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STEP 1 > 03b: Cardio 2 > Flashcards

03b: Cardio 2 Flashcards

1
Q

Most common cause of non-bacterial endocarditis is (X). What’s another common cause?

A

X = malignancy (esp mucinous adenocarcinoma)

Chronic inflamm disorders (SLE/Libman-Sacks, DIC/sepsis)

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2
Q

PCWP in hemorrhagic shock is (increased/decreased). CO is (increased/decreased).

A

(Preload) decreased and CO decreased

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3
Q

Rx for hemorrhagic shock

A

IV fluids (to increase preload and SV)

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4
Q

Rx for cardiogenic shock

A

Inotropes or diuretics (depending on cause/preload status)

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5
Q

A Pulmonary Embolus can put patient into (X) shock.

A

X = cardiogenic

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6
Q

Which pH abnormality is a characteristic finding of shock?

A

Metabolic acidosis (with elevated anion gap) due to lactic acidosis (from impaired organ perfusion and tissue oxygenation)

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7
Q

Cold and clammy skin is a finding in which type(s) of shock?

A

Cardiogenic and hemorrhagic

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8
Q

Give two examples of high-output shock.

A

Septic and anaphylactic (both forms of distributive shock) - patient will have warm peripheries with rapid, bounding pulses

Heart’s increase in CO is an attempt to compensate for very low SVR

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9
Q

Rx for distributive (septic, anaphylactic, CNS injury) shock

A

IV fluids and pressors

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10
Q

Pt presents with fever and heart murmur. Retina has round white spots surrounded by hemorrhage called (X) spots. He has small, red, tender raised lesions on his palm called (Y). Diagnosis?

A

Bacterial endocarditis

X = Roth
Y = Osler nodes
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11
Q

Pt presents with fever and small hemorrhages under nails. You also notice Janeway lesions, which are:

A

Small, painless, erythematous lesions on palms/soles

Diagnosis: bacterial endocarditis (esp since splinter hemorrhages/fever also present)

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12
Q

Aschoff bodies are associated with (X) disease and histologically appear as:

A

X = rheumatic fever

Granulomas with giant cells

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13
Q

Anitschkow cells are (X) cells seen in which disease?

A

X = enlarged macrophages with ovoid, wavy, rod-like nucleus

Rheumatic heart disease

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14
Q

Otherwise healthy 30 yo M presents with mild fever, recent onset chest pain, and diffuse ST elevations on EKG. Most likely diagnosis/etiology?

A

Pericarditis (viral; likely Coxackie)

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15
Q

60 yo F smoker with Hx of hypertension, DM II, rheumatoid arthritis presents with recent onset chest pain and friction rub. Which factor in hx put her at greatest risk/caused the disease?

A

Rheumatoid arthritis (Dx: pericarditis)

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16
Q

45 yo F lifetime non-smoker with Hx of breast cancer presents with chest pain that is relieved by sitting up and leaning forward. Diagnosis? What’s the likely etiology/risk factor that caused the condition?

A

Acute pericarditis

Likely radiation exposure from breast cancer

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17
Q

Pt with low BP, high JVP, and muffled heart sounds. Diagnosis?

A

Cardiac tamponade (Beck’s triad)

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18
Q

Cardiac tamponade: which chamber has the highest pressure in diastole?

A

None - all four chamber pressures equilibrate in this condition

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19
Q

Explain mechanism of pulsus paradoxus

A

Decrease in SBP by over 10 mmHg with inspiration;

Fluid accumulation limits RV expansion so an increase in venous return w inspiration causes bowing of septum into LV and decrease in EDV/SV

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20
Q

The basis of heart disease in (1/2/3)o syphilis is destruction of:

A

3o syphilis

Vasa vasorum of aorta (w consequent vessel wall atrophy/dilatation)

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21
Q

T/F: Tertiary syphilis causes aortic stenosis.

A

False - Aortic regurg (dilatation of aorta and valve ring)

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22
Q

Most common heart tumor

A

Metastasis (ex: melanoma)

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23
Q

Most frequent 1o cardiac tumor in kids is (X) and associated with which disease?

A

X = rhabdomyoma

Tuberous sclerosis

24
Q

Kussmaul’s sign mechanism/explanation:

A

Increase (instead of normal decrease) in JVP with inspiration

Due to impaired filling of RV (blood backs up); may be due to constrictive pericarditis, R heart tumors, or restrictive heart diseases

25
Q

Most common cause of death in lightning strike patient

A

Resp arrest

26
Q

Immune system, especially (cellular/humoral) and (X) cytokine(s), is of primary importance in giant cell arteritis.

A

Cellular

X = IL-6

27
Q

Best initial test for giant cell arteritis is:

A

ESR (will be elevated; highly sensitive)

28
Q

T/F: Treatment precedes biopsy in temporal arteritis.

A

True (high-dose corticosteroids to prevent blindness)

29
Q

List the large vessel vasculitides. Star the one(s) with granulomatous inflammation.

A
  1. Giant cell arteritis*

2. Takayasu arteritis*

30
Q

Medium vessel vasculitides:

A

“PeeKaBoo”

  1. Polyarteritis nodosa
  2. Kawasaki
  3. Buerger disease (thromboangiitis obliterans)
31
Q

40 yo M with Hx of Hep B, fever, palpable purpura, and RBCs in urine. Most likely diagnosis?

A

Polyarteritis nodosa

32
Q

Polyarteritis nodosa typically involves (X) vessels, but not (Y) vessels.

A 
X = renal and visceral
Y = pulmonary
33
Q

Histopath of polyarteritis nodosa:

A

Transmural inflammation with fibrinoid necrosis

34
Q

Polyarteritis nodosa Rx:

A

Corticosteroids and cyclophosphamide

35
Q

Kawasaki disease Sx:

A

“CRASH and burn”

  1. Conjunctival injection
  2. Rash (desquamating)
  3. Adenopathy (cervical)
  4. Strawberry tongue
  5. Hand-foot changes (erythema, edema)
  6. fever
36
Q

Most common cause of MI in kids is:

A

Kawasaki (can cause coronary a aneurysm/thrombosis)

37
Q

Kawasaki Rx:

A

IVIG and aspirin

38
Q

Autoamputation of digits in heavy smokers. Diagnosis?

A

Buerger disease (thromboangiitis obliterans)

39
Q

Rx of Buerger disease

A

Smoking cessation

40
Q

Disease associated with PR3-ANCA aka (X) and (c/p)-ANCA positivity

A

X = anti-proteinase 3
cANCA
Granulomatosis with polyangiitis (Wegener)

41
Q

Granulomatosis with polyangiitis (Wegener) triad: (X) in vessels, (Y) in lung, (Z) in kidney.

A 
X = focal necrotizing vasculitis
Y = necrotizing granulomas
Z = necrotizing glomerulonephritis (crescentic, rapidly progressive)
42
Q

Disease associated with MPO-ANCA aka (X) and (c/p)-ANCA positivity

A

X = anti-myeloperoxidase
pANCA

  1. Microscopic polyangiitis
  2. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
43
Q

T/F: Wegener and Microscopic polyangiitis share the same histopathology

A

False - no granulomas in Micro Poly

44
Q

Key clinical distinguisher between Wegener and Microscopic polyangiitis

A

Involvement of nasopharynx in Wegener

45
Q

T/F: Wegener and Microscopic polyangiitis share the same treatment method

A

True - cyclophosphamide and corticosteroids

46
Q

Most common vasculitis associated with antibiotic use

A

Microscopic polyangiitis

47
Q

7 yo F with recent cold presents with palpable purpura on buttocks/legs. What’s at the top of differential? What other two signs would you look for in triad?

A

Henoch-Schölein Purpura

Arthralgia and GI pain

48
Q

Henoch-Schölein Purpura: vasculitis is the result of (X) formation

A

X = immune complex (IgA and C3 deposition in vascular lesions)

49
Q

(X) calcium channel blocker can be used to prevent (Y) complication following subarachnoid hemorrhage

A 
X = nimodipine
Y = cerebral vasospasm
50
Q

(X) drugs can be used to decrease the edema that’s a side effect of (dihydropyridine/non-dihydropyridine) CCBs.

A

X = RAAS inhibitors (cause post-cap venule dilation to counter pre-cap arteriolar dilation by CCBs)

Dihydropyridines

51
Q

Hydralazine frequently administered with (X) to prevent reflex (Y)

A 
X = BB
Y = tachycardia
52
Q

Digoxin (increases/decreases) HR by which mechanism

A

Decreases

Stimulates vagus nerve (decrease conduction at AV node)

53
Q

First-line agent for acute ventricular arrhythmia post-MI was once (X) antiarrhythmic but has been replaced with (Y).

A 
X = lidocaine (class 1B)
Y = amiodarone (class 3)
54
Q

Adenosine is a (short/long)-acting drug used to terminate certain forms of supraventricular tachycardias. How does this drug work?

A

Very short (15s)

Rapid efflux of K from cells, hyperpolarization and decrease in Ca current (thus decreasing AV node conduction)

55
Q

(X) drug selectively inhibits funny Na channels, thus (shortening/lengthening) phase (0/1/2/3/4) and having (pos/neg) (chronotropic/inotropic) effect.

A

X = Ivabradine (“Iva dining in her bra looks FUNNY”)

Lengthening phase 4; negative chronotropic (decrease HR) without affecting inotropy

STEP 1 (21 decks)

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