Cardio Flashcards
1
Q
cardiac tissue conduction velocity
A
purkinje system –> atrial muscle –> ventricular muscle –> AV node
“Park AT VENTura AVenue”
2
Q
P-wave
A
atrial depolarization
3
Q
PR interval
A
conduction delay thru AV node (<200 ms)
4
Q
QRS complex
A
ventricular depolarization (<120 ms)
5
Q
QT interval
A
mechanical contraction of ventricles (depol + repol)
6
Q
T-wave
A
ventricular repolarization
7
Q
T-wave inversion indicates?
A
recent MI
8
Q
ST segment
A
ventricles depolarized
9
Q
U-wave caused be?
A
hypokalemia, bradycardia
10
Q
preference for Pacemaker activity?
A
SA > AV > bundle of His/Purkinje/ventricles
11
Q
conduction pathway of heart?
A
SA node –> atria –> AV node –> common bundle –> bundle branch –> Purkinje fibers –> ventricles
12
Q
AV node delay?
A
100 ms –> allow for ventricular filling
13
Q
how do ventricles depolarize?
A
from apex to base and endocardium to epicardium
14
Q
ST elevation indicates?
A
transmural MI
15
Q
QRS interval prolongation indicates?
A
ventricular dyssynchrony or slowed intraventricular impulse conduction
16
Q
prolonged QT interval
A
torsades de pointes
17
Q
no discrete P-waves
A
Afib
18
Q
“sawtooth” appearance of waves
A
atrial flutter
19
Q
no identifiable waves
A
Vfib
20
Q
common cause of Vfib in <30 y.o pt
A
hypertrophic cardiomyopathy
21
Q
PR interval prolonged
A
1st degree AV block
22
Q
P-wave not followed by QRS complex
A
2nd degree AV block = Mobitz type I = Wenckebach
23
Q
distinguishing feature of Wenckebach
A
progressive lengthening of PR interval until beat “dropped”
24
Q
2 or more P-waves to 1 QRS complex
A
Mobitz type II
25
distinguishing feature of Mobitz type II
not preceded by lengthening of PR intervals
26
narrow QRS complex
3rd degree AV block (complete)
27
atria and ventricles beat independently of each other (P waves have no relation to QRS complex)
3rd degree AV block (complete)
atrial rate faster (SA node) than ventricular rate (AV node)
28
uses accessory pathway (bundle of Kent)
WPW synd
29
early ventricular depolarization w/ delta waves at beginning of QRS complex
WPW synd
30
where does ANP work?
medullary collecting tubule
31
what presents w/ sharp chest that is worsened by inspiration and relieved by sitting up/leaning forward?
acute pericarditis
32
striking physical finding of acute pericarditis
friction rub
33
kussmaul's sign description + seen in?
INC in JVP on INSPIRATION instead of NORMAL DEC
```
constrictive pericarditis
restrictive cardiomyopathies
RA/ventricular tumors
right-sided HF
tricuspid stenosis
```
34
pulsus paradoxus description + seen in?
dec in amplitude of systolic BP by >= 10 mmHg during INSPIRATION
```
severe cardiac tamponade
asthma
obstructive sleep apnea
pericarditis
croup
```
35
bifurcation of abd aorta @ what level?
L4
36
IVC courses through what?
abdomen and inferior thorax in location ANTERIOR to the right half of the vertebral bodies
37
renal veins join IVC @ what level?
L1/L2
38
common iliac veins merge to become IVC @ level
L4
39
fibrinous pericarditis caused by?
Dressler's synd
uremia
radiation
40
serous pericarditis caused by?
viral pericarditis
| SLE, RA, etc. (noninfectious inflamm dz)
41
suppurative/purulent pericarditis caused by?
bacterial infections
42
cardiac tamponade triad?
hypotension
increased venous pressure (JVD)
muffled heart sounds
43
"tree-bark" appearance of aorta
tertiary syphilis (disrupts vasa vasorum)
44
cardiac myxomas are ass w/?
multiple syncopal episodes
45
V1-V4 leads w/ Q waves implies infarct in?
anterior wall (LAD)
46
V1-V2 leads w/ Q waves implies infarct in?
anteroseptal (LAD)
47
V4-V6 leads w/ Q waves implies infarct in?
anterolateral (LCX)
48
I, aVL leads w/ Q waves implies infarct in?
lateral wall (LCX)
49
II, III, aVF leads w/ Q waves implies infarct in?
inferior wall (RCA)
50
Cardiac Output (CO) = ?
HR x SV
51
Fick principle?
CO = rate of O2 consumption/(arterial - venous O2)
52
PT for? PTT for?
```
PT = extrinsic
PTT = intrinsic
```
"my PET uPITT caused me to BLEED"
PET = PT extrinsic (PT less letter, less factors)
PITT = PTT intrinsic (PTT more letters, more factors)
53
reduced LV compliance indicates what?
diastolic dysfunction ("stiff ventricle")
54
predom mechanism of HF in restrictive cardiomyopathy
diastolic dysfunction ("stiffer ventricle")
55
predom mechanism of HF in dilated cardiomyopathy
systolic dysfunction
56
what can lead to dilated cardiomyopathy?
viral myocarditis
alcohol toxicity
diphtheric myocarditis
doxorubicin/danorubicin tx
57
S1 =
mitral/tricuspid closure
| loudest @ mitral area
58
S2 =
aortic/pulmonary valve closure
| loudest @ left sternal border
59
S3 =
EARLY diastole
rapid ventricular filling phase
ass w/ increased filling pressures (mitral regurg, CHF) + common in dilated ventricles
normal in children + pregnant women
60
S4 =
"atrial kick"
LATE diastole
ass w/ ventricular hypertrophy
high atrial pressure (LA must push against stiff LV wall)
61
truncus arteriosus forms?
ascending aorta + pulm trunk
62
bulbis cordis forms?
SMOOTH parts of left/right ventricles (outflow tract)
63
primitive ventricle forms?
TRABECULATED left/right ventricles
64
primitive atria forms?
TRABECULATED left/right atria
65
left horn of sinus venosus forms?
coronary sinus
66
right horn of sinus venosus forms?
SMOOTH part of RA (sinus venarum)
67
SVC formed from?
right common cardinal vein and right anterior cardinal vein
68
mean arterial output =
CO x TPR
69
pulse pressure is proportional to?
stroke volume
70
factors that increase SV
increased PRELOAD
decreased AFTERLOAD
increased CONTRACTILITY
71
contractility and SV increased by
catecholamines
increased INTRAcell Ca
decreased EXTRAcell Na
Digitalis (blocks Na/K pump)
72
contractility and SV decreased by
```
beta blockade
HF
acidosis
hypoxia/hypercapnia
non-dihydropyridine CCB
```
73
afterload =
MAP
74
histo in temporal (giant cell) arteritis?
focal granulomatous inflamm (branches of carotid a.)
75
histo in Takayasu's arteritis
granulomatous thickening (of media of aortic arch @ branch pts)
76
histo in polyarteritis nodosa (PAN)
transmural inflamm of arterial wall w/ fibrinoid necrosis (except in lungs)
77
weird tx in Kawasaki dz
aspirin (bc never given to children)
78
histo in Buerger's dz (thromboangiitis obliterans)
segmental thrombosing vasculitis (necrotizing vasculitis involving digits) - often of tibial/radial a.
79
histo in microscopic polyangiitis
segmental fibrinoid necrosis (can be caused by AB use - penicillins)
NO granulomas
80
histo in Wegeners granulomatosis (granulomatosis w/ polyangiitis)
focal necrotizing vasculitis
necrotizing granulomas in lung
necrotizing glomerulonephritis
81
histo in Churgg-Strauss synd
granulomatous necrotizing vasculitis w/ eosinophilia (diff from MP)
82
histo in Henoch-Schonlein purpura
vasculitis 2ndary to IgA complex depositions
83
ECG changes in V1-V4, V5
LAD (anterior wall)
84
ECG changes in V1-V2
LAD (anteroseptal)
85
ECG changes in I, aVL
LCX (lateral wall)
86
ECG changes in V4-V6
LCX (anterolateral)
87
ECG changes in II, III, aVF
RCA (inferior wall)
88
common cause of death BEFORE reaching hospital in MI pts
arrhythmia (Vfib)
89
common cause of death in pt hospitalized for MI
cardiogenic shock (esp if large infarct)
90
cardiac tamponade in post-MI pt
ventricular wall rupture (up to 14 days after)
91
severe mitral regurg in post-MI pt
papillary muscle rupture
92
new VSD in post-MI pt
interventricular septum rupture
93
embolus from mural thrombus in post-MI pt
ventricular aneurysm formation (common 1 wk after)
94
friction rub 1-3 days after MI
fibrinous pericarditis
95
pulmonary wedge pressure is pretty equivalent to?
LA pressure
96
murmurs heard @ right 2nd ICS adjacent to sternum (aortic area)
SYSTOLIC MURMURS!
aortic stenosis (radiates to neck [carotids])
flow murmur
aortic valve sclerosis
97
murmurs heard @ left sternal border
systolic murmurs:
hypertrophic cardiomyopathy
diastolic murmurs:
aortic regurg (if caused by aortic root dilation, heard best @ RIGHT sternal border)
pulmonic regurg
98
murmurs heard @ left 2nd ICS adjacent to sternum (pulmonic area)
systolic ejection murmurs!
pulmonic stenosis
flow murmur (ex. ASD [mid-systolic ejection murmur])
99
murmurs heard @ left 4th ICS adjacent to sternum (aka "left lower sternal border" or the tricuspid area)
pansystolic murmurs:
tricuspid regurg (radiates to right sternal border)
VSD
diastolic murmur:
tricuspid stenosis
ASD
100
murmurs heard @ left 5th ICS at midclavicular line (apex of heart) (mitral area)
```
systolic murmur:
mitral regurg (radiates toward axilla)
MVP (late systolic crescendo w/ midsystolic click; loudest @ S2)
```
diastolic murmur:
mitral stenosis
101
murmur heard @ left infraclavicular region
PDA
102
valsalva increases intensity of what murmurs
MVP, hypertrophic cardiomyopathy
103
rapid squatting decreases the intensity of what murmurs
MVP, hypertrophic cardiomyopathy
104
in pacemaker action potential, what phase determines HR and how
slope of phase 4 (Na channels)
105
increasing afferent baroreceptor firing does what to HR?
decreases HR
106
Cushing reaction triad
HTN
resp depression
BRADYcardia! (due to reflex baroreceptor-induced)
