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2nd Time Through > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Fetal Erythopoiesis from where/when?

A

Yolk sac - 3-10 weeks
Liver 6wks -birth
Spleen 15-30 wks (liver does most)
Bone marrow 22 wk to adult

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2
Q

Pathway of blood in fetus?

A

Syncytiotrophoblasts to cytotrophoblasts to stroma of chorionic villus, umbilical vein to liver

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3
Q

Which papillary muscle may rupture post MI?

A

One fed by RCA

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4
Q

Most resistance in what vessels?

A

arterioles

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5
Q

2 Formulas for CO?

A

see 253

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6
Q

2 Formulas for MAP?

A

see 253

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7
Q

Acidosis - affect on contractility?

A

decreases

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8
Q

Myocardial O2 demand increased by?

A

increased afterload
increased contractility
increased HR
increased heart size

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9
Q

Normal ejection fraction?

A

55%

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10
Q

increased blood viscosity with?

A

polycythemia, hyperproteinemic states, hereditary spherocytosis

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11
Q

Exercise - effect on lymph flow?

A

increased flow during exercise - increased hydrostatic pressure - increased capillary filtration - increased lymph flow

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12
Q

HCM murur - loudest when?

Effect of: handgrip, valsalva, squatting

A

When less blood in LV.

decreased, increased, decreased

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13
Q

MVP - is “click” closest to S1 or S2:
Increased preload
Decreased preload
Anxious

A

S2, S1, S1

click happens when at a certain LV volume (more blood means more time before it hits that level of empty). Anxiety increases HR, decreasing preload.

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14
Q

heart Valves - type of tissue?

A

connective tissue

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15
Q

S3 murmur suggests? normal in what pts?

A

Mitral Regurg

children and pregnant women

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16
Q

S4 suggests?

A

LV hypertrophy

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17
Q

Pt with sycope, angina and dyspena. Heart murmur?

A

AS

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18
Q

Holosystolic murmur loudest at tricuspid area? Made louder with?

A

VSD. Handgrip

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19
Q

Mumur heard best when leaning forward?

A

AR.

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20
Q

Mech of SNS increasing HR?

A

increased opening of funny current in cardiac pacemakers.

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21
Q

U wave caused by?

A

HypoK and bradycardia

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22
Q

Order of signal transduction in heart? (speed?)

A 
SA
Atria (2)
AV (4)
Bundle of His
Purkinje (1)
Ventricles (3)

(1 = fastest)

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23
Q

Pt with defects in cardiac Na/K pumps and congenital sensorineural deafness?

A

Jervell and Lange-Nielsen syndrome. Congenital long QT syndrome.

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24
Q

Aortic arch receptors vs carotid sinus receptors (responds to/nerve)

A

Increased BP via vagus nerve
vs
Increased and decreased BP via CN9

25
Q

ANP - functions?

A

constricts EA and dilates AA

26
Q

1st vs 2nd (type I) vs 2nd (type II) vs 3rd heart block

A

long PR vs increasing PR until dropped P vs Randomly dropped QRS vs random P and QRS complexes

27
Q

Increased BaroR caused by? leads to?

A

increased pressure. Increased PSNS (and decreased SNS) to lower heart rate, contractility (point of Carotid massage)

28
Q

Central vs peripheral chemoreceptors?

A

stimulated by CO2 vs O2

29
Q

Circulation

1) largest share of cardiac output?
2) Higher blood flow per gram of tissue?
3) Organ with largest extraction of O2?

A

1 - liver
2 - kidney
3 - heart

30
Q

Causes of early cyanosis?

A 
Right to Left shunts:
Tetrology
Transposition
Truncus arteriosus
Tricuspid atresia (if with ASD and VSD)
TAPVR
31
Q

Congenital Causes of adult cyanosis.

A

ASD, VSD, PDA. Cause cyanosis after switching to become R-to-L shunts

32
Q

Boot Shaped heart on x-ray?

A

Tetralogy of fallot

33
Q

Infantile vs adult coarcation

A

before vs after ductus arteriosis

34
Q

Xanthomas - histo?

A

Multinucleated giant cells with lipids

35
Q

Corneal arcus?

A

Lipids in eyes

36
Q

Califications in blood vessels in this location does no affect blood flow?

A

Media

37
Q

Pt with DM. Likely will get disease of what vessels?

A

Arterioloes

38
Q

Arteriolosclerosis - types?

A

Hyaline - HTN/DM

Hyperplastic - Onion skinning

39
Q

Pt with plaques in vessels. Affects what vessels?

A

Atherosclerosis. Arteries

40
Q

Most common location of atherosclerosis? Complication?

A

abdominal aorta. Abdominal aneurysm

41
Q

Thoracic aortic aneurysm - causes?

A

Marfans
HTN
Syphilis

42
Q

Myocardial stunning?

A

gradual regaining of function post MI

43
Q

MI as cells lose energy form ishemia they release this to vasodilate. Where does it come from?

A

ATP - ADP - AMP - Adenosine (dilates)

44
Q

Evolution of MI

A

time points: 0, 4, 12, 24, 4, 12

see 271

45
Q

Pathologic Q waves?

A

transmural infarct

46
Q

Tropoinin vs CKMB

A

peaks in 4 hours and stays elevated vs peaks in a day and dips

47
Q

MI, what can rupture (leads to?)

A

1) free wall - cardiac tamponade
2) papillary muscle - Mitral Regurg
3) Interventricular septum rupture - VSD

48
Q

Ventricular aneurysm - cause lead to?

A

arrythmia or CHF. Will not rupture

49
Q

Causes of high output cardiac failure?

A

Thiamine deficiency
Graves dz
AV-fistula
Pagents dz

50
Q

Bacteria involved? Endocarditis vs Rheumatic fever

A

growth on values vs no bacteria on valves

51
Q

Pt with thick, calcified leaflets on mitral valves. Hx may show?

A

Rheumatic fever

52
Q

SIgns of Bacterial Endocarditis?

A

FROM JANE

Fever, roth spots, oslers, nodes, murmur, janeway lesions, anemia, nail hemorrage, emboli

53
Q

Signs on rheumatic fever?

A

FEVERSS

fever, increased ESR, valular damage, Erythema marginatum, Red-hot joints, subcutaneous nodules, Sydenham’s chorea

54
Q

Pericarditis: Fibrinous vs serous vs suppurative

A

Fibrinous - dresslers/uremia
Serous - viral/RA/SLE
Suppurative - bacterial

55
Q

Pulsus paradoxus - seen in?

A

Cardiac tamponade, asthma, sleep apnea, croup

56
Q

Medium vessel vasculities? Risk of?

A

PAN, Kawasakis, Buerger’s. Infarction

57
Q

Small vessel vasculities? Mech?

A

Type III HSR - see purpura

Microscopic polyangiits, wegners, Churg-Strauss, Henoch-Schonlein purpura

58
Q

Strawberry vs cherry hemangioma?

A

infants, will regress vs elderly, will not regress

59
Q

Vessel growth seen in pregnancy?

A

Pyogenic granuloma. Hemangioma that can ulcerate and bleed

2nd Time Through (23 decks)

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