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USMLE Step 1 > Cardio > Flashcards

Cardio Flashcards

1
Q

What is epinephrine reversal?

A

Epi + phentolamine (non-selective alpha antag) = epi acts as vasodilator and decreases HR

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2
Q

Which antiarrhythmics prolong QT interval?

A

Class IA: Quinidine, Procainamide, Disopyramide (Quid Pro Do)
Class III: Amiodarone, Ibutilide, Dofetilide, Sotalol (AIDS)

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3
Q

What characterizes mitral stenosis?

A

LA pressure > LV pressure towards the end of diastole

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4
Q

What characterizes mitral regurg?

A

LA pressure > LV pressure towards the end of systole

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5
Q

What is Hypertrophic cardiomyopathy (aka HOCM)?

A

Assymetric cardiac hypertrophy: characterized by increased ejection fraction and impaired diastolic function
Causes syncope during exercise and may lead to sudden death in young athletes

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6
Q

Whats the equation for net filtration pressure?

A

(Hc-Hi)-(Oc-Oi)

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7
Q

What is coartation of the aorta?

A

Constriction of the aorta that decreases perfusion of the kidneys –> activates RAAS system –> increased systolic pressure

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8
Q

What drug do you use to treat Tetralogy of Fallot until surgery can be done?

A

Alprostadil (prostaglandin E1)

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9
Q

What maintains a PDA? what closes it?

A

Maintains: Prostaglandin E (like Alprostadil)
Closes: NSAIDs (Indomethacin)

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10
Q

What are 4 effects of chronic HTN on vasculature?

A
  1. decreased # of arterioles
  2. thickened arteriole walls
  3. increased vascular resistance of end organs
  4. ischemic/hemorrhagic end organ damage
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11
Q

What are the early side effects of digoxin toxicity?

A

anorexia, nausea, ecg canges

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12
Q

What are the late side effects of digoxin toxicity?

A

disorientation, yellow-green halos, cardiac arrhythmias

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13
Q

What is the path of drainage for the ovaries?

A

Right ovarian –> IVC
Left ovarian –> left renal –> IVC

Same applies to testicles.

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14
Q

What are the hallmarks of coartation of the aorta?

A

Brachial-femoral delay (HTN in upper extremities, weak pulse in lower)
Collateral arteries erode inferior aspect of ribs

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15
Q

What are the effects of ACEI toxicity?

A 
CATCHH:
Cough (brady block)
Angiodema
Teratogen
Creatinine increase
HyperK
HypoTN

Switch to AngioII block (Losartan)

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16
Q

Anterograde flow through which arteries is responsible for weak lower pulses in coartation of the aorta?

A

Internal thoracic (mammary) arteries

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17
Q

What is a common side effect of fibrates that activate PPAR-α?

A

LUQ pain (gallstones)

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18
Q

What is transposition of the great vessels?

A

Aorta and Pulm are switched = separates systemic and pulm circulations = death unless theres a shunt

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19
Q

Hallmarks of transposition of the great vessels?

A

Diabetic mother; early cyanosis

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20
Q

What is a concern for using beta-blockers in diabetics?

A

They block the symps of hypoglycemia with tachycardia

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21
Q

Cocaine-induced inhibition of which receptor causes cardiac arrest?

A

cocaine is a beta-blocker = unopposed alpha1-agonism

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22
Q

What is the clinical manifestation of VSD?

A

child* w holosystolic murmur that radiates over the precordium* and a palpable thrill at the left sternal border*
adult = tricuspid regurg

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23
Q

What transmitter/receptor comes into play in the anticipation of exercise (or anxiety)?

A

Norepinephrine, B1

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24
Q

What is the consequence for severing the glossophrangeal nerve?

A

Sends the medulla a false signal that theres a decrease in blood pressure –> HTN and tachy

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25
What is a side effect of the repeated blood transfusion needed in Beta-thalasemia?
Fe overload --> hemosiderosis --> restrictive cardiomyopathy
26
Which beta-blocker is best used in asthmatics?
B1-(cardio)selective like atenolol
27
How to remember the beta-blockers?
A-M are B1-selective, N-Z are non-selective; C & L block all (carvedilol & labetalol block a, b1, b2)
28
How does sepsis lead to pulm edema?
increase microvascular permeability
29
Which vein is the major accessory pathway for pts with portal HTN?
azygous vein (anterolateral aspect of spine)
30
What causes Thrombotic thrombocytopenic purpura?
deficiency of ADAMTS 13 (vWF metalloprotease) = platelet aggregates and thrombi
31
What cardiac structure can be found in the 3rd intercostal space of the left sternal border?
AV node
32
When does coronary blood flow occur?
diastole
33
How does nitroglycerin affect a normal person's cardiac function?
decrease LV-EDV and decrease LV-ESV (bc BOTH arteries and veins are dilated)
34
What is amourosis fugax and what causes it?
painless transient vision loss from atherosclerotic disease of the carotid (microemboli to ipsi eye)
35
What is the pathogenesis of atherosclerotic plaques?
fatty streak --> fibrous plaque --> rupture of plaque --> rough surface induces clotting --> thrombotic occlusion of artery --> MI
36
What causes increased blood flow thru coronary arteries due to aortic stenosis?
Adenosine (vasodilator)
37
Enlargement of which chamber causes esophageal compression?
Left atrium
38
What is a paradoxical embolism?
Patent foramen ovale has clots bypass pulm and go into brain (stroke) and other organs
39
Which beta blocker is contraindicated in angina?
Pindolol bc its a partial agonist and thus does not lower HR enough
40
What causes varicose veins?
chronically high pressure in the leg veins
41
Which drugs cause gynecomastia?
``` Some Drugs Create Awesome Knockers Spironolactone, Digoxin, Cimetidine, Alcohol, Ketoconazole ```
42
What causes "double bubble" on xray in infants?
Duodenal atresia bc inadequate migration of neural crest cells
43
Whats the drug of choice for pts with HOCM?
beta blocker
44
How do loop diuretic contribute to digoxin toxicity?
They cause hypoK and hypoMg
45
What is niacin used to treat and what is its biggest side effect?
dyslipidemia; lowers levels of VLDL and raises levels of HDL. -facial flushing (aspirin helps)
46
How does anemia affect arterial diameter?
Causes small arteries and arterioles to dilate to allow greater amounts of blood to return to the heart
47
#1 cause of death in men and women?
cardiovascular disease
48
Where does the thoracic portion of the esophagus get blood supply?
branches of the aorta and the bronchial arteries.
49
What is the most common cause of renovascular HTN in middle-aged women?
Fibromuscular dysplasia (also has beads on string) -atherosclerosis in men
50
What is the classic presentation of Dressler Syndrome (fibrinous pericarditis)?
fever, positional substernal chest pain (prefer upright or lean forward), and friction rub 4-6wks after MI
51
What are the classic findings of aortic dissection?
- sudden, severe chest pain radiating to the back - aortic regurg w diastolic murmur - wide mediastinum on x-ray
52
What is digoxin MOA?
decreases conduction thru AV node by inhibiting Na-K ATPase (for A-fib w rapid ventricular rate)
53
What additional finding often accompanies aortic regurg?
widened pulse pressure
54
What disease is dextrocardia (situs inversus) assoc with?
Kartagener disease (immotile cilia due to a dynein arm defect.)
55
Associate the change in pressure pulse with disease: increased pulse pressure
``` arteriosclerosis aortic regurg (dec diastolic) ```
56
Associate the change in pressure pulse with disease: decreased pulse pressure
``` aortic stenosis mitral stenosis (inc diastolic) ```
57
Associate the change in pressure pulse with disease: increased diastolic pressure
mitral stenosis
58
Associate the change in pressure pulse with disease: decreased diastolic pressure
aortic regurg | PDA
59
What is a cystic hygroma?
Cavernous lymphangioma of the neck; creates the webbed neck in Turner syndrome.
60
What causes unstable angina?
thrombosis (of coronary artery) with incomplete coronary artery occlusion
61
What causes angina?
atherosclerosis
62
The smooth part of the right atrium comes from which embryonic structure?
Sinus venosus
63
What causes muffled heart sounds?
cardiac Tamponade
64
What is Beck's triad for cardiac tamponade?
1. hypoTN 2. JVD 3. muffled heart sounds
65
What clinical signs strongly suggest pulm embolism?
1. sudden hypoemia 2. afebrile/bedridden 3. but normal BP
66
What condition causes loss and vacuolization of myocytes with fibrosis in the heart?
chronic stable angina
67
You have an older pt with a history of MI, what would make you think of CHF?
(new) S3 heart sound
68
What causes a primum type ASD?
Failure of septum primum to fuse completely w endocardial cushions, leaves a persistent ostium primum
69
What drug is used to treat pregnant women w chronic HTN?
methyldopa (a2-agonist)
70
What drug is used to treat HTN and BPH?
Terazosin (a1-antagonist)
71
What are key side effects of Terazosin?
"first dose" syncope/hypoTN/dizziness
72
What pharmacotherapy is used to treat methemoglobinemia?
methylene blue
73
Where do the right and left umbilical arteries arise from?
internal iliac arteries
74
What happens to the umbilical arteries after birth?
They obliterate and become the medial umbilical ligaments
75
Which 2 enzyme elevations indicate atypical MI?
AST(w/o ALT increase) and lactate dehydrogenase
76
Which antihypertensive meds cause lipid abnormalities?
metoprolol and thiazides
77
Which drug class causes gout by decreasing elimination of uric acid?
Thiazide diuretics

USMLE Step 1 (13 decks)

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