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Step 1 DIT > 4. Cardio > Flashcards

4. Cardio Flashcards

1
Q

What substances act on smooth muscle myosin light-chain kinase? (3)

How does this affect blood pressure?

A
  1. Ca2+ channel blockers
  2. Epinephrine B2
  3. Prostaglandin E2

2 and 3 act to increase cAMP, inhibiting myosin light-chain kinase, which will decrease phosphorylation of myosin

  • all the above lead to vasodilation, and decrease in BP
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2
Q

Describe the chain of events in which hypotension (vasodilators) causes reflex tachycardia

A
  • baroreceptors in the carotid sinus sense low BP
  • decrease stretch of carotid sinus
  • decreased stimulation of CN9 (which transmits to solitary nucleus of medulla)
  • decreased inhibition of sympathetic output => more sym
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3
Q

What would you most suspect the cause of HTN to be in a pt with paroxysms of increased sympathetic tone: anxiety, palpitations, diaphoresis

A

pheo

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4
Q

What would you most suspect the cause of HTN to be in a pt age of onset 20-50

A

essential HTN

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5
Q

What would you most suspect the cause of HTN to be in a pt with abdominal bruit

A

renal artery stenosis

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6
Q

What would you most suspect the cause of HTN to be in a pt with BP in arms > legs

A

coarct

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7
Q

What would you most suspect the cause of HTN to be in a pt with family hx of HTN

A

essential HTN

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8
Q

What would you most suspect the cause of HTN to be in a pt with tachycardia, heat intolerance, diarrhea

A

hyperthyroidism

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9
Q

What would you most suspect the cause of HTN to be in a pt with hyperkalemia

A

renal insufficiency

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10
Q

What would you most suspect the cause of HTN to be in a pt with hypokalemia

A

renal artery stenosis

- b/c body’s response to poor renal perfusion is to activate RAAS (=> aldo leads to potassium wasting)

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11
Q

What would you most suspect the cause of HTN to be in a pt with central obesity, moon-shaped face, hirsutism

A

Cushing

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12
Q

What would you most suspect the cause of HTN to be in a young pt with acute onset tachy

A

cocaine, amphetamine

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13
Q

What would you most suspect the cause of HTN to be in a pt with proteinuria?

A

renal disease

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14
Q

What category of BP medication is preferred in the treatment of aortic dissection?

A

b-blocker

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15
Q 
Which antihypertensive class or drug fits each of the following S/Es? 
- hypertrichosis
A

Minoxidil

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16
Q 
Which antihypertensive class or drug fits each of the following S/Es? 
- cyanide toxicity
A

sodium nitroprusside

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17
Q 
Which antihypertensive class or drug fits each of the following S/Es? 
- reflex tachycardia
A

any vasodilators

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18
Q 
Which antihypertensive class or drug fits each of the following S/Es? 
- cough
A

ACE-i

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19
Q 
Which antihypertensive class or drug fits each of the following S/Es? 
- possible development of drug-induced lupus
A

hydralazine

  • remember SHIPP
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20
Q 
Which antihypertensive class or drug fits each of the following S/Es? 
- possible angioedema
A

ACE-i and ARBs

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21
Q

Which antiHTN are particularly beneficial to heart failure pts? (4)

A
  • ACE-i or ARB
  • aldosterone antagonist
  • b-blockers (carvedilol, metoprolol, bisoprolol)
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22
Q

Which antiHTN are safe to use in pregnancy? (4)

A
  • hydralazine
  • methyldopa
  • labetolol
  • nifedipine

Hypertensive Moms Love Nifedipine

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23
Q

What is the most likely cause of chest pain in a pt who has ST segment elevation only during brief episodes of chest pain?

A

Prinzmetal angina

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24
Q

Which lipid-lowering agent matches

SE: facial flushing

A

niacin

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25
Q

Which lipid-lowering agent matches

SE: elevated LFTs, myositis

A

statins, fibrates

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26
Q

Which lipid-lowering agent matches

SE: GI discomfort, bad taste

A

bile acid resins

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27
Q

Which lipid-lowering agent matches

- best effect on HDL

A

niacin

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28
Q

Which lipid-lowering agent matches

- best effect on trig/VLDL

A

fibrates

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29
Q

Which lipid-lowering agent matches

- best effect on LDL/cholesterol

A

statin (HMG-CoA reductase inhibitors)

30
Q

Which lipid-lowering agent matches

- binds C. diff toxin

A

Cholestyramine (bile acid resin)

- can use in C. diff pt

31
Q

A 50 yo man is started on lipid-lowering medication. Upon his first dose, he develops a rash, pruritus, and diarrhea. What drug is he taking?

A

niacin

32
Q

How can the flushing rxn of niacin be prevented?

A
  • take aspirin or NSAID 30 min before niacin
33
Q

What is the most common lethal complication after an MI?

A

arrhythmia

34
Q

What would cause each of the following findings after an MI?
- cardiac tamponade

A

free wall rupture

35
Q

What would cause each of the following findings after an MI?

- severe mitral regurg

A

papillary muscle rupture

36
Q

What would cause each of the following findings after an MI?

- new VSD

A

rupture of intraventricular septum

37
Q

What would cause each of the following findings after an MI?

- stroke

A

pseudoaneurysm –> mural thrombus –> embolus

38
Q

Which ECG leads will show evidence of ischemia in an anterior wall MI?

A

V1-V4, maybe V5

this is LAD

39
Q

What is the differences b/w acute and subacute infective endocarditis?

A

Acute: S. aureus

  • rapid onset (days)
  • normal valves

Subacute: Viridans

  • insidious onset (wks to months)
  • affects prev damaged/congenitally abnormal valves
40
Q

An IVDU presents with chest pain, dyspnea, tachycardia, and tachypnea. What is the most likely cause?

A

Endocarditis –> bacterial embolism –> septic pulmonary emboli

41
Q

A young girl with congenital valve disease is given penicillin ppx. In the ER, infective endocarditis is diagnosed. What is the next step in her management?

A

Empiric IV vanc pending culture results

42
Q

Under what circumstances might you see pulsus paradoxus? (5)

A
  • cardiac tamponade
  • asthma
  • croup
  • obstructive sleep apnea
  • COPD
43
Q

What are the Jones criteria for the dx of acute rheumatic fever?

A
  • Joints (migratory polyarthritis)
  • carditis (pancarditis)
  • Nodules (subQ)
  • Erythema marginatum
  • Sydenham chorea
44
Q

What heart pathology cause focal myocardial inflammation with multinucleate giant cells?

A

Aschoff bodies

45
Q

What heart pathology cause chest pain and course rubbing heart sounds in a pt with Cr of 5.0

A

Uremic pericarditis

46
Q

What heart pathology cause tree-barking of the aorta?

A

Tertiary syphilis

47
Q

What heart pathology cause child with fever, joint pain, cutaneous nodules 4 wks after a throat infection?

A

Acute rheumatic fever

48
Q

What heart pathology cause ST elevation in all ECG leads

A

pericarditis

49
Q

What heart pathology cause ECG showing electrical alternans

A

cardiac tamponade

50
Q

Which type of vasculitis fits description

  • weak pulses in upper extremities
A

Takayasu arteritis

51
Q

Which type of vasculitis fits description

  • granulomas of lung, glomerulonephritis, c-ANCA positive
A

GPA (granulomatosis with polyangiitis)

52
Q

Which type of vasculitis fits description

  • necrotizing immune complex inflammation of visceral/renal vessels
A

PAN (polyarteritis nodosa)

  • spares the lungs, ANCA (-)
53
Q

Which type of vasculitis fits description

  • 2 yo East Asian female
A

Kawasaki

54
Q

Which type of vasculitis fits description

  • 20 yo East Asian female
A

Takayasu

55
Q

Which type of vasculitis fits description

  • young male smokers
A

Thromboangiitis obliterans (Buerger disease)

56
Q

Which type of vasculitis fits description

  • young asthmatics
A

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

57
Q

Which type of vasculitis fits description

  • infants and young children; involves the coronary arteries
A

Kawasaki

58
Q

Which type of vasculitis fits description

  • most common vasculitis
A

Giant cell (temporal) arteritis

59
Q

Which type of vasculitis fits description

  • associated with hep B infection
A

PAN

60
Q

Which type of vasculitis fits description

  • occlusion of ophthalmic artery can lead to blindness
A

Giant cell

61
Q

Which type of vasculitis fits description

  • perforation of nasal septum
A

GPA (Wegener’s)

62
Q

Which type of vasculitis fits description

  • unilateral headache, jaw claudication
A

Giant cell

63
Q

Which disorders are commonly discovered in pts with Raynaud phenomenon? (4)

A
  • lupus
  • CREST scleroderma
  • Buerger disease
  • Mixed connective tissue disease
64
Q

Which vascular tumor fits the following description?

  • benign, raised, red lesion about the size of a mole in older pts
A

cherry hemangioma

65
Q

Which vascular tumor fits the following description?

  • raised, red area present at birth; increases in size initially then regresses over months to years
A

strawberry hemangioma

66
Q

Which vascular tumor fits the following description?

  • lesion caused by lymphoangiogenic growth factors in an HIV pt
A

Kaposi Sarcoma

67
Q

Which vascular tumor fits the following description?

  • polypoid red lesion found in pregnancy or after trauma
A

pyogenic granuloma

68
Q

Which vascular tumor fits the following description?

  • benign, painful, red-blue tumor under fingernails
A

glomus tumor

69
Q

Which vascular tumor fits the following description?

  • cavernous lymphangioma associated with Turner syndrome
A

cystic hygroma

70
Q

Which vascular tumor fits the following description?

  • skin papule in AIDS pt caused by Bartonella spp.
A

Bacillary angiomatosis

remember, it causes cat scratch disease

Step 1 DIT (20 decks)

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