Cardio Flashcards
What predisposes to aortic aneurysms as opposed to aortic dissection?
Aneurysm = atherosclerosis. Dissection - HTN.
Guy has a blocked LAD and circumflex coronary artery - what graft do they use?
They use the left internal thoracic artery if one vessel. Otherwise, great saphenous vein.
Where does the great saphenous vein run and where do surgeons harvest?
Along the medial foot and leg/thigh draining into femoral vein in proximal anteromedial thigh. It join the femoral vein in femoral triangle immediately inferior to pubic tubercle where surgeons harvest.
Describe the bifurcations leading into the IVC
They are formed by the union of the R and L common iliac veins at L4-L5. Renal arteries/veins lie at L1.
What tissue expresses ACE?
Expressed in the vascular endothelium, particularly lungs. Converts AT1 to AT2 and degrades bradykinin.
Necrotizing vasculitis of the URI and LRI (nasal ulcerations, sinusitis, hemoptysis) with oliguria has abs against what?
Neutrophils. C-ANCA. Wegener’s. Target NE proteinase 3.
Atorvastatin would do what with LDL receptor density
Increase them.
What heart chamber can compress the esophagus and cause dysphagia?
Left atrium, posterior chamber. TEE is closest to it.
What part of the aorta is the TEE closest to?
The descending thoracic aorta. L anterior surface of vertebral column and POSTERIOR to esophagus and L atrium. 3 branches of heart: brachiocephalic, L common carotid, L subclavian arteries.
If a patient has extensive atheroscloerosis and near-total occlusion of LAD but no necrosis or scarring…why?
If it’s slow enough growth, vessels can anastoamosis around it preventing any damage. Note: rich lipid cores, active inflammation of atheroma and fibrous caps are more prone to rupturing.
If a patient has MRSA endocarditis and complains later of muscle pains and serum CK are up, how does the abx work?
Daptomycin, for gram+. Depoliarzation of cellular membrane by creating electrolyte channels. Myopathy and CPK elevation. Inactivated by pulmonary surfactant.
How does Korotkoff sounds function?
Basically pulvus pardoxus. Normally, systole is R heart blood filling. In constrictive cases, cannot push to L. Therefore, L diastolic volume and SV reduced, hence drop in SBP.
Intimal fatty streaks are what and can cause what
AAA. Intimal lipid-filled foama cells derived from MO and smooth musce cells that engulfed lipoproteins, predominantly LDL. Then go into injured, leaky endothelium.
What starts a aortic dissection?
Intimal tear
A patient with normal heart dies. Histology show prominent intracytoplsaic granules that are yellowish-brown. What are they?
Lipfuscin - product of lipid peroxidation and free radical injury. Common in mal-nourished patients or cachexic patients.
