cardio

Question 1

diseases that can cross placenta (ToRCHeS)

Answer 1

• toxoplasmosis
• rubella
• CMV
• HPV/HIV
• syphilis

Question 2

maternal risk factor for PDA

Answer 2

-rubella

Question 3

5 T’s pf neonatal cyanosis

Answer 3

-tetralogy of ballot, transposition of the great vessels, truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous return

Question 4

kawasaki disease (what is it, who gets it, symptoms, dangerous complication)

Answer 4

• acute, self-limiting vasculitis, small and medium vessels
• common in… asians
• fever, conjuntivitis, changes in lips/oral mucosa, rash
• SE: coronary aneurysms

Question 5

pathophysiology of viral myocarditis

Answer 5

• infection with– coxsakie, influenza, HIV, CMV, adeno, and echo virus– leads to dilated cardiomyopathy and CHF
• direct myotoxicity via receptor mediated pathway

Question 6

sensitive and specific test for CHF

Answer 6

• sensitive: elevated b-type natriuretic peptide

- specific: S3

Question 7

reflex bradycardia effect

Answer 7

• consequence of norepi administration
• increased systemic vascular resistance and return blood flow (alpha 1) increased contractility (beta 1) means that SV and CO increase, so HR can decrease reflexively

Question 8

asymmetric pulses (cause, and feared complication)

Answer 8

• aortic dissection until proven otherwise

- tamponade

Question 9

why is that really pregnant lady hypotensive while laying down?

Answer 9

• IVC compression

- tx: lay on left side

Question 10

familial hypercholesterolemia

Answer 10

-AD defect in cholesterol receptor

Question 11

major risk factors for aortic dissection

Answer 11

-HTN and cystic medial necrosis (associated with Marfans)

Question 12

umbilical arteries (what do they do, what happens if you’re missing one)

Answer 12

• transport deoxygenated blood from fetus to placenta

- not a problem on its own, but often an indication of other underlying cardiac or renal abnormality

Question 13

giant cell arteritis

Answer 13

• same thing as temporal arteritis
• most common systemic vasculitis
• granulomatous inflammation
• tx with steroids to prevent blindness

Question 14

most common cause of pericarditis

Answer 14

-viral…coxsackie: picornavirus, positive single stranded naked icosahedral RNA virus

Question 15

thoracic coarctation of the aorta is associated with…

Answer 15

bicuspid aortic valve

Question 16

embryologic origin of the smooth parts of the left and right ventricles

Answer 16

-bulbus cordis

Question 17

pompe disease and cardiac effects (pathophys and ECG)

Answer 17

• type II glycogen storage disorder, due to lack of alpha-1,-glucosidase enzyme, necessary for debranching
• glycogen is deposited in the myocardium
• ECG shows short PR and wide QRS

Question 18

post-ductal coarctation of the aorta (signs and risks)

Answer 18

• higher BP in upper extremities than in lower, rib notching

- risk of cerebral hemorrhage and bacterial endocarditis

Question 19

rheumatic heart disease causes… (valve, histo, cell types)

Answer 19

-mitral valve stenosis, aschoff bodies with giant multinucleated cells and anitschkow cells

Question 20

takayasu arteritis (demographic, signs, path)

Answer 20

-asian women, “pulseless disease”, granulomatous changes

Question 21

most common cardiac defect in Turners syndrome

Answer 21

-coarctation of the aorta, 3-10%

Question 22

electrolyte imbalance in Digoxin tox… (and symptoms)… what makes it worse

Answer 22

• hyperK, peaked T, blurry and/or yellow vision

- hypoK, K and Digoxin compete for the binding site on Na/K/ATPase, when there is lowK, even more Dig binds