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IM > CARDIO > Flashcards

CARDIO Flashcards

1
Q

Common causes of HFpEF

A

Aging
Obesity
Hypertension

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2
Q

High cardiac output, low SVR HF causes

A

Thiamine deficiency

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3
Q

occurs when there is normal or increased cardiac function and low systemic vascular resistance, but the heart is unable to supply the body’s demands.

A

High output failure

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4
Q

Concentric hypertrophy: A.
Eccentric Hypertrophy: B

A

A. Pressure Overload (HPN, AS)
B. Volume overload (MR, AR)

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5
Q

Potent vasoconstrictors

A

Aldosterone
Angiotensin II

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6
Q

Vasodilators

A

Bradykinin
Nitric Oxide
Natriuretic Peptides

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7
Q

Inactivates bradykinin

A

Neprilysin

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8
Q

MOA of Diuretics in HF

A

Decreasing pressure within the abdominal compartment, improving renal perfusion

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9
Q

alternatingly strong and weak pulse resulting from variation in the left ventricular stroke volume with every cardiac cycle because of incomplete LV recovery.

A

Pulsus Alternans

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10
Q

exaggerated fall in a patient’s blood pressure during inspiration by greater than 10 mm Hg seen in cardiac tamponade and constrictive pericarditis,

A

Pulsus Paradoxus

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11
Q

weak pulse seen among patients with aortic stenosis.

A

Pulsus parvus et tardus

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12
Q

increased pulse with double systolic peak seen in aortic regurgitation.

A

Pulsus bifriens

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13
Q

Indicates severe biventricular heart failure and is a marker of poor outcome.

A

Kussmaul’s sign
- rise in JVP with inspiration

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14
Q

indicates right-sided heart failure, without necessarily involving the left side.

A

Hepatojugular reflex

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15
Q

Loud P2 component of S2 is seen in patients with

A

Pulmonary Hypertension

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16
Q

Echo findings:

asymmetric hypertrophy of the septum, with the mitral valve moving anteriorly towards it during systole.

A

HOCM

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17
Q

Echo

Pseudonormalization of the mitral inflow velocity pattern

A

Diastolic dysfunction

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18
Q

Echo

billowing of the mitral valve leaflets into the left atrium during systole

A

MVP

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19
Q

Micro infarcts consistent with small vessel ischemia and thrombosis secondary to endothelial dysfunction is a classic histopathology findings

A

Stimulant-induced cardiomyopathy

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20
Q

a typical viral syndrome occurs without cardiac symptoms but with elevated biomarkers

A

Possible sub clinical myocarditis

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21
Q

a typical viral syndrome occurs with cardiac symptoms but with elevated biomarkers

A

Probable Acute Myocarditis

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22
Q

Pericarditis happens after a myocardial infarction

A

Dressler’s syndrome

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23
Q

Main therapeutic agent for Prinzmetal angina

A

Nitrates
CCB

24
Q

Hemodynamic evidence of systolic function appears when contraction is impaired by _______, whereas infarction of _______% leads to shock.

A

A. 10-25%
B. >40%

25
Q

Chemo therapeutic agent according to their myocardial damage

Recurrent coronary spasm leading to decreased myocardial contractility

A

5FU, cisplarion, other alkylating agents

26
Q

Chemo therapeutic agent according to their myocardial damage

cause myocardial damage via mitochondrial damage and inhibition of DNA repair

A

Anthracyclines (doxorubicin)

27
Q

Chemo therapeutic agent according to their myocardial damage

blocks the normal HER2 action on the cardiomyocytes.

A

Trastuzumab

28
Q

Chemo therapeutic agent according to their myocardial damage

endoplasmic reticulum stress and inflammation among myocytes.

A

Tyrosine Kinase İnhibitors

29
Q

click and murmur of MVP occur earlier and intensify with

A

standing
strain phase of the Valsalva maneuver and
any intervention that decreases LV volume (preload)

30
Q

Click and murmur of MVP is delayed, moves away from S1 or even disappears with

A

squatting
isometric exercises, and
passive leg raising which increase LV volume

31
Q

Hemodynamic hallmark of MS

A

Abnormally elevated left ateioventricular pressure gradient

> elevated pulmonary venous and arterial wedge pressures
increased pulmonary vascular resistance, leading to elevation in the right ventricular end-diastolic pressure
LV diastolic pressure is normal in isolated MS.

32
Q

Favors a diagnosis of ASD over MS

A

Absence of left atrial enlargement and Kerley B lines

33
Q

3 Major determinants of Myocardial Oxygen Demand

A

Heart Rate
Myocardial Contractility
Myocardial Wall tension

34
Q

Determinant of adequate oxygen supply

A

Level of oxygen carrying capacity of blood: inspired O2, pulmonary fxn, hb concentration
Level of coronary flow

35
Q

Contraindications to exercise stress testing

A

rest angina within 48 hrs
unstable rhythm,
severe aortic stenosis
acute myocarditis
uncontrolled heart failure
severe pulmonary hypertension and
active infective endocarditis.

36
Q

most typical symptom is intermittent claudication, which is defined as a pain, ache, cramp, numbness, or a sense of fatigue in the muscles; it occurs during exercise and is relieved by rest.

A

PAD

37
Q

buttock, hip, thigh, and calf discomfort occurs in patients with A?

whereas calf claudication develops in patients with B?

A

A. aortoiliac disease
B. femoral-popliteal disease.

38
Q

Patients complain of rest pain or a feeling of cold or numbness in the foot and toes. Frequently, these symptoms occur at night when the legs are horizontal and improve when the legs are in a dependent position. When, rest pain may be persistent.

A

Critical Limb Ischemia

39
Q

episodic digital ischemia, manifested clinically by the sequential development of digital blanching, cyanosis, and rubor of the fingers or toes after cold exposure and subsequent rewarming. A sensation of cold or numbness or paresthesia of the digits often accompanies the phases of pallor and cyanosis.

A

Raynaud’s Phenomenon

40
Q

vasculitic disorder associated with exposure to cold wherein raised erythematous lesions develop most commonly on the toes or fingers in cold weather.

A

Pernio

41
Q

characterized by burning pain and erythema of the feet more frequently than the hands.

A

Erythromelalgia

42
Q

arterial vasoconstriction and secondary dilation of the capillaries and venules with resulting persistent cyanosis of the hands and, less frequently, the feet,

A

Acrocyanosis

43
Q

Edema, stasis dermatitis, and skin ulceration near the ankle may be present if there is

A

Supervicial venous thrombosis

44
Q

increased leg circumference, venous varicosities, edema, and skin changes.

A

Deep Venous insufficiency

45
Q

combination of induration, hemosiderin deposition, and inflammation, and typically occurs in the lower part of the leg just above the ankle.

A

Lipodermatosclerosis

46
Q

white patch of sear tissue, often with focal telangiectasias and a hyperpigmented border; it usually develops near the medial malleolus.

A

Atrophie blanche

47
Q

Surgical revascularization in acute limb ischemia is indicated in patients with

A

Restroration of blood flow must occur within 24 hours to prevent limb loss
Symptoms of occlusion is present > 2 weeks

Amputation:
Limb is not viable (loss of sensation, paralysis, absence of Doppler detected blood flow in both arteries and veins

48
Q

Findings indicative of high risk for intracradiac complications from IE

A

Congestive Heart Failure
New regurgitant murmur
New electrocardiographic conduction changes

49
Q

Most common complication with aortic valve infection (10-15% with NVE, 45-60% with PVE)

A

Perivalvular extension

50
Q

Antibiotics for Viridans group IE highly susceptible to Penicillin

A

Pen G
Ceftriaxone
Vancomycin
Pen G + Genta

*4 weeks

51
Q

Early PVE (within 2 months) etiologies

A

S. Aureus
CoNs
Fac gram neg bacilli
Diphteroids
Fungi

52
Q

Staph PVE MSSA antibiotics

A

Nafcillin, oxacillin, flu + Genta + Rif

MRSA:
Vanco + Genta + Rif

  • 6-8 weeks
53
Q

Major indication for cardiac surgery in IE

A

Mod to Severe HF

54
Q

Lake Louise Criteria for mycoarditis (MRI)

A

2 out of 3

  1. Abnormal T2
  2. Early gd enhancement
  3. Late gd enhancement

Revise Criteria
Both
1. T2 with edema
2. T1 with inflammation

55
Q

Most commonly non-infectious inf affecting the myocardium

A

Granulomatous myocarditis (inc sarcoidosis and giant cell myocarditis)

56
Q

Doppler ultz of tamponade

A

> tricuspid and pulmonic valve flow velocities increase markedly during inspiration
pulmonic vein, mitral, and aortic flow velocities decrease.

In tamponade,
> there is diastolic inward motion (collapse) of the right ventricular free wall and the right atrium.

IM (7 decks)

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