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2024 - élo - usmle rx qbank > cardio > Flashcards

cardio Flashcards

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USMLE® Step 1 flashcards
1
Q

subacute vs acute endocarditis

A

acute —s taph aureus and quick onset

subacute —- prosthetic vavles strept virdian

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2
Q

his patient presents with decreased distal pulses, dry gangrene, and ulceration over the digits. Together, these findings indicate a diagnosis of

A

buerger disease

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3
Q

history of sharp pain at rest but not while exercising

A

prinzmetal

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4
Q

pt has essential hyp and prizmetal angina plus wants to become pregnant
whats the best medicaiton

A

hydrochlorothiazide

amlodipine

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5
Q

bblocker overdose txt

and the cellualr signalling pathway

A

glucagon

activate Gs adenyl cyclase

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6
Q

which vasculitis has a . Granulomatous infiltrate

A

giant cell arteritis

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7
Q

cystic hygroma

A

cystic hygroma is a congenital malformation resulting in lymph accumulation in jugular lymphatic sacs; it is caused by congestion of the lymphatic system in the neck.
in turners or down

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8
Q

which pattern of inheritence is demonstrated by AD conditions likes BRCA 1

A

incomeplete penetrance

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9
Q

Loss of hetrozygosity

A

oss of heterozygosity is a phenomenon in which an individual who previously lost an allele (usually congenitally) loses the last and final allele due to an additional insult. This occurrence is well represented by the two-hit hypothesis in which loss of two alleles is required to activate a proto-oncogene. Retinoblastoma (Rb) gene is a well known example in which Rb mutations can either be sporadic or inherited.

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10
Q

pt works in a factory with high exposure to nitrates

what can this condition be

A

mondays disease
Monday disease, reflex tachycardia, dizziness, hypotension, flushing, and headache occur on Monday with re-exposure to nitrates
most severe consequence occurs when compensatory vasoconstriction is unopposed in critical areas such as the coronary vessels, leading to nonatherosclerotic-related cardiac ischemia.

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11
Q

digeorge pharyngeal arch or pouch

A

POUCH 3 4

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12
Q

treatment of septic shock and the receptors this drug works on

A

norepi

alpha1>2> beta1

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13
Q

short term SVT txt

A

diltiazem

negative dromotropic effect

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14
Q

which antiarrythmic drug can cause torsade pointes

A

sotalol

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15
Q

what drug is given to treat vent fibrillation

A

amiodarone

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16
Q

centrally acting hypertension medication

can cause

A

clonidine

presynaptic alpha 2 agonism …. decrease sympathetic outflow

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17
Q

virus causing pericarditis

A

small non enveloped single stranded RNA virus

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18
Q

the only two double stranded RNA virus

A

colti virus

rotavirus

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19
Q

what would increase prevalance but not incidence

A

better healthcare quality

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20
Q

sacubitril mechanims

A

inhibits neprilysin

which is responsible for deactivating ANP BNP … which help reduce BP

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21
Q

he compensatory neurohumoral mechanisms of CHF include

A

The activation of the RAASproduces an increase in the level of angiotensin II and aldosterone, which both function to increase sodium reabsorption in the kidneys.

Increased sympathetic output by the central nervous system
Increased activation of the RAAS
Increased secretion of ADH

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22
Q

acute SVT first second third line therapy

A

vagal manneuver
adenosine
BB

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23
Q

HCM treatment

A

BB or nondehydropyridine ca channel blocker

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24
Q

describe murmur in HCM

A

when heart it full murmur decreases (squatting)

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25
Q

atient presented with unexplained palpitations, tachycardia, and shortness of breath. These signs indicate that she should be evaluated for an

A

arrythmia

possibly SVT

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26
Q

treatment given to a patient iwth SVT
causes sudden drop in pressure and flushing
name of drug

A

adenosine
denosine is a very short-acting drug that is useful in terminating certain forms of supraventricular tachycardia by hyperpolarizing the cell and decreasing atrioventricular (AV) node conduction. Adverse effects include flushing, hypotension, chest pain, bronchospasm, and a sense of impending doom.

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27
Q

34-year-old man comes to the physician due to difficulties speaking and swallowing due to mitral stenosis
why is he having such symptoms

A

The left recurrent laryngeal nerve loops beneath the aortic arch leaving it vulnerable to compression from an enlarging left atrium in rare cases. Such an obstruction can also compress surrounding structures such as the esophagus, resulting in hoarseness and aphonia (loss of voice). In extremely severe cases, the enlargement of the left atrium may cause difficulty swallowing.

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28
Q

pt is on simvastatin
developds community acq pneumonia
txt is given and he expereiences muscle aches
WHY

A

Macrolides also inhibit the cytochrome P-450 enzyme, CYP3A4, which metabolizes simvastatin. Increased serum concentration of simvastatin results in simvastatin-associated muscle pain that may evolve to rhabdomyolysis.

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29
Q

Inherited defects of myocyte ion channels cause what condition

A

long QT syndrom

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30
Q

heart condition assoc to marfan

A

MVP
aortic regurg
mitral regurg

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31
Q

adenosine mechanism

A

Adenosine is an antidysrhythmic that hyperpolarizes the cell via potassium channels and inhibits L-type calcium channels. It will not significantly affect the calcium flow.

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32
Q

in order to reach the IVC … an umbilical vein catheter must pass thru which ductus

A

ductus venosus!!

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33
Q

nitroglycerin physiological impact

A

reduces PRELOAD

reduces oxygen demand by heart muscle

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34
Q

SLE endocarditis vegetations

A

SMALLLLLLLLL verrucous

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35
Q

fibrates mechanims

A

upregulate lipoprotein lipase

and activate PPR

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36
Q

umbilical vessels

A 
one vein (oxygenated)
two arteries
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37
Q

what is coronary dominance

A

which artery supplies the PDA

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38
Q

treatment of choice fortype IIa and IIb familial hyperlipidemia.

A

high dose statin

and ezetemib

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39
Q

statin with cholestyramine

A

NO

it will decrease absp of statin toooo

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40
Q

normal essential HTN drugs

A

thiazaide
CCB
ACEi

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41
Q

in blacks treatmnt for HTN

A

thiazide and long acting ACEi

42
Q

necrotizing granulomas are seen in whcih type of vasculitis

A

polyangitis granulomatos

43
Q

necrotizing vasculitis with eosinophilia

A

churg straus

44
Q

igA complex deposition

A

henoch schonlen

45
Q

segmental thrombosing vasculitis

A

beurger

46
Q

drug x is given which causes increase in systolic diastolic and MAP
after the affect is worn off another drug Y is given before drugX is given again … now the BP DECREASES

A

drug x epinephrine (a b receptors)
drug y phenoxybenzamine
phenoxy blocks the a1 affects of epi ….. means only b1 and b2 rec are activated

47
Q

patient presents with severe chest pain, a history of hypertension and type 2 diabetes mellitus, and asymmetric pulses in the upper extremities

A

aortic dissection

cardiac tamponade complication

48
Q

define kawasaki disease

A 
Kawasaki disease is an acute necrotizing vasculitis of medium to small muscular arteries. 
CRASH
conjunctival injection
Rash
adenopathy
strawberry tongue
fever
49
Q

digoxin effects on heart

A

increase EF

decrease HR

50
Q

reperfusion injury histology

A

Contraction bands on histology following MI are caused by massive calcium influx, and result in hypercontraction of the sarcomeres

51
Q

inhibition of hormone senstive lipase

A

niacin
increases HDL
also decreases triglyceride

52
Q

what is a serious side effect of hydralazine

A

reflex tachy

use labetolol

53
Q

when is flecainide used

A

it is also used for intractable supraventricular tachycardia.

54
Q

lidocaine use

A

lass Ib antiarrhythmic, is used in the treatment of acute ventricular arrhythmias such as postmyocardial infarction arrhythmias.

55
Q

PDA in a baby can be caused by which infection

A

rubella
fever lymphadenopathy arthralgia
rash from face down

56
Q

many of the adverse effects are related to central nervous system (CNS) depression
fatigue drowsiness

A

clonidine

centrally acting

57
Q

internal jugular vein anatomy

A

within the carotid sheath lateral to the common carotid artery and anterior to the vagus nerve.

58
Q

stenosis/regurgitation vs endocarditis/RHF

A

stenosis in RHF

regurg in endocarditis

59
Q

post MI fibrillation

A

1b lidocaine … decrease AP ARP

60
Q

cardiac remodelling with sarcomeres added in parallel

A

concentric hyprtrphy

diastolic dysf

61
Q

long qt syndrome with sensorineural deafness

which ion chanel involved

A

Jervell and Lange-Nielsen syndrome is an autosomal-= recessive condition caused by mutated voltage-gated potassium channels. Individuals commonly present with sensorineural deafness, a family history of sudden death, and a prolonged QT interval on ECG (>420 ms).

62
Q

L-type Ca2+ channels mutation causes

A

malignant hyperthermia

63
Q

ostium primum wall defect

A

. Ostium primum septal defect is seen in the lower portion of the septum at the level of the tricuspid and mitral valves. It is also known as endocardial cushion defect. It is associated with mitral and tricuspid valve defects as well as Downsyndrome.

64
Q

2 days post MI

pt has pleuritic chest pain … widespread ST elevations … and friction rub

A

fibrinous pericarditis

65
Q

ventricullar wall ruptture post MI occurs after

A

2-8 days

66
Q

troponin levels

A

after 6 hours
can peak by 24
down in 2 weeks

67
Q

CKMB

A

peak by 24 and down by 72

used to check for reinfarction

68
Q

buproprion mechanism in smoking cessation

A

blocks reuptake of norepi and dopamine

69
Q

what factors predispose digoxin toxicity

A

amiodarone
verapamil
quinidine
hypokalemia

70
Q

brugada

A

Brugada syndrome is an inherited sodium channel abnormality that leads to arrhythmias in young men.

71
Q

The Gαq subunit

A

The Gαq subunit is part of a G-protein pathway that activates phospholipase C (PLC) after exchanging guanosine diphosphate (GDP) for guanosine triphosphate (GTP). As a result, PLC splits phosphatidylinositol bisphosphate (PIP2) into diacylglycerol (DAG) and inositol trisphosphate (IP3). As a result, protein kinase C is activated and calcium levels increase intracellularly resulting in muscle contraction.

72
Q

amiodarone mechanism

A

prolonging the repolarization phase via potassium channel blockade.

73
Q

how to improve HDL

A

aerobic exercise and weigh tloss

74
Q

how can an epidural hematoma present (what type of herniation)

A

causes increased ICP
transtentorial herniation
CN III palsy

75
Q

acute kidney injury can lead to what electrolyte imbalance

A

hyperkalemia

76
Q

which BB acts by decreasign phase 4 of pacemaker cells

A

The β-blocker metoprolol is the only cardioselective β-blocker among the options listed. It acts by decreasing the slope of phase 4 in cardiac pacemaker cells.

77
Q

old pt has P.HTN i chose BMP2 is the cause

A

Patients with hereditary pulmonary arterial hypertension typically present at a younger age and do not have pulmonary crackles.

78
Q

reinke crystals

A

Reinke crystals are found in Leydig cell tumors of the testis. They are plump, rod-like cytoplasmic inclusions.

Cytoplasmic inclusionLeydig cell tumor
Bottom Line:

79
Q

mechanism of fibrates

A

Fibrates activate peroxisome proliferator-activated receptor α to decrease expression of 7-α-hydroxylase, which catalyzes the rate-limiting step of bile acid synthesis.

80
Q

risk factor for AAA

A

smoking
atherosclerosis
HTN is more for thoracic AA

81
Q

pressures of heart

A

The right atrium has a normal mean pressure range of 1-8 mm Hg.
The right ventricle has a normal pressure range of 1-30 mm Hg.
The mean pulmonary artery wedge pressure is normally 4-12 mm Hg and identical to that of the pulmonary artery diastolic pressure.
The left ventricle would normally have a dramatically higher peak systolic pressure (>90 mm Hg).

82
Q

causes of dialated cardiomyopathy

A

Dilated cardiomyopathy has several causes, including chronic alcohol abuse, beriberi, coxsackie B myocarditis, chronic cocaine use, Chagas disease, and doxorubicin toxicity.

83
Q

causes of dialated cardiomyopathy

A

Dilated cardiomyopathy has several causes, including chronic alcohol abuse, beriberi, coxsackie B myocarditis, chronic cocaine use, Chagas disease, and doxorubicin toxicity.

84
Q

granulomatous inflammation with mononuclear and giant cells

A

giant cell arteritis

85
Q

mitarzapine

A

Mirtazapine is a selective α2-receptor antagonist used in the management of depression.

86
Q

granulomatous inflamamtion of cardiac myocytes is a sign of

A

Granulomatous inflammation of cardiac myocytes is characteristic of infiltrative diseases such as sarcoidosis.

87
Q

dialated CM after viral infectino

A

autoimmune attack on cardiomyocytes

88
Q

incidence formula

A

new cases / population at RISK

so subtract ppl that already have diseas

89
Q

amiodarone works on which phases of action potential

A

phase 2 3

90
Q

how does norepi effect heart rate

A

it decreases heart rate

a1 causes vasoconstricton which increases blod flow bak to heart… this increases SV … and lowers hr

91
Q

which heart tumor is assoc with Tuberous sclerosis

A

rhabdomyoma

92
Q

seizures, intellectual disability, and facial angiofibromas

A

TS

93
Q

turner has a specific typoe of coarctation of aorta

A

The most common is coarctation of the aorta, a congenital narrowing of the descending aorta, usually just distal to the origin of the left subclavian artery and opposite the ductus arteriosus (and so termed “juxtaductal”). If the left subclavian artery is involved, juxtaductal coarctation of the aorta can result in a small left arm because of compromised blood flow.

94
Q

central line technique

A

lateral to commmon carotid artery

95
Q

MVP murmur increased by

A

valsalva

low flow brings the mid systolic click closer to S1

96
Q

s1q3t3 found in

A

P embolism

97
Q

which antiarrythmic can cause tosade pointes

A 
class I a and III
ibutilide
98
Q

tyoes of amyloidosis

A

AL amyloidosis, also known as primary amyloidosis, which is due to immunoglobulin light chain deposition arising from bone marrow antibody production (most common type)
AA amyloidosis, also known as secondary amyloidosis, which occurs as a consequence of chronic inflammation
β2-microglobulin amyloidosis, which is related to long-term dialysis in patients with renal failure
Familal/senile ATTR amyloidosis, which is either inherited or acquired in old age

99
Q

wpw treatment

A

procainamide 1A

100
Q

hydralazine most imp side effect

A

sudden vasodialataion … activate baroreflex

can cause angina

101
Q

increase her cardiac contractility and decrease her peripheral vascular resistance.

A

milrinone

pde5 inhibitors

2024 - élo - usmle rx qbank (29 decks)

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