Cardio Flashcards
1
Q
When does autoregulation of coronary blood flow breakdown?
A
> 75%
2
Q
> 90% stenosis may be what?
A
Insufficient at rest
3
Q
When does most perfusion of coronary artery occur?
A
Diastole
4
Q
What is stable angina?
A
Not getting worse predictable effects!
5
Q
Unstable angina/
A
Unpredictable coronary artery spasm-
6
Q
Crescendo angina is bad because?
A
pain at rest, unpredictable getting worse
7
Q
What is ACS not acronym actual conditions?
A
Acute MI +/- ST elevation crescendo angina
8
Q
STEMI affects what parts of heart?
A
Full thickness myocardium necrosis “transmural”
9
Q
NSTEMI is physiologically what?
A
Partial block to a coronary artery sub-endocardial
10
Q
After X weeks you cannot tell how old an infarct is?
A
4 around
11
Q
creatine kinase type thats mostly cardiac?
A
MB type
12
Q
Complications of MI?
A
Arrhythmia, rupture, infarct extension, aneurysm
13
Q
What is dresslers syndrome?
A
secondary pericarditis due to cardiac injury
14
Q
Mural thrombus?
A
Thrombus or thrombi that adhere to vessel wall
15
Q
LDL receptor gene frequency>
A
1/500
16
Q
Apolipoprotein B frequency?
A
1/1000
17
Q
When to start worrying about sustained BP?
A
Sys = >140 Dia = >90
18
Q
Causes of secondary HTN?
A
Cushings, phaeochromocytoma,
19
Q
What does HTN do to kidneys?
A
Slow decline in renal function :(
20
Q
Cerebral problems with HTN?
A
Haemmhorage and berry aneurysms
21
Q
Hypertensive crisis talk?
A
> 180/120 quick onset, organ damage and stroke risk!
22
Q
Pulmonary hypertension?
A
++ blood pressure in pulmonary artery
23
Q
Pulmonary hypertension causes?
A
Many loss of vasculature, idiopathi, or secondary to left failure
24
Q
What can pulmonary HTN cause?
A
Right heart failure
25
Left or right failure causing oedema?
Right venous return
26
Where is renin released from?
Juxtaglomerular apparatus
27
What does renin do?
Angiotensinogen to angiotensin I
28
Angiotensin II cause what to be released?
Aldosterone = bp higher
29
Where is angiotensin I converted?
Lungs
30
What is conns syndrome
Excess aldosterone from "somewhere"
31
Conns syndrome most likely cause?
Adrenocortical adenoma
32
Conns syndrome biochem?
+aldosterone -renin -K+
33
Phaeochromocytoma symptoms?
HTN, nervousness, sweating, flushing, headaches, pallor
34
Phaeochromocytoma ?
Adrenal medulla tumour
35
24 hr urine collection for diagnosis of what?
Phaeochromocytoma adrenaline metabolites
36
Difference between cushings syndrome and disease?
Syndrome is by any steroid you have taken etc disease = pituatary lesion usually
37
Cause of cushings disease?
Adrenacortico neoplasm, or pituatary adenoma (80%) cases
38
Which cancer may produce adrenacorticotopic hormone?
Small cell lung producing ACTH
39
Left sided heart failure?
Congestion, PND, dyspnoea, orthopnoea,,cyanosis
40
Right sided heart failure?
Ascites, congestive splenomegaly, transudates and pleural effusion
41
BOXCAR nuclei consistent with what finding in autopsy?
Congestive heart failure
42
70% of all valvular heart disease involves which?
Aortic and mitral
43
Mitral stenosis is associated with what?
Rheumatic fever
44
Aortic stenosis can cause hypertrophy of what?
Left ventricle in abscence of HTN
45
What is mitral annular calcification?
Calcification of mitral skeleton- usually no dysfunction, may be regurg
46
Causes of Aortic regurg?
Rheumatic, infectious, dilatation syphillis or rheumatoid arth)
47
Mitral regurg (prolapse) causes?
Infection, fen Phen, Pappillary muscle problems, mitral ring calcification
48
WHat does myxomatous mean?
Weakening of connective tissue
49
MVP is more common in which sex?
Women
50
Mid systolic click characteristic of what?
MVP
51
Holosystolic murmur of MVP present only is what ?
There is regurg
52
What is tetrology of fallot?
Right ventricular hypertrophy, overriding aorta, VSD, pulmonary stenosis
53
Which chromosome important for heart development
22
54
Characteristics of L-R shunts?
All D's in names, no cyanosis, pulmonary hypertention- significant = irreversible.
55
Characteristics of R-L shunts ?
All T's in name, cyanosis (blue baby) Venous emboli become systemic (paradoxical)
56
Most common congenital heart defect?
VSD often with fallot
57
Continuous machine like murmur?
PDA
58
> 1/3 AVSD seen in ?
Downs
59
R-L from what?
Tetralogy,transposition, truncus, tricuspis atresia
60
What is endocarditis?
colonisation and or invasion of heart valves or chamber by microbe
61
Prognosis for acute endocarditis?
Poor, highly virulent organism, often fatal and requires surgery.
62
Sub-acute infective endocarditis prognosis?
Lower virulent organisms, less destructive often cured with antibiotics, but can be a wax and wane course
63
Common causes of infective endocarditis?
MVP, stenosis, artificaila valves, bicuspid AV
64
Most common organism causing endocarditis?
Strep viridans (from mouth ) 50-60%
65
Staph aureus endocarditis common in which group of people?.
IV drug users
66
prosthetic valves often infect with what?
s. epidermis (coag negative)
67
Strep bovis prompts what?
bowel cancer investigation
68
Characteristics of vegetations in acute IE?
Single, multiple bulky and friable
69
% of left heart IE with murmurs?
90%
70
pneumonic for IE?
FRoth spots OM JANE
71
Marantic endocarditis aka?
NBTE non bacterial
72
Non bacterial endocarditis occurs in who?
Debilitated patients usually
73
What are vegetation sin non infective endocarditis like?
Small, sit on valve leaflets, minimal local effect
74
SLE is associated with what type of endocarditis?
Libman -sacks
75
In libman sacks endocarditis which valves are affected?
Mitral and tricuspid
76
Characteristic of vegetation in libman sacks?
Small warty and pink vegetations often on under surfaces
77
What is diagnostic histologically for rheumatic fever?
Aschoff bodies in all layers
78
Classical valve changes in rheumatic fever?
Mitral- called vurrucae vegetation (virtually only cause of mitral stenosis)
79
Fishmouth abnormality associated with what?
Mitral stenosis of rheumatic fever
80
What criteria are used to diagnose rheumatic fever?
Jones
81
Pericarditis causative organims?
Coxsackie virus, bacteria etc
82
Acute pericarditis is more ...
inflamed (serous, purulent etc)
83
Chronic pericarditis characteristic?
Adhesive
84
Serous pericarditis causes?
Non infectious usually
85
Serofibrinous pericarditis causes?
Acute MI, dresslers
86
Cheesy pericarditis in what infections?
TB
87
Pain associated with pericarditis?
Pleuritic, relieved by sitting forwards
88
Complication of pericarditis?
Pericardial effusion
89
Main causes of dilated cardiomyopathy?
Genetics, cytoskeletal protein mutation-
| alcohol and chemo too
90
Age of dilated cardiomyopathy?
young usually 20-50 bad survival
91
5 year survival of dilated cardiomyopathy?
25%
92
Hypertrophic myopathy is what?
Hypertrophy in absence of obvious cause, diastolic dysfunction with preserved systolic
93
Histological hypertrophy?
Disarray of myocytes
94
Is hypertrophic cardiomyopathy genetic?
Yes 100%
95
Murmur in cardiomyopathy?
Systolic ejection
96
n atheletes can be caused by what?
Hypertrophic and or arrythmogenic right ventricular cardiomyopathy
97
Restrictive cardiomyopathy affects what part of heart?
Myocardium is non compliant decrease in ventricular compliance
98
Cause of arrythmogenic right ventricular cardiomyopathy?
Fibrofatty replacement if right ventricle- disorder of cell-cell desmosomes exercise = detachment and death of cells
99
Myocarditis infective causes?
Coxsackie, chaga disease (south america), diptheria borellia (lymes)
100
Histology of vasculitis?
Blue dots in blood vessel
101
Most common form of vasculitis?
Giant cell arteritis
102
Pathology of giant cell artertitis?
Chronic granulamatous, large to medium arteries- esp in head
103
Importance of recognising temporal arteritis?
Can involve opthalmic artery = blindness :(
104
Morphology of GCA?
Intimal thickening, ganulamatoud inflammation, multinucleated giant cells
105
Classic symptoms of temporal arteritis?
pain tneder temporal region, and jaw claudication (paind on eating in temples)
106
How much artery to sample with temporal artery?
2-3cm!
107
Main risk factor for rupture of AAA
Size >6cm
108
What is a dissecting aneurysm?
Tear in wall, blood tracks between layers
109
Dissecting aneurysm symptoms?
Tearing pain radiating to left shoulder
110
What is charcot bouchard aneurysm?
Occur in intracerebral cappilaries in hypertensive disease
111
Tertiary syphillis can cause what aneurysms?
Ascending thoracic aneurysm
112
False aneurysm?
Blood filled space around a vessel, usually following traumatic rupture or perforating injury
