CARDIO Flashcards
Which vessel type accounts for the majority of total peripheral resistance?
arteriole
Anterosuperior displacement of the infundibular septum results in __________
Tetralogy of Fallot
What are the 3 histologic layers of the valves?
Ventricular layer and Spongiosa (spongiosa is where myxomatous change may occur), as well as fibrous
Tx of Microscopic polyangiitis
corticosteroids and cyclophosphamide
Why are there muscle pains in Giant Cell arteritis?
It is associated with polymyalgia rhuematica
What murmur is heard in acute rheumatic fever? Chronic?
Carey-Coombs (if valvulitis is present); Mitral stenosis
Which vasculitis is associated with a strawberry tongue?
Kawasaki disease
What antibodies are present in Scleroderma with CREST and diffuse scleroderma?
Anti-centromere in CREST scleroderma; diffuse scleroderma = Scl-70
What are you approximating with the pulmonary capillary wedge pressure (PCWP)?
Left Atrial Pressure
What is Felty Syndrome?
Splenomegaly, neutropenia, and repeated infections (you “felty” the spleen)
What is a pyogenic granuloma?
A capillary hemangioma that ulcerates and bleeds
What protein do fibrates upregulate?
lipoprotein lipase
What kind of conditions would cause wide splitting of S2?
Anything that delays RV emptying, such as pulmonic stenosis and RBBB? This causes splitting REGARDLESS of breath
How do you treat HOCM?
BB and CCB
Which CV disease is associated with Friedrichs ataxia?
HOCM
What is the function of chylomicrons?
Deliver dietary lipids (main component is triglycerides)
2 infectious causes of dilated cardiomyopathy
Coxsackie B and Chagas disease
Endocarditis with spaghetti and meatballs appearance is most likely obtained via what route?
IVDA i.e. a Candida infection
Which murmur is loud at the apex and radiates to the axilla? What murmur radiates to the carotids?
Mitral regurgitation; Aortic stenosis
What dermatologic finding may be associated with early onset glaucoma?
Nevus flammeus in sturge weber
What is the main AIDS related pathology of the stomach?
Kaposi Sarcoma
What are the two most common causes of hyaline arteriolosclerosis?
Diabetes and essential hypertension
Why is stroke volume increased in pregnancy?
There is more blood
Compare and contrast the carotid sinus and aortic arch baroreceptors
Carotid sinus responds to increase and decrease in BP and sends info via CN IX to the nucleus solitarius? Aortic arch responds ONLY to increase BP and sends info via CN X to nucleus solitarius
What is Carney Syndrome?
Atrial myxoma with blue nevi and lentigines
Where to the SMOOTH parts of the left and right ventricles come from?
Bulbus cordis (trabeculated parts come from primitive ventricles)
Why are veins more susceptible to being a route for metastasis than arteries?
Veins have thinner walls
What lipid-lowering agent can cause acanthosis nigricans?
Niacin
Contrast Mobitz I and Mobitz II
These are both second degree AV blocks? The difference is that Mobitz I (Wenckebach) has longer and longer PR intervals until a beat is dropped. Mobitz II involves dropped beats as well usually with a 2:1 P to QRS ratio? Type I is usually asymptomatic and Type II is usually symptomatic…. The Tx of symptomatic bradycardia can involve atropine, DA, epi and transvenous pacing
Explain the transcriptional regulation of cholesterol synthesis by SREBP and SCAP
SREBP is Sterol Regulating ER binding protein and binds DNA to activate HMG-CoA reductase synthesis? When high cholesterol is present, it binds SCAP which then binds SREBP, changing its conformation and preventing cholesterol synthesis
What do the right and left horns of the sinus venosus give rise to?
right = smooth part of right atrium, left = coronary sinus)
What forms the medial umbilical ligaments? Median umbilical ligaments?
medial = umbilical arteries, median = urachus
What 3 uncorrected lesions may lead to Eisenmenger’s syndrome?
PDA (don?t forget this one!!), ASD, and VSD
What are 3 causes of mediastinal widening?
Aortic dissection, Thoracic aortic aneurysm, and Pulmonary anthrax
What cancer is associated with spindle cells in the dermis?
Kaposi Sarcoma
How do HDL and Nascent chylomicrons interact? (What does HDL do for them?)
HDL (in the bloodstream) gives chylomicrons apoCII (to deliver to skm and adipose via LPL) and it also gives them ApoE in order to be accepted by hepatocytes
Explain Jervell and Lange-Nielsen Syndrome
This is a congenital long QT interval syndrome that affects the same K channel as the one in the ear, hence the deafness. This predisposes to Torsade de Pointes which is treated with magnesium sulfate
Why do heart transplant patients have atypical S/S of MI?
Because their nerves have been severed. They will not experience angina and will have silent MI’s
Explain the wavy fiber formation after an MI on histology?
Edema from acute inflammation leads to fluid between the fibers, giving them a wavy appearance
Define Sudden Cardiac Death
Death from cardiac causes WITHIN 1 HOUR OF SX
Coal worker pneumoconiosis with rheumatoid arthritis is called what?
Caplan syndrome
A kid with a foot and hand rash with conjunctival injection and angina likely has what?
Kawasaki disease
What is a good way to differentiate Kawasaki from Hand Foot and Mouth?
Kawasaki will also have CONJUNCTIVAL INJECTION
What should you think with a large serous pericardial effusion?
Likely malignant
When do S3 and S4 occur?
S3 is early diastole, S4 is late diastole
Explain how coarctation of the aorta could lead to aortic regurgitation
The proximal high pressure prior to the coarctation can lead to dilatation of the aortic root = aortic regurgitation
Tx of polyarteritis nodosa
corticosteroids and cyclophosphamide
in whom is an S3 normal?
Kids and Pregnant women
Which part of the heart conducting system has the fastest conduction?
Purkinje fibers (purkinje > atria > ventricles > AV node)
What drug might cause the right ventricle to become atrialized?
Lithium is a common cause of the Ebstein anomaly
Which vasculitis is associated with pauci-immune glomerulonephritis and palpable purpura?
Microscopic polyangiitis and Churg Strauss
What is a mycotic aneursym?
Septic embolus from bacterial endocarditis went to vasa vasorum of aorta and caused aneurysm
What effect does atrial natriuretic peptide have on sodium reabsorption?
Decreases its absorption at the medullary collecting tubule
What dysrhythmia can have P on T and P on ST phenomena?
3rd degree (p and qrs don?t agree!) AV block
What artery supplies the SA and AV nodes?
RCA
What is the function of ApoA-1 and ApoE on HDL?
ApoA-1 activates LCAT which esterifies cholesterol so that it stays in the core; ApoE is recognized by hepatocytes, it also gives ApoE to chylomicrons and VLDL
What is it called when sarcomeres are added in series? In parallel?
Sarcomeres in series = eccentric hypertrophy; sarcomeres added in parallel = concentric hypertrophy
What drug decreases hepatic secretion of VLDL?
Niacin–watch that cutaneous flush!
Explain the outflow tract obstruction in hypertrophic cardiomyopathy
The banana shaped ventricle places the septum too close to the mitral valve leaflet which has a Venturi effect and creates lift on the mitral valve pulling it in close and obstructing the tract
The ligamentum teres hepatis is contained in what larger CT structure?
falciform ligament
Name 2 large vessel vasculitides
Takayasu (pulsless dz) and Temporal arteritis
Which cardiac tissue has permanently inactivated sodium channels due to the less negative resting voltage?
Nodal tissue–AV and SA nodes. The If channel allows a less negative resting membrane potential so their spike is due to Ca not Na because there is no activation of voltage gated Na channels
What classes of antiarrhythmics may be used to Tx atrial flutter?
Anti-arrhythmics = Class IA, IC and III (you should also rate control with a BB or CCB); note that the goal of anti-arrhythmic therapy is to CONVERT to sinus rhythm
Myofiber disarray on histology
HOCM
What artery supplies the IV septum?
Anterior 2/3 is by LAD (septal branch), Posterior 1/3 is by the PDA which may arise from either the RCA or LCX
What is an anitschkow cell?
A histiocyte with a caterpillar nucleus inside an Aschoff body, typical of rheumatic endocarditis
What disease involves nevus flammeus, ipsilateral leptomeningial angiomatosis, AVM, siezures, and early onset glaucoma?
Sturge Weber
Which ASD type is associated with total or partial anomalous pulmonary venous return?
Sinus venosus ASD
What is type I AV block?
This is simply a prolonged PR interval (> 200 msec)
Which cardiac disease results from a B-myosin mutation?
Hypertrophic Cardiomyopathy
What kind of inflitrate willl you find in Bacillary angiomatosis and in Kaposi?
Bacillary angiomatosis = neutrophilic; Kaposi = monocytic (bc viral)
What is the most important factor in maintaining cardiac output late in exercise?
HEART RATE? Stroke volume plateaus but HR can maintain it to a point (CO = SV x HR)
Where do you see Erythema marginatum?
in rheumatic fever
Tx of Buerger’s Dz
Quit fucking smoking