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1 Flashcards

1
Q

Mitral valve auscultation?

A

Apex

Apex auscultation is typically performed at the point of maximal impulse (PMI) on the chest.

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2
Q

Where is the tricuspid valve (TV) auscultation location?

A

Left parasternal border

This area is often used to assess the function of the tricuspid valve.

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3
Q

Where is the aortic valve (AV) auscultation location?

A

Right 2nd intercostal space

This location is standard for evaluating aortic valve sounds.

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4
Q

Where is the pulmonary valve (PV) auscultation location?

A

Left 2nd intercostal space

This area helps in assessing pulmonary valve activity.

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5
Q

What does S1 signify in heart sounds?

A

Closure of MV and TV

S1 is commonly referred to as the ‘lub’ sound.

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6
Q

What does S2 signify in heart sounds?

A

Closure of AV and PV

S2 is commonly referred to as the ‘dub’ sound.

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7
Q

What happens to A2 and P2 during inspiration?

A

They split due to increased blood in the right side of the heart

This physiological change is important in assessing heart function.

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8
Q

What is S3 and what does it indicate?

A

Abnormal heart sound due to blood entering a volume overloaded ventricle in early diastole

S3 can indicate heart failure or other conditions.

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9
Q

What causes S3 heart sound?

A

Valve regurgitation; congestive heart failure

These conditions lead to volume overload in the ventricles.

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10
Q

What do murmurs indicate?

A

Stretching of the valve ring or damage to the valve

Murmurs can indicate various cardiac conditions.

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11
Q

How does inspiration affect heart sounds and murmurs?

A

Increases right-sided abnormal heart sounds and murmurs

This is due to increased venous return to the right heart.

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12
Q

How does expiration affect heart sounds and murmurs?

A

Increases left-sided abnormal heart sounds and murmurs

This is due to decreased venous return to the left heart.

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13
Q

What is S4 and what does it indicate?

A

Abnormal heart sound due to blood entering a non-compliant ventricle with atrial contraction in late diastole

S4 is often associated with hypertrophy or stiff ventricles.

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14
Q

What causes S4 heart sound?

A

Volume overloaded ventricle; hypertrophy

These conditions lead to decreased compliance of the ventricle.

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15
Q

What do stenosis murmurs indicate?

A

Problem in opening the valve

Stenosis can lead to increased pressure gradients across valves.

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16
Q

What do regurgitation murmurs indicate?

A

Problem in closing the valve

Regurgitation can lead to volume overload in the heart chambers.

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17
Q

Which valves open during systole?

A

AV and PV

This is when blood is ejected from the heart.

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18
Q

Which valves open during diastole?

A

MV and TV

This is when the heart fills with blood.

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19
Q

Which valves close during systole?

A

MV and TV

This closure prevents backflow into the atria.

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20
Q

Which valves close during diastole?

A

AV and PV

This closure prevents backflow into the ventricles.

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21
Q

What is LDL’s role in the body?

A

Primary vehicle for carrying cholesterol

High levels of LDL are associated with increased cardiovascular risk.

22
Q

What is VLDL’s role in the body?

A

Primary vehicle for carrying liver-synthesized triglyceride

VLDL is converted to LDL in the bloodstream.

23
Q

What is Type IV hyperlipoproteinemia associated with?

A

Increased VLDL; commonly seen in alcoholics

This condition can lead to pancreatitis among other issues.

24
Q

What is familial hypercholesterolemia (type II)?

A

Autosomal dominant; deficiency of LDL receptors; increased LDL

This genetic condition leads to high cholesterol levels from birth.

25
Q

What characterizes Type III hyperlipoproteinemia?

A

Deficiency of apo E; increased remnants (chylomicron, intermediate density)

This can lead to premature atherosclerosis.

26
Q

What is the consequence of apo B deficiency?

A

Deficiency of apo B48 (chylomicrons) and B100 (VLDL); leads to increased CH and TG

This condition can cause malabsorption and hemolytic anemia.

27
Q

What are clinical findings in apo B deficiency?

A

Malabsorption; hemolytic anemia

These findings are due to impaired lipid transport.

28
Q

What is atherosclerosis a reaction to?

A

Injury of endothelial cells

This process is complex and involves multiple factors.

29
Q

What are the risk factors for atherosclerosis?

A
  • Smoking
  • Increased LDL
  • Increased homocysteine
  • Chlamydia pneumoniae infection

These factors contribute to the development of atherosclerotic plaques.

30
Q

What cells are involved in atherosclerosis?

A
  • Platelets
  • Macrophages
  • Smooth muscle cells
  • T cells with cytokine release

These cells play roles in inflammation and plaque formation.

31
Q

What is a fibrous plaque?

A

Pathognomonic lesion of atherosclerosis

This lesion is a hallmark of advanced atherosclerotic disease.

32
Q

What is C-reactive protein a marker of?

A

An inflammatory atheromatous plaque

Elevated levels can indicate increased cardiovascular risk.

33
Q

What does an inflammatory atheromatous plaque predispose to?

A

Platelet thrombosis

This can lead to acute cardiovascular events.

34
Q

What effect does increased plasma homocysteine have?

A

Promotes vessel thrombosis; associated with folate (MC)/vitamin B12 deficiency

Elevated homocysteine levels are a risk factor for cardiovascular diseases.

35
Q

What is hyaline arteriolosclerosis?

A

Small vessel disease of DM and hypertension; excess protein in vessel wall

This condition leads to narrowing of small blood vessels.

36
Q

What mechanisms cause hyaline arteriolosclerosis in diabetes mellitus?

A

Non-enzymatic glycosylation

This process leads to increased permeability of the vessel wall.

37
Q

What happens during non-enzymatic glycosylation?

A

Glucose attaches to amino acids in the basement membrane; causes increased permeability to protein

This is a significant mechanism in diabetic complications.

38
Q

What mechanisms cause hyaline arteriolosclerosis in hypertension?

A

Pressure pushes proteins into the vessel wall

This leads to changes in blood vessel structure.

39
Q

What can cause abdominal aortic aneurysm rupture?

A

Due to atherosclerosis; presents with flank pain, hypotension, pulsatile mass

This is a medical emergency requiring immediate attention.

40
Q

What is a syphilitic aneurysm?

A

Vasculitis of vasa vasorum of aortic arch; can lead to aortic regurgitation

This condition is associated with untreated syphilis.

41
Q

What causes aortic dissection?

A

Due to hypertension and collagen tissue disorders (e.g., Marfan syndrome)

This is a life-threatening condition that requires urgent treatment.

42
Q

What is cystic medial degeneration?

A

Elastic tissue degeneration creates spaces filled with mucopolysaccharides

This is often seen in Marfan syndrome.

43
Q

What causes an intimal tear in the aorta?

A

Due to wall stress from hypertension and structural weakness

This can lead to aortic dissection.

44
Q

What are the types of aortic dissection?

A
  • Proximal (most common)
  • Distal
  • Combination of both

Proximal dissections are more likely to be life-threatening.

45
Q

What is the most common cause of death in Marfan’s and Ehlers-Danlos syndrome?

A

Aortic dissection

These connective tissue disorders predispose individuals to vascular complications.

46
Q

What is phlebothrombosis?

A

Stasis of blood flow; deep veins below knee are the most common site

This condition can lead to deep vein thrombosis.

47
Q

Where do pulmonary thromboemboli originate from?

A

Femoral veins

This can lead to serious complications such as pulmonary embolism.

48
Q

What does superficial migratory thrombophlebitis indicate?

A

Sign of carcinoma of the head of the pancreas

This condition can be a paraneoplastic syndrome.

49
Q

What are the signs and symptoms of proximal aortic dissection?

A

Chest pain radiating to back, lack of pulse; cardiac tamponade

These symptoms indicate a medical emergency.

50
Q

What is the most common cause of death in Marfan’s syndrome?

A

Aortic regurgitation/dissection; lens dislocation; MVP with sudden death

These complications are critical in managing patients with Marfan’s.

51
Q

What is thoracic outlet syndrome?

A

Absent radial pulse with positional change

This syndrome can cause pain and neurological symptoms.

52
Q

What are the symptoms of Turner’s syndrome?

A

Lymphedema hands/feet in newborn; preductal coarctation

Turner’s syndrome is a chromosomal disorder affecting females.

Cvs (3 decks)

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