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FA: random > Cardio > Flashcards

Cardio Flashcards

1
Q

Truncus arteriosus (TA)

A

Ascending aorta and pulmonary trunk

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2
Q

Bulbus cordis

A

Smooth parts (outflow tract) of left and right ventricles

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3
Q

Primitive atria

A

Trabeculated part of left and right atria

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4
Q

Primitive ventricle

A

Trabeculated part of left and right ventricles

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5
Q

Primitive pulmonary vein

A

Smooth part of left atrium

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6
Q

Left horn of sinus venosus (SV)

A

Coronary sinus

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7
Q

Right horn of SV

A

Smooth part of right atrium

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8
Q

Right common cardinal vein and right anterior cardinal vein

A

SVC

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9
Q

Aortic area murmurs

A

Systolic murmur =>
Aortic stenosis
Flow murmur
Aortic valve sclerosis

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10
Q

Left sternal border murmurs:

A

Diastolic murmur=>
Aortic regurgitation
Pulmonic regurgitation

Systolic murmur =>
Hypertrophic cardiomyopathy

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11
Q

Pulmonic area murmurs

A

Systolic ejection murmur =>
Pulmonic stenosis
Flow murmur (e.g., physiologic murmur)

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12
Q

Tricuspid area murmurs

A

Pansystolic murmur=>
Tricuspid regurgitation
Ventricular septal defect

Diastolic murmur =>
Tricuspid stenosis
Atrial septal defect

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13
Q

Mitral area murmurs

A

Systolic murmur =>
Mitral regurgitation

Diastolic murmur =>
Mitral stenosis

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14
Q

BEDSIDE MANEUVER Inspiration

A

increase intensity of right heart sounds

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15
Q

BEDSIDE MANEUVER Hand grip (increase systemic vascular resistance)

A

Increase intensity of MR, AR, VSD murmurs
decrease intensity of AS, hypertrophic cardiomyopathy murmurs

MVP: increase murmur intensity, later onset of click/murmur

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16
Q

BEDSIDE MANEUVER Valsalva (phase II), standing (decrease venous return)

A

decrease intensity of most murmurs (including AS)
increase intensity of hypertrophic cardiomyopathy murmur

MVP: decrease murmur intensity, earlier onset of click/murmur

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17
Q

BEDSIDE MANEUVER Rapid squatting (Increase venous return,increase preload, increase afterload with prolonged squatting)

A

decrease intensity of hypertrophic cardiomyopathy murmur
increase intensity of AS murmur

MVP: increase murmur intensity, later onset of click/murmur

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18
Q

Name the systolic heart sounds

A

aortic/pulmonic stenosis,
mitral/tricuspid regurgitation,
ventricular septal defect.

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19
Q

Name the diastolic heart sounds

A

aortic/pulmonic regurgitation,

mitral/tricuspid stenosis.

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20
Q

ECG P wave

A

atrial depolarization

Atrial repolarization is masked by QRS complex

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21
Q

ECG PR interval

A

conduction delay through AV node (normally < 200 msec).

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22
Q

ECG QRS complex

A

ventricular depolarization (normally < 120 msec).

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23
Q

ECG QT interval

A

mechanical contraction of the ventricles.

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24
Q

ECG T wave

A

ventricular repolarization.

T-wave inversion may indicate recent MI.

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25
Q

ECG ST segment

A

isoelectric, ventricles depolarized.

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26
Q

ECG U wave

A

caused by hypokalemia, bradycardia

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27
Q

Give the speed of conduction in heart

A

Purkinje > atria > ventricles > AV node.

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28
Q

Give pacemakers of heart

A

SA > AV > bundle of His/ Purkinje/ventricles.

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29
Q

What Rx prolong the QT interval?

A 
Sotalol
Risperidone (antipsychotics) 
Macrolides
Chloroquine
Protease inhibitors (-navir) 
Quinidine (class Ia; also class III) 
Thiazides
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30
Q

RV MI => name area, coronary artery & ECG leads

A

inferior wall (RV);
RCA
II, III, aVF

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31
Q

Septum MI => name coronary artery & ECG leads

A

LAD for anterior 2/3 of septum; RCA for posterior 1/3;

V2, V3

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32
Q

LV MI => name area, coronary artery & ECG leads

A

lateral wall of LV;
left circumflex artery;
I, aVL, V5, V6

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33
Q

Aortic stenosis murmur => location & sound

A

Left 2nd ICS radiating toward carotid or cardiac apex;

crescendo-decrescendo systolic ejection murmur

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34
Q

Mitral regurg murmur => location & sound

A 
cardiac apex (confused w/ TR); 
holosystolic blowing murmur => louder on inspiration;
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35
Q

Define sarcomere. What is it composed of?

A

Z line to Z line (Z line=middle dark line bw light areas);

composed of thick filament (myosin) & thin filaments (actin, troponin, tropomyosin)

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36
Q

Role of T tubule

A

carry AP into cell interior

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37
Q

Location & role of intercalated disks

A

ends of cells & mediate adhesion bw cells

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38
Q

Location & role of gap junctions

A

occur at intercalated disks;

provide path of low resistance for AP to rapidly spread

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39
Q

What happens in S1 heart sound?

A

MV & tricuspid valve close => MV closes before so can be split

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40
Q

What happens in S2 heart sound?

A

AV & PV close => AV closes first;

inspiration causes increase S2 split

41
Q

What happens in S3 heart sound? What does it mean?

A

at end of rapid ventricular filling;
normal in kids & pregnant;
adults have dilated CHF

42
Q

What happens in S4 heart sound? What does it mean?

A

Filling of ventricle by atrial systole;
not normally audible in adults;
signifies high atrial pressure or stiff ventricle

43
Q

What physical exam will identify RHF?

A

JVD

44
Q

Slope of Y descent decreases when? increases when?

A

decreases in tamponade => RA empties slower

increases in constrictive pericarditis

45
Q

What increases O2 consumption?

A

increases in after load, contractility, HR, size of heart

46
Q

What increases Mean systemic pressure?

A

increased blood volume;
decreased venous compliance (blood shifted from veins to arteries);
exercise (SANS)

47
Q

Name the 7 ways BP is regulated

A

Short term => baroreceptor reflex active & activity increases BP
Long term => RAAS;
Relative term => cerebral ischemia to hypercapnia, hypoxia w/ < PO2, severe volume depletion leading to ADH; ANP from atrial stretch; autoregulation

48
Q

What is the highest resistance in the CV system? what are they responsible for?

A

arterioles => largest drop in perfusion pressure

49
Q

What has the highest proportion of blood in CV?

A

veins

50
Q

What has largest total cross sectional & surface area? What does it facilitate?

A

capillaries => gas exchange

51
Q

What are the roles of histamine & bradykinin in vasculature?

A

mediate arteriolar dilation & venous constriction

52
Q

What is role of serotonin in vasculature?

A

arteriolar constriction

53
Q

Name the different roles of types of prostaglandins in vasculature

A

prostacyclin => vasodilator

TXA-2 => vasoconstrictor

54
Q

What increases Hct to increase resistance of flow?

A

polycythemia;
hyperproteinemia (multiple myeloma);
hereditary spherocytosis

55
Q

What increases turbulence (bruits)?

A

decreased blood viscosity (anemia);

increased blood velocity (narrow vessel, increased CO)

56
Q

Edema caused by increase in capillary hydrostatic pressure?

A

increased venous pressure;

standing (edema in dependent limbs)

57
Q

Edema caused by decreased in capillary oncotic pressure?

A 
decrease in plasma protein 2' to:
decreased synthesis (liver dz);
decreased intake (protein malnutrition);
increased excretion (nephrotic syndrome)
58
Q

Edema caused by increasing the filtration coefficient?

A

burn;

inflammation (sepsis)

59
Q

What typically causes a transudate?

A

increased capillary hydrostatic pressure or decreased capillary oncotic pressure

60
Q

What typically causes an exudate?

A

more permeable vessels => increased filtration coefficient;

vessel becomes leaky & protein & fluid leave

61
Q

What are the locations & corresponding leads…inferior? anterior?

A

inferior => II, III, aVF

anterior=> V1-V6

62
Q

What does the PR interval depend on? tachycardia?

A

depends on conduction velocity through AV node & HR;

shortens

63
Q

Differentiate Mobitz type I vs type II AV blocks

A

PR interval in type I lengthens until beat is dropped;

PR interval remains constant before dropped beat in type II

64
Q

What is a mural thrombus? what is a risk factor for LA mural thrombus?

A

adheres to wall of heart or artery;

mitral stenosis is risk factor for LA mural thrombus

65
Q

What is MCC of atrial fib in US?

A

HTN

66
Q

What is the initial DOC for Tx of primary HTN?

A

thiazides

67
Q

How do ACE-inhibitors lower mortality & morbidity in diabetic HTN?

A

decrease renal HTN by decreasing efferent arteriolar vasoconstriction to decrease intraglomerular pressure to lessen proteinuria

68
Q

Define primary aldosteronism

A

HTN, hypokalemia, metabolic acidosis (increased aldosterone, decreased renin)

69
Q

Medial calcification of radial, ulnar, tibial, uterine or femoral arteries have what Sx?

A

benign medial calcification of medium sized arteries does NOT INVOLVE the intima so does NOT obstruct arterial flow

70
Q

Define arteriolosclerosis. When is it most often seen?

A

affects intima of small arterioles & arteries;

seen in elderly, diabetics, metabolic syndrome, HTN

71
Q

Differentiate the 2 types of arteriolosclerosis

A

hyaline => protein deposits in arterial wall to narrow lumen => seen in diabetics due to NEG;
=>in HTN pt from pressure forcing proteins into wall causing increased muscle & elastic tissue

hyperplastic => malignant HTN => increased smooth muscle proliferation & BM duplication to onion skinning

72
Q

Where are aneurysm’s typically found? why?

A

below level of renal arteries due to fewer vasa vasorum in the media of these vessels leading to increased risk & damage of ischemia

73
Q

What is the MC etiology of myocarditis?

A

viral => coxsackie B, rubella, CMV => lymphocytic infiltrates

74
Q

When is bacterial myocarditis seen? what are usual bugs?

A

immundodeficiency/suppression =>

S aureus; Corynebacterium diphtheriae, Haemophilus influenzae

75
Q

Other than bacteria, pt w/ HIV get myocarditis how?

A

toxoplasmosis or Kaposi’s sarcoma

76
Q

What are diseases & Rx that can cause myocarditis?

A

Chagas, Lyme, acute renal failure, rheumatic fever, lupus, doxorubicin

77
Q

How does myocarditis present?

A

muffled S1; S3; MR murmur

diffuse T wave inversion & ST elevations => Bx is best Dx

78
Q

Bacterial cause of endocarditis assoc w/ prosthetic device

A

Staph epidermis w/in first 6 months;

after 6 mo then S. aureus & viridans

79
Q

Bacterial cause of endocarditis assoc w/ colon cancer

A

Strept bovis

80
Q

Bacterial cause of endocarditis assoc w/ dental procedure

A

Stept viridans

81
Q

Bacterial cause of endocarditis assoc w/ GI surgery

A

enterococcus

82
Q

Bacterial cause of endocarditis assoc w/ total parenteral nutrition

A

fungal

83
Q

Bacterial cause of endocarditis assoc w/ alcoholics or homeless

A

Bartonella henselae

84
Q

Bacterial cause of endocarditis assoc w/ fastidious & culture negative

A

HACEK organisms => Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella

85
Q

Nutmeg liver on histology

A

congestion of centrilobular veins surrounded by paler region

86
Q

What are the treatments for acute decompensated CHF?

A 
LMNOP
Lasix (furosemide);
Morphine
Nitrates;
O2;
Position upright
87
Q

Murmur of MVP is seen in who? what makes it worse?

A

Marfan’s & young women; SLE; mucopolysaccharidoses (hurler & hunter); hypothyroidism; Ehlers-Danlos
Valsalva makes it worse

88
Q

What does S3 in older adult mean?

A

occurs in early diastole & implies volume overload

89
Q

What does TR murmur increase w/ inspiration?

A

blowing holosystolic murmur at L LSB due to increase in venous return to R side of heart

90
Q

What are the ONLY 2 murmurs that do not increase intensity w/ squatting & decrease in intensity w/ valsalva?

A

MVP & hypertrophic cardiomyopathy

91
Q

What types of patients are typically assoc w/ PDA? what is a common complication?

A

premature & congenital rubella;

endarteritis

92
Q

Where do red (hemorrhagic) infarcts occur? pale infarcts

A

red infarcts => tissues w/ collateral circulation => lung, intestine, post-reperfusion

pale infarcts => solid tissue w/ single blood supply => brain, kidney, spleen

93
Q

How does septic shock mimic artervenous fistula (high flow state)?

A

ALL arterioles are vasodilator leading to increased CO

94
Q

What can LAD infarction cause?

A

LBBB, anterior wall rupture & mural thrombi

95
Q

What can RCA infarction cause?

A

LV papillary rupture, posterior flail leaflet & MR

96
Q

How does constrictive pericarditis present?

A

Kussmaul’s sign & pericardial knock

97
Q

Compare platelet counts in Henoch Schonlein purpura & ITP

A

platelet counts normal to elevated in HSP;

decreased in ITP

98
Q

Pt w/ Sx in multiple organ systems & palpable purpura, what should be highest on Ddx?

A

small vessel vasculitis

FA: random (15 decks)

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