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CV II Exam 3 > Blonder > Flashcards

Blonder Flashcards

1
Q

ASD

A

opening in intra-atrial septum

most common - secundum

closure - catheter device

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2
Q

patent foramen ovale

A

foramen covered by septum primum not sealed shut in 20% of normal subjects

bubble study on echo

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3
Q

over time ASD

A

resistance - stiff and non-compliant

then pressure increases

pressure follows resistance

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4
Q

myxomatous mitral valve

A

mitral valve prolapse syndrome

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5
Q

most common septal defect

A

bicuspid AV

ASD is second**

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6
Q

ASD

A

usually asymptomatic until adult - surgery by age 40

atrial arrhythmia, paradoxical emboli, cerebral abscess, right heart failure, pulmonary HTN > eisenmanger syndrome

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7
Q

ASD at bottom of septum

A

primum

-worse

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8
Q

sinus venosus ASD

A

least common
-cannot be closed percutaneously

two types
-superior (SVC) and inferior (IVC)

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9
Q

scimitar syndrome

A

partial anomalous venous return

hypoplasia of lobe of right lung

thoracic aorta > pulmonary artery collaterals

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10
Q

lesions <8mm without symptoms

A

larger lesions enlarge with age

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11
Q

pulmonary HTN and eisenmenger syndrome

A

require >2.5:1 shunt

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12
Q

wide fixed split S2

A

ASD - splitting stays equal

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13
Q

increased P2

A

pulmonary HTN

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14
Q

S1 split

A

tricuspid component

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15
Q

upper left sternal border murmur

A

systolic ejection murmur

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16
Q

most common congenital heart disease at birth

A

VSD

spontaneous closure

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17
Q

infundibular VSD

A

below aortic and pulmonic valves

leading to progressive aortic regurgitation, the hallmark

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18
Q

membranous VSD

A

conoventricular

deficiency of membranous septum

19
Q

inlet defect VSD

A

AV canal

down’s

20
Q

muscular VSD

A

in trabecular system

21
Q

small/restrictive VSD

A

orifice diameter < or = 25% aortic annulus diameter

no LV volume overload
no pulmonary HTN

22
Q

moderate size VSD

A

orifice 25-75% diameter

mild-moderate volume overload

23
Q

large VSD

A

orifice 75% diameter

moderate L>R shunts with LV volume overload

pulmonary HTN
> eisenmenger

24
Q

tetralogy of fallot

A

VSD
aorta overrides
concentric RV hypertrophy
RVOT obstruction

25
Q

causes of AV block

A

-vagal tone increase
-fibrosis of conduction system (50%)
-IHD
-cardiomyopathy and myocarditis
-congenital heart disease
familial AV block (auto dom)

26
Q

latrogenic

A

Dr. caused AV block
-digitalis, non-DHP CCBs, beta blockers, amiodarone, adenosine

cardiac surgery
catheter
alcohol septal ablation

27
Q

first degree AV block

A

PR interval >0.2

decreased CO

28
Q

progressive PR interval prolongation

A

mobitz type I second degree AV block

29
Q

PR interval unchanged, but get P wave that doesn’t conduct

A

mobitz type II second degree AV block

30
Q

P and QRS dissociation

A

third degree AV block

usually need a pacemaker

31
Q

rheumatic heart disease

A

mitral valve stenosis

32
Q

indication for pacing

A

wide QRS

33
Q

most common arrhythmia

A

atrial fib

more in men, increases with age

reduced CO - decreased diastolic filling time

34
Q

risk factors for A fib

A

hypertensive heart disease
CHD
RF

35
Q

AF that terminates spotaneously or within 7 days, may recur

A

paroxysmal AF

36
Q

AF that fails to terminate within 7 days

A

persistent

require pharm or cardioversion

37
Q

AF longer than 12 months

A

long standing persistant

38
Q

patients with persistant AF where joint decision is made to no longer control rhythm

A

permanent AF

39
Q

palpitations, syncope, dyspnea, fatigue

A

AF

40
Q

rate control for AF

A

patient anti-coag

-rate controlled by AV blockers

41
Q

rhythm control for AF

A

anticoag and restore NSR by meds
-or electrical cardioversion

TEE used to rule out LA thrombus prior to cardioversion

42
Q

CHA2DS2 - Vasc

A 
CHF
HTN
Age 65-74 1 point 
>75 2 points
DIabetes
Stroke 2 points

Vasc disease Hx +1
Female +1

all 9 15% per year for A-fib stroke risk

43
Q

PVCs

A

with syncope = serious**

very common complaint

  • not really that big of a deal
  • unless with acute coronary syndromes or MI

reassurance is mainstay of treatment

beat after pause - very forceful

CV II Exam 3 (21 decks)

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