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Cardio Flashcards

1
Q

Murmur associated with Rheumatic Fever:

A

Mitral stenosis

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2
Q

Murmur associated with Infective endocarditis:

A

Mitral and/or tricuspid regurgitation

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3
Q

Mutation on HCM:

A

AD mutation in the beta-myosin heavy chain

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4
Q

Histo of HCM:

A

Inappropriate hypertrophy of LV myocardium and disordered arrangement of cardiac myofibrils (myofibril disarray)

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5
Q

Physiological changes in HC:

A 
Diastolic dysfunction
LV outflow obstruction (increase afterload)
Myocardial ischemia (d/t increased work of LV)
Normal coronary arteries
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6
Q

Murmur associated with HCM:

A

Systolic crescendo-decrescendo murmur b/w apex and left sternal border, radiating to the suprasternal notch

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7
Q

Murmur changes in HCM:

A

Decrease with increased preload and afterload (to relieve obstruction)
Increase with decrease preload and afterload

Decrease with squatting
Increase with standing after squatting

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8
Q

A split S2 indicates:

A

Lengthening of the RV ejection time with delayed closure of the pulmonary valve

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9
Q

When can you hear an S2:

A

Complete RBBB, pulmonary stenosis, and pulmonary HTN

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10
Q

What structure lies behind the LA and esophagus on TEE?

A

descending aorta

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11
Q

fever, pericardial friction rub, ST elevations in all leads

A

pericarditis

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12
Q

tx of pericarditis

A

NSAIDs

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13
Q

distended neck veins, distant heart sounds, hypotension, pulsus paradoxus

A

cardiac tamponade

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14
Q

electrical alternans

A

cardiac tamponade

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15
Q

prevents intestinal reabsorption of bile acid and forces liver to use cholesterol to make more bile acids

A

bile acid resins

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16
Q

prevents cholesterol absorption at the intestinal brush border

A

ezetimbe

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17
Q

upreulates LPL to increase TG clearance and activates PPAR-a to induce HDL synthesis

A

fibrates

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18
Q

inhibits lipolysis (HSL) in adipose tissue and reduces hepatic VLDL synthesis

A

niacin

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19
Q

inactivates LDL-R degradation, increasing the amount of LDL removed from bloodstream

A

PCSK9 inhibitors

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20
Q

hepatotoxicity and myopathy

A

AEs of statins

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21
Q

upset GI, decreased absorption of fat soluble vitamins and drugs, increased risk of chol. gallstones

A

AEs of bile acid resins

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22
Q

increased LFTs and diarrhea

A

AEs of ezetimbe

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23
Q

myopathy, cholesterol gallstones

A

AEs of fibrates

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24
Q

red flushed face decreased by NSAIDs, hyperglycemia, hyperuricmia, rash

A

AE of niacin

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25
myalgias, delirium, dementia, neurocognitive effects
AEs of PCSK9 inhibitors
26
renal impairment is a CI for use of...
fibrates
27
why you shouldn't use fibrates in patients with severe renal impairment....
fibrates can increase serum creatinine
28
treatment for chronic atrial fibrillation
Calcium channel blockers and beta blockers
29
bioprosthetic heart valves are subject to....
wear and tear, calcification leading to stenosis, perforation or tearing, leading to insufficiency
30
acute rheumatic fever presents with
pancarditis and acute LV failure
31
most common cause of hemorrhagic pericarditis
TB and metastatic carcinoma
32
LA dilation, systemic abscess, arterial aneurysm
complications of staphylococcal septicemia followed by mitral endocarditis
33
what medications should patients who undergo mechanical prosthesis be put on to avoid thrombotic complications?
anticoagulants (warfarin)
34
the most common toxin producing dilated cardiomyopathy
alcohol
35
most important cause of LVH and failure
systemic HTN
36
how long does troponin I levels stay elevated?
7-10 d
37
sensitive marker for myocardial injury w/in the first 24-48 hrs
CK-MB
38
How long does it take CKMB to return to normal
72 hrs
39
gross findings 0-24 hr post MI
none
40
light microscopy findings 0-24 hrs post-MI:
early coagulative necrosis, release of necrotic cell contents into blood stream (troponin), edema, hemorrhage, wavy fibers, neutrophils appear, reperfusion injury, hypercontraction of myofibrils via increased free calcium influx
41
complications 0-24 hrs post MI
ventricular arrhythmia, HF, cardiogenic shock
42
gross findings 1-3 days post MI:
hyperemia
43
light microscopy findings 1-3 days post MI
extensive coagulative necrosis, acute inflammation with neutrophils
44
complications 1-3 days post MI:
postinfarction fibrinous pericarditis, arrhythmia
45
gross findings 3-14 days post MI:
hyperemic border; central brown-yellow softening
46
light microscopy findings 3-14 days post-MI:
macrophages and granulation tissue at borders
47
what comprises granulation tissue?
type III collagen (fibroblasts), capillaries, and myofibroblasts
48
complications 3-14 days post-MI:
free wall rupture leading to cardiac tamponade; papillary muscle rupture leading to mitral regurgitation; interventricular rupture d/t macrophage mediated structural damage; LV pseudoaneurysm
49
gross findings 2 wks-months post-MI:
recanalized artery, gray-white scar
50
light microscopy findings 2 weeks-months post-MI:
contracted scar complete, increased collagen deposition and decreased cellularity
51
complications 2 weeks-months post-MI:
Dressler syndrome, HF, arrhythmia, true ventricular aneurysm (w/ a risk of mural thrombus)
52
plaque disruption with superimposed mural thrombosis gives rise to...
unstable angina
53
MC of fibrinous pericarditis...
uremia following renal failure
54
top 3 causes of fibrinous pericarditis:
uremia, RA and Dressler syndrome
55
top 2 causes of serous pericarditis:
Lupus and rheumatic fever
56
MC cause of suppurative pericarditis:
infection of the pericardium
57
nonbacterial (marantic/thrombotic) vegetations can occur on any valve and is associated with...
malignancy (especially mucin-secreting adenocarcinomas)and a hypercoaguable state
58
along with mitral stenosis, what is an additional late complication of rheumatic fever?
aortic stenosis
59
mutation associated with TOF:
NOTCH pathway
60
pathway that plays a major role in in modulations of vascular development, including cardiac outflow tracts
NOTCH
61
mutation seen in long QT syndrome:
KCNQ1 mutations

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