemostasis What is primary haemostasis? Formation of platelet plug
• First year::Cardiology::Physiology of the heart::Haemostasis What is secondary haemostasis? formation of fibrin clot
• First year::Cardiology::Physiology of the heart::Haemostasis What are the steps of platelet plug formation? (5) 1 - endoothelial injury2 - exposure3 - adhesion4 - activation5 - aggregation
• First year::Cardiology::Physiology of the heart::Haemostasis What is the first response of a blood vessel to endothelial injury? vasoconstriction
• First year::Cardiology::Physiology of the heart::Haemostasis What is the function of von-willebrands factor? binds to collagen beneath endothelial cells and allows for platelet adhesion
• First year::Cardiology::Physiology of the heart::Haemostasis How is a platelet activated? - Binding to Von-williebrand factor through GP1B- Or through ADP/ Thromboxane 2 interactions- Or through thombrin
• First year::Cardiology::Physiology of the heart::Haemostasis What happens once a platelet is activated? It produces more VWF, serotonin, ADP, Thromboxane A2 and Ca2+
• First year::Cardiology::Physiology of the heart::Haemostasis How do platelets activate other platelets? they release ADP and thombroxane 2
• First year::Cardiology::Physiology of the heart::Haemostasis How is the positive feedback loop of platelet activation limited to the site of injury? uninjured endothelial cells produce NO and prostaglandins which prevents platelets from being activated
• First year::Cardiology::Physiology of the heart::Haemostasis What is required for a platelet to be considered fully activated? expression of GPIIB/IIA
• First year::Cardiology::Physiology of the heart::Haemostasis What does GPIIb/IIIa do? binds fibrinogen
• First year::Cardiology::Physiology of the heart::Haemostasis What is the end-product of secondary haemostasis? fibrin
• First year::Cardiology::Physiology of the heart::Haemostasis How does the extrinsic pathway of activating fibrin work? - Factor 7A circulates in the blood and binds to TF expressed on damaged smooth muscle cells- TF and Ca2+ are cofactors for 7a so it can cleave factor 10 into 10a- 10a cleaves 5 into 5a and uses it as cofactor to cleave prothombrin into thombrin