Cardio Flashcards
Name Pharyngeal( arches, aortic arch, pouches )?
1/2/3/4/5/6 = 5/7/9/10(s.l)/-/10(r.l) nerve= maxillary/ stapedieal(regresses)/ common carotid + prox. internal carotid/ aortic arch + subclavian/ -/ PA + DA arteries = ear/mouth/thymus + inf pth/ ultimobranchial + sup pth/-/- pouch
Diastolic heart failure change on P.V graph of LV? What initiates Sequence? HTN->LV hypertrophy->LV pressure _ + _ in SV but preserved EF ->pulmonary edema-RHF only change is elevated LV filling pressures!! to maintain normal end diastolic volume.
Diastolic heart failure change on P.V graph of LV? What initiates Sequence? HTN->LV hypertrophy->LV pressure inc + dec in SV but preserved EF ->pulmonary edema-RHFonly change is elevated LV filling pressures!! to maintain normal end diastolic volume.
Systolic HF what causes decomepensation? Chronic _overload->eccentric hypertrophy-> in volume but dec EF
Systolic HF what causes decomepensation? Chronic volume overload->eccentric hypertrophy-> in volume but dec EF
Hypertrophic/dilated heart looks like?
Hypertrophic/dilated heart looks like?
- Pulses paradoix? How calculate? Indicates what type of disease(3)?
korotkoff sounds pressure diff when put on cuff= pulses paradoxus(>10mg drop in SBP) because when inspire-> inc RV volume-> heart unable to expand well so interventricular septum bows toward LV->dec LV SV->systolic pressure dec) in disesase that constrict hearts ability to expand ( asthama, COPD because decrease space for heart to expand) !
Pulmonary edema and lung compliance? Pulmonary edema => _ surface tension( diluted surfactant) - + restrictive edema->_ lung compliance; Pulm edema presents as _ lung disease
Pulmonary edema and lung compliance? Pulmonary edema => inc surface tension( diluted surfactant) - + restrictive edema->decrease lung compliance; Pulm edema presents as restrictive lung disease
LF/RH= _/ _edema
LF/RH= pulm/ systemic edema
Antiarthymic class 1A/B/C AP looks? _. —–adenosine acts via _channels and _
Antiarthymic class 1A/B/C AP looks? like prolonged on phase 0( Na) + prolonged/ shortened/ no change on K so prolong/shorten/no change action potential form. —–adenosine acts via k channels and Ca
TTN gene for what protein in what disease? Genetics?
TTN gene for what protein in what disease? Genetics? for titin protein dorm mutation Familial dilated cardiomyopathy
Amlodipine side effect? amlodipine/amiodarone = CCB/ antiarth
Amlodipine side effect? Effects of vasodilation—Flushing, edema, dizziness; amlodipine/amiodarone = CCB/ antiarth
When deos most LV perfusion occur? So what is limiting factor( what affects it the most) for perfusion during times with hi HR( excercis)?
When deos most LV perfusion occur? So what is limiting factor( what affects it the most) for perfusion during times with hi HR( excercis); Diastole. because LV pressures inverly related perfusion. Length of diastole
PAN? Spare? PAN( segmental, transmural,( like chrons) of arteries) spares lung artereis present with GI pain, ( also cardiac & kidney & skin purpura/livedo reticularis)
PAN? Spare? PAN( segmental, transmural,( like chrons) of arteries) spares lung artereis present with GI pain, ( also cardiac & kidney & skin purpura/livedo reticularis)
neprilysin breakdown _ & _ can treat _
neprilysin breakdown ANP & BNP can treat HF
glucagon( via GS) treats _ toxicity
glucagon( via GS) treats BB toxicity
Elastin how like rubber(2)? Elastin rbber-like due to lysly _ cross-linking(after _ acts as scaffold) and many hydrophobic aa.
Elastin how like rubber(2)? Elastin rbber-like due to lysly oxidase cross-linking(after fibrilin acts as scaffold) and many hydrophobic aa.
Most people are what heart dominance? Determined by?
Most people are what heart dominance? Determined by? Right. Who supplies AV node supplied by R or left PDA form RCA or LCircumflex(from LCA) …( determines right or left dominance). SA node via RCA!
What does it mean to have decompensated HF? Decompensation occurs after what maladaptive compensations? Cause what murmur? murmur treated via?
What does it mean to have decompensated HF? Decompensation occurs after what maladaptive compensations? Cause what murmur? HF decompensation( symptomatic SOB and/or peripheral edema if L and /or RHF) -> secondary MR( diuretics and vasodilators treat this but for chorda tendinae ruptor need surgery). Chronic maladaptive compensatory mechanisms-in RAAS & sympathetic.
Nitropruside affect both a& v why?
Nitropruside affect both a& v why? Nitroglycerin, isosorbide mono/dinitrate -> NO & S-nitrosothiols via mitcho in sm so veins effects but nitropruisde metabol in bld so balanced( v & a)
What vessel has least amount of o2 in body and why?
What vessel has least amount of o2 in body and why? Heart(more than any other organ) extracts most oxygen-> coronary sinus with least O2 concentration
Class 3 vrs Class 1 antiarrythmic?
Class 3 vrs Class 1 antiarrythmic? Class 3 block K but some class 1 block K as well inaddition to Na
Atrial & ventricular action potential ions ?
Atrial & ventricular action potential ions ? for both na, Ca, K
septic shock hallmark? What must temperature be? hypovolumic shock has to do with effects of low _?
septic shock hallmark? What must temperature be? dec SVR can be either hyper or hypothermia even though septic…hypovolumic shock has to do with effects of low preload
Frank-Starling graph determined by 5 parameters looks like? How would nitroprusside look like?
Frank-Starling graph: Graph on Frank stling curve( P vrs Vol of LV) Afterload, preload, contractility, compliance SV.
hypovolumeia symptoms( _ mucous membranes, _statis _tension so _) compensatory methods include _ urine sodium & _ Bun/creatinine Difference with ATN is prerenal azotemia
hypovolumeia symptoms( dry mucous membranes, osthostatis dizz/hypotension) compensatory methods include low urine sodium & elevated Bun/creatinine
Bosetan/eternercept? = is _ receptor antagonist (treat _)/ bind _ to inhib( treat _)
Bosetan/eternercept? = is endothelin receptor antagonist (treat PAH)/ bind TNF to inhib( treat inflam)
Digoxin toxicity is _ beats
Digoxin toxicity is premature beats
Coactation (seen in ? ) vrs PDA ? ………….Marfan associated with what heart defect( +) fratix is _ cardiamyopathty
PDA ? Turners, bicupid aortic valve. is bp vrs SpO2 differences in upper and lower extremities………….Marfan associated with what heart defect( MVP) fratix is hypertrophic cardia?
What cause HF to decompensate?
What cause HF to decompensate? RAAS pathway cause decompensated HF so that is why they are disease modifying meds.
skeletal/ smooth & cardiac susceptibility to CAB?
skeletal/ smooth & cardiac susceptibility to CAB? not/dependent on extracellular caclium due to presence/absence of L-type Ca channel coupling with RYR receptors of SR..so skeletal muscle is resistant to calcium channel blockers.
ECF leads infarct? 3 leads( ant, inf, lat); (Inf)2, 3, AVF = RCA, LAD->(ant V1-4 : 1-2 are spetal if dista,l (3-4) only), Circumflex -> lat(I, AVL + V5-6) , LMC->( LAD + circunflex)
ECF leads infarct? 3 leads( ant, inf, lat); (Inf)2, 3, AVF = RCA, LAD->(ant V1-4 : 1-2 are spetal if dista,l (3-4) only), Circumflex -> lat(I, AVL + V5-6) , LMC->( LAD + circunflex)
CO calculate
CO = rate of oxygen consumption/ diff in arterial or venous gradient
ASD/PFO defect?
ASD/PFO= dysplasia/ incomplete fusion of atrial septa-f for fusion
Benefit of nitroprusside’s balanced vasodilation? maintaines _ & _
Benefit of nitroprusside’s balanced vasodilation? balanced vasodilation( due to No release in bld rather than venous sm) -> both A & V dilate->maintain CO & SV @ lover LV pressure( does less work for same
How does flow and resistance relate to vessel radius?
How does flow and resistance relate to vessel radius? R/flow is inversely/directly proportional to vessel radius to the 4th power
When doing a CV catheter to prevent infection?
When doing a CV catheter to prevent infection? Most are g-postive cocci so use barrier precaution( hand hygiene, cover up, antiseptic-alcohol not antibiotic!), avoid femoral insertion
acute pericarditis most common cause? Presents? On ECG?
acute pericarditis most common cause? Presents? On ECG? most common cause is viral infection of myocardium(inflamed->elevated ST seg); pleuritic chest pain that improves with leaning forward,
Example of a drug that causes inc in systolic + Diastolic BP yet dec in HR?
Example of a drug that causes inc in systolic + Diastolic BP yet dec in HR? a1-adrenergic agonists increase bp -> reflexive vagal tone->bradycardia….sympathomemics
Hybernation myocardium due to? _ LV function(may present as _kinesis) to prevent myonecrosis due to _ischemia but _ gets rid of dysfunction.
Hybernation myocardium due to? dec LV function(may present as hypokinesis) to prevent myo necrosis due to chronic ischemia but revasculization gets rid of dysfunction.
Biventricle pacemaker leads placed in RA/ RV/ LV @? Pacemaker may cause what valve problem?
biventricle pacemaker leads placed in RA/ RV/ LV @? Pacemaker may cause what valve problem? SA/ septum/ coronary sinus ; tricuspid regurg
TIA treat ? Side effect? .
with low(cox-1) dose asprin + bp control and statins; GI bleed
septal defects & tetralogy of fallot vrs PDA = _/lower _ cynosis
septal defects & tetralogy of fallot vrs PDA = whole/lower body cynosis
aortic dissection mainly due to? _ ->intimal tear ( _ is more for aneurysm formation) Mockeberg sclerosis is isolated _hypertension
aortic dissection mainly due to? hypertension ->intimal tear( atherosclerosis is more for aneurysm).. Mockeberg sclerosis is isolated systolic hypertension
243 BP tracing graft norm? Systolic murmurs? _ and _ for _ are systolic MI ( MS- mid diastolic rumble with opening snap AS -(intensity(?) proportional to _ between aorta and lV pressures, worse with inc LV bld volume) TI PS H( what makes better? _ V
243 BP tracing graft norm? Systolic murmurs? _ and _ for _ are systolic MI ( MS- mid diastolic rumble with opening snap AS -(hi Lv pressures( dec SV) ntensity(?) proportional to _ between aorta and lV pressures) TI PS H( what makes better? inc vol V
Medications that cause hyperkalemia? are those that block_, nsaid(via _), glycosides(via _) Beta-blocker via _
Medications that cause hyperkalemia? If block aldosterone or Na intake, nsaid(via PGE-> dec RAAS), glycosides(via blocking na/k pump). Beta-blocker..via JG cell
1836 Isoproterenol causes? Name sympatomemics? Eisenmenger syndrome can happen with all _ to _ shunts.
1836 Isoproterenol causes? Name sympatomemics? B1&2 agonist so inc contractility and dec SVR Eisenmenger syndrome can happen with all left to right shunts.
constrictive pericarditis signs(3) ?_ in pericardial space-> _sign(paradoxical rise in _) & pericardial knock( early diastolic sound before S3?), pulsus paradox left parasternal lift suggest _ hypertrophy S3/ s4 suggest _/_ ventricle.
constrictive pericarditis signs(3) ? tissue in pericardial space-> kussmaul sign(paradoxical rise in JVP) & pericardial knock( early diastolic sound before S3?) , pulsus paradoxix…..left parasternal lift suggest RV hypertrophy and S3/ s4 = dilated/ hypertrophic ventricle.
Lipid lowering drugs? Best one? Mech and side effect?
Lipid lowering drugs? Best one? Mech and side effect? Statins(reductase) & Ezemtimibe & bile acid sequestranst/ fibrates(via PPAR-> hi LPL activity & dec VLDL produce) & Exercise & Omega3( dec apoB & VLDL produce)/ Niacin = LDL/ TG/ HDL = Statins side effect? muscle & liver toxicity; best one Niacin side effect? cutaneous flushing due to PG so inhib via asprin .
Granulation tissue vrs scar? MI resolution? granulation after _ scar in a _
Granulation tissue vrs scar? MI resolution? 1 day/ 1 week/ 1 mth = coagu necor/ neuto macro/ granulation->scar so granulation after 1 wk, scar in a month.
Migratory(comes and goes) thrombophlebitis/troussearu syndrome indicates?
Migratory(comes and goes) thrombophlebitis/troussearu syndrome indicates? -> paraneoplastic visceral (pancrease, colon, lung) cancer
hypertrophy from hypertension is _.
hypertrophy from hypertension is reversible
Mortality benefits: drugs with effect on _pathway
Mortality benefits: drugs with effect on RAAS pathway
In systemic sclerosis(or creast) heart complication? What is heart on auscultation?
In systemic sclerosis(or creast) heart complication? What is heart on auscultation? PAH due to T-cell release of cytokines-> collagen->occlude vessels->dyspnea + loud Pulmonic S2 ……PAH can develope in systemic sclerosis due to collagen deposition -> damage in pulm arteries
Heriditary PAH gene? On auscultation? On ECG?
Heriditary PAH gene? On auscultation? Dorm Inactivating mut in BMPR2 gene in females cause smooth muscle proliferation->PAH->r.axis deviate of ECG, loud pulm S2
fat/thrombo emoblisim=_/_ within thrombus
fat/thrombo emoblisim= fat globules, hemorrhage!
mannitol is _ dirutic that can cause pulmonary _!
mannitol is osmotic dirutic that can cause pulmonary edema!
ACEI effect on K? on creatine?
ACE inhib electrolyte side effects? hyperkalemia + hi creatine( due to low GFR)
digoxin toxicity? (3)
digoxin toxicity? Arrthymias, confusion, hyperk
symp¶symp receptor locations
symp¶symp receptor locations
BB carvedililol side effect?
carvedililol side effect? Hypoglycemia
loop direutics side effect?
loop direutics side effect? ototoxicity(1 other antibiotic)
hyaline arteriolosclerosis( due to normal _/_) looks like in kidney? vrs Multiple myloma deposits in kidney? _
hyaline arteriolosclerosis( due to normal HTN/diabetes) looks like in kidney? ->eosinophilic(pink) hyaline that stains pink with PAS… vrs. Multiple myloma deposits in kidney? Tubular cast(BJ + TH proteins)
NSAID + acetaminophen kidney problems(2)? interstitial nephritis(via _) & ischemic papillary necrosis( via dec _)…. CKD itch due to _ toxins
NSAID + acetaminophen kidney problems? instertitial nephritis(via ozidative stress) & ischemic papillary necrosis( via dec PGE)…. CKD itch due to uremia toxins
Adenosine treats _ side effects?
Adenosine treats PSVT side effects are flushing, AV block, chest burning(broncospasm), hypotension
Delayed cerebral ischemia can happen about _after SAH due to _ so _ onset neuro deficits.. _improves to treat
Delayed cerebral ischemia can happen about 1 week after SAH due to vasospam so new onset neuro deficits..Nimodipine improves outcomes
Arterial vrs venous insufficiency= due to _/ _ =effects of _/ effects of _ = risk intermittent claudication & MI or stroke /stasis _ _inc risk for Pulm embolism and present with phelegmasia alba dolens (_ leg)
Arterial vrs venous insufficiency= due to artherosclerosis/ insufficient valves so backflow =effects of ischemia/ effects of edema = risk intermittent claudication & MI or stroke /stasis dermatitis ….while DVT inc risk for Pulm embolism and present with phelegmasia alba dolens: milk leg
Neurosarcoidosis can present as mass effect of hypothalamic mass->_, _ vison defect; A lesion @ hypothalamus and pituitary stalk is diff from lesion within pituitary.
Neurosarcoidosis can happen; Mass effect of hypothalamic mass->headache, bitemp vision defect;A lesion @ hypothalamus and pituitary stalk is diff from lesion within pituitary.
Left atrial enlargement can compress of _nerve->left vocal cord _ and _.
Left atrial enlargement can compress of left recurrent laryngeal nerve->left vocal cord paresis and horseness.
Complete atrioventricular canal defect( ASD, VSD and common AV valve) seen in _ syndrome.
Complete atrioventricular canal defect( ASD, VSD and common AV valve) seen in Down syndrome.
Cortisol has _effect on hormones( allow _effects); tachyphylaxis( means ?->rapidly developing _).
Cortisol has permissive effect on hormones( allow max effects); tachyphylazes( dec drug responsiveness with increasing dose=rapidly developing tolerance)
Watershed zone infact in brain looks like? due to _
Watershed zone infact(bilateral wedge-striped strips parallel to interhemispheric fissue) due to hypoperfusion
Hypertension induced retinopathy? _ necrosis of vessel with 3 ->_ hemorrhage, thick walls with arteriovenous _, foci of retinal _(cotton-wool spots),
Hypertension induced retinopathy: fibrinous necrosis of vessel->dot or flame shaped hemorrhage, thick walls with arteriovenous nicking, foci of retinal ischemia(cotton-wool spots),
Neprilyisn inhibitors(sacubitril) ? Effect of BNP & ANP on kidney (3) adrenals(1) blood(2)
Neprilyisn inhibitors(sacubitril) prevent degradation of ANP & BNP-> kidney (dilate aff arterioles, constrick eff arterioles, dec renin sec) adrenals( dec aldosterone) blood(vasodilate & permeability inc)
Viral myocarditis will presents as _ cardiomyopathy so decompensated _.
Viral myocarditis will presents as dilated cardiomyopathy so decompensated HF
If with MI and acute sytolic murmur that resolves after restoring bld flow: MR due to _
If with MI and acute sytolic murmur that resolves after restoring bld flow: MR due to pap muscle rupture
OCP’s not for those over _ or _ cause risk of thrombosis
OCP’s not for those over 35 or smokers cause risk of thrombosis
Myoxmas( from LA) cause valve obstruction which worsen with certain_, mimic _ and can _.
Myoxmas( from LA) cause valve obstruction which worsen with certain positions, mimc MS and can embolise
Hocm murmur gets better with inc LV blood volume : passive leg raise inc preload.
Hocm murmur gets better with inc LV blood volume ( inc with inc in afterload) : passive leg raise inc preload.
ESA( Eythropoeisis stimulating agents) have risk of _ and _ events
ESA( Eythropoeisis stimulating agents) have risk of hypertension and thromboembolic events
Artheroma: cells release PDGF( _, _, _)->sm recruit->_
Artheroma: cells release PDGF( endo, platelet, macro)->sm recruit->fibrin
Mi complication: 1/1wk/1mth = arythmias, HF, hypotension with _ lungs and _ sign/ pericarditis ->ruptures: pap(3d. MR with pulm edema) before septal( 3d. holosystolic murmur, diff O2 levels) before free wall( 5d. after pseudo aneurysm contained ruptures-> cardiac tamponande, JVD,) / Dressler syndrome, true aneurysms
Mi complication: Acute/ 3-5 days/ 5-14 days / >1 month= RV failure/ pap mus rupture & IV septum rupture / free wall rupture = hypotension & clear lungs, kussmall sign/ pulm edema, MR/ & holosytolic murmur, diff oxygen levels/ pericardial tamponade, JVD, muffled heart sound/ true aneurysms
Aortic stenosis formation? early/late progression.
Aortic stenois: early/late = like atherosclerosis ->/ fibroblast differentiate into OB to deposit bone matrix->calcification….murmur worse with things that inc LV bld volume
Rheumatic fever/ MVP with regurg predispose to subacute IE( which can emboli) in _/ _nations
Rheumatic fever/ MVP with regurg predispose to subacute IE( which can emboli) in developing/ developed nations
Concentric vrs eccentric hypertrophy on biopsy: _thick & _ LV volume/ _thick & _ LV volume = due _( hypertension, AS) / volume _( MR, AR)
Concentric vrs eccentric hypertrophy on biopsy: in thick & low LV volume/ low thick & inc LV volume = due pressure( hypertension, AS) / volume overload( MR, AR)
Rodenticides similar to _toxicity so give _or _( faster)
Rodenticides similar to warfarin toxicity so give vit k or FFP( faster)
After ischemic stroke(on CT looks _) -> neutron->microglia(_ due to lipids from myelin)
After ischemic stroke(hypodensity of CT) -> neutron->microglia(foamy due to lipids from myelin
Absence of s3 can exclude severe chronic _.
Absence of s3 can exclude severe chronic MR
Carotid sinus massage: _pressure-> _ firing-> _ PS tone on SA & AV node( meaning slow conduction time), can treat _
Carotid sinus massage: pressure-> inc firing-> in PS tone on SA & AV node( meaning slow conduction time), can terminate PSVTachycardia
Stable angina when plaque obstructs >_ of lumen
Stable angina when plaque obstructs >70% of lumen
Ischemia sec/ minutes/ more than 30 mins loose?
Ischemia: sec/ minutes/ more than 30 mins = loss of contractility due to decreasing ATP /+ reversible/ irrv injury
Thoracic aortic aneurysm presents with chest/back pain and _ (eso, left recurrent laryngeal , phrenic = _, _ ,_) on CXR _
Thoracic aortic aneurysm presents with chest/back pain and compressions (eso/ left recurrent laryngeal , phrenic = dysphagia/ hoarsness, dyspnea) on CXR widened mediastinum
2105 AR due to _/ _ best heard at RUSB/L 3rd IC space both @ end of _ with patient leaning _.
2105AR due to root dilation/ valvular pathology best heard at RUSB/L 3rd IC space @ end of expiration with patient leaning forward
Diabetes drugs Thiazolidinediones mech? why delay in onset? ->
Thizolidinediones -> PPAR ( may have delay in onset cause a Trancription regulator) -> glut4 + adiponectin
Idiopathic intracranial hypertension(_ cerebri) occurs in _ _ women due to _ ICP compressing optic nerves -> impaired axoplasmic _ and optic disc _ worsens with _ maneuver fundoscopy _ disk margins
Idiopathic intracranial hypertension(pseudotumor cerebri) occurs in young obese women due to hi ICP compressing optic nerves -> impaired axoplasmic flow and optic disc edema; worsens with valsavar maneuver and on fundoscopy blurred disk margins
Hypertentsion drugs ACEI can cause_dose hypotension in patients with _ or_ depletion so try at low dosage first nitrates contraindicated with RV infarction nitrorpusside: cynide toxicity
ACEI can cause first dose hypotension in patients with HF or volume depletion so try at low dosage first
Irrversible ischemic injury in nuerons presents? 1day/1wk/1mth: _ to _ hrs(_ nissle bodies, cyto _, _, _ nucleus) /
Irrversible ischemic injury in nuerons: 12-24 hrs(loose nissle bodies, cyto eosinophilia, shrink, pyknosis=red equals dead
Cystic medial degeneration is _changes with _ pooling->aortic _&_; seen in _ and _ that inhibit lysyl oxidase so low elastin
Cystic medial degeneration is myxomatous changes with proteoglycan pooling->aortic disssection & anneurysms; in marfans and peas that inhibit lysyl oxidase so low elastin
_->Nutmeg liver looks like? _around centrilobular regions and_ periportal regions.
HF->Nutmeg liver looks like? Congestion around centrilobular regions and normal periportal regions
Glycopyrrolate, hyocyamine, propantheline are anti_
Glycopyrrolate, hyocyamine, propantheline are antimuscarinics
Initial hypoglycemia response in brain? _ &_ release if persists-> neurogenic/nuerglycopenic compensation =_ / _ Nonselective BB cause _glycemia so use b1 antago instead
Initial hypoglycemia response in brain: glucagon & epinephrine release if persists-> neurogenic/nuerglycopenic compensation = S & PS autonomic symptoms-sweat, palpitation, hunger/ behavioral changes, seizures, confusion; Nonselective BB cause hypoglycemia so use b1 antago instead;
HF acute/chronic lung findings?
HF acute/chronic lung findings? engorged capillaries with acelluar pink material/ heart failure cells
Risk factors for neonatal Vit K bleeding?
Risk factors for neonatal Vit K bleeding? CFTR due to malabsorption and refusal of intramuscular vit K
Abdominal aortic aneurysm occurs below _vessels? Risk factors: 3 Pathogenesis: chronic transmural inflammation vrs. Cystic medial degeneration which occurs in _ aorta due to connective tissue diseases vrs Aortic Dissection which is _tear
Abdominal aortic aneurysm occurs below renal vessels? Risk factors: male. Pathogenesis: chronic transmural inflammation vrs. Cystic medial degeneration which occurs in ascending aorta & Connective tissue diseases Dissection is intimal tear
Aflutter on ECG? target _ for radioablation
Aflutter: sawtooth pattern on ECG; target cavotricuspid isthmus for radioablation cause where reentrant loop is at
WPW is _ wave and bypass at _ node. Findings on ECG 3 may cause?
WPW is delta wave and bypass at AV node; findings on ECG: short PR, prolong QRS, delta wave=kent may cause SVT
Idiopathic ventricular tachycardia usually from_ FA 292 Brugada syndrome: Asians, with pseudo R.bundle branch block & v1-3 st elevation -> vtach
Idiopathic ventricular tachycardia usually from right ventricular outflow
Afib from _; on ECG ? can be cause by _
Afib from pulmonary vein; no p waves; on ECG Afib on ECG(3). Ablation @? Irreg irreg with variable R-R and absent p waves; ectopic electoral foci in pulmonary veins can be caused by alcohol
AV nodal reentrant tachy cardia: _ & _pathway @ AV node on ECG (2)? To ablate ?
AV nodal reentrant tachy cardia: slow & fast pathway @ AV node ; on ECG narrow QRS + retrograde p waves. ; target slow pathway for ablation
_ treats acetaminophen overdose
N-acetycystein treats acetaminophen overdose
Treacher-collins syndrome( _ pharyngeal arch disrupted) Second pharyngeal arch has _horn.
Treacher-collins syndrome( 1st & 2nd pharyngeal arch disrupted) Second pharyngeal arch has lesser horn( on top of greater horn)
_happens at blood vessels in_ Ant. Kiesselbach plexus ( thmodial, sphenopalatine and sup. Labial artery) is most common for injury, to treat _ is best second is cautery
Epistaxis happens at blood vessels in septum; ant. Kiesselbach plexus ( thmodial, sphenopalatine and sup. Labial artery) is most common for injury, to treat compression is best second is cautery
Posterior nose bleed from posterior sphenopalatine artery are too severe for treatment with cautery
Posterior nose bleed from posterior sphenopalatine artery are too sever for treatment with cautery
Organophosphates are _ ACHE inbitiors so lead to cholinergic excess_ treat with( 2)
Organophosphates are irrv ACHE inbitiors so lead to cholinergic excess DUMBELS treat with pralidoxime +muscarinic antagonist
Phenylephrine signal transduction?
Phenylephrine bind a1 which activates PLC->DAG/IP3(via ca)->PKC
Nitrates deaminate cytosine, adenine and guanine to form _?
Nitrates deaminate cytosine, adenine and guanine to form uracil hypoxantine and xanthine
Young person with HF symptoms after viral prodome suspect?
Young person with HF symptoms after viral prodome suspect? Viral myocardiatis-dilated SHF
Lisonopril angioedema presents? Due to?
Lisonopril angioedema presents? Due to? Swelling of lips and tongue. Inc bradykinin which inc vascular perm
What vessel can be compromised at 3rd part of duodenum?
What vessel can be compromised at 3rd part of duodenum? SMA
What on aorta is most succeptible to damage in car accident?
What on aorta is most succeptible to damage in car accident? Isthmus because least mobile
On PV curve of LV function, bottom line in means? relationship is direct or inverse?
On PV curve of LV function, bottom line in means? DHF( dec Compliance ie hypertrophy, amyloidosis)
2108 heart sound audio. Listern to hear S3 occurs insetting of(2)? What happens first in MR?
s1 is what closure?
2108 heart sound audio. Listern to hear S3 occurs insetting of(2)? mitral regurg & SHF after s2. What happens first in MR? inc left ventricular end-systolic volume before inc pulm pressure
s1 is mitral & tricuspid closure
Left upper sternal border and wide split S2 murmur?
Left upper sternal border and wide split S2 murmur? PS
- Anticholinergic effects(5)?
- Anticholinergic effects(5)? Hot, dry, red, blind, , mad, full, fast Anticholinergic toxicity presents as ? causes(?) Hot , dry, dilated pupils , altered mental status, urinary retention, tachycardia; amitriptyline
What type of antiarrythmic for Ventricular arrythmias? Mech?
What type of antiarrythmic for Ventricular arrythmias? Mech? Class IB binds bad(rapidly depolarizing ischemic V. fiber) not good ones
Trigers for Prinzmetal angina(3)
Trigers for Prinzmetal angina(3) Cigarette smoking, cocian/amphetamines, dihydroegotamines/triptans
ANP/BNP works via _ to vasodilate nesiritide is synthetic BNP/ANP
ANP/BNP works via guanylyl cyclase to vasodilate
LMWH bind mostly _( but _ too)
LMWH bind FX but thrombin
Theophylline toxicity(2)?
Theophylline toxicity: seizures and tachyarrythmia
After TIA treat? 2
After TIA treat? 2 Risk factors (antiplatelets + statin)
Amiadorone( antiarrythmic!) lengthen t wave on qrs??
Amiadorone( antiarrythmic!) lengthen t wave on qrs
Major determinant of degree of Tetralogy of fallow cyanosis?
Major determinant of degree of Tetralogy of fallow cynosis? degree of RV outflow tract obstruction
GLP-analogs mech? Weight side effect?
GLP-analogs mech? Weight side effect? Slow gastric emptying; weight loss
Gemfibrozil mech? Side effect?
Gemfibrozil mech? Side effect? inc LPL -> dec TG Gallstones.
ARB mech?
ARB mech? inhib Ang2 receptor(Renin is an enzyme, ACE in lungs)
What are the heart sounds and what do they mean? ¾ normal when?
What are the heart sounds and what do they mean? ¾ normal when? S4 decribed as S4(before S1=atrial contraction gallop, old,), S1,S2, S3(after S2=ventricular filling gallop, young)
Hypertension associated with Valve _
Hypertension associated with Valve _ calcifications.
Asymptomatic HF mainted via neurhuromonal mechs? 3
Via SNS & RAAS to inc volume retention & maintain perfusion but leads to cylcle of hypertension that worsen HF and cause decompensation( BNP’s help)
Rhuematic heart disease is different from Infective endocarditis how?
Valver inflammatory damage PREDISPOSE to infective endocarditis(vegetations on valve ). Chordea tendina reupture is a COMPLICATION
Endomyocardial fibroisis occurs where?
Endomyocardial fibroisis where? Tropics
Maglignant( _/120) vrs chronic hypertension effect on blood vessels ? 2 vrs 1
Fibrinoid necrosis & hyperplastic arteriolosclerois vrs hyalination(diabetes + hypertension)
In chronic HF, _ offsets acute pro-edema factors.
Lymphatic drainage.
Factor X/2 inhitors? 3/3
Factor X,2 inhitors? X(rivaroxaban, apixaban, fondaparinux)/ argaroban, bivalirudin, Dabigatran
Cardiac auscultatory locations? Pulmonic area: PS, ASD LSB: HCM, AR, PR LLSB: VSD
Cardiac auscultatory locations? USB & LSB
3rd heart sound heart best at?
3rd heart sound heart best at? End of expiration
Intermittent claudication is due to _
Intermittent claudication is due to Artheriolosclerosis stenosis
Hypertrophic cardiomyopathy obstruction is from_
Hypertrophic cardiomyopathy obstruction is from mitral valve and septum!
AAA incidence risk factors: (3) due to pathogenicity( hypertension will be _ risk)
AAA incidence risk factors: old, smoke, male due to transmural inflammation( hypertension will be rupture risk)
!! 237 how do you maintain CO in Aortic regurg?
!! 237 how do you maintain CO in Aortic regurg? acute(hi preload, low afterload(?), dec CO but EJF(inc?)) -> lV volume overload-> eccentric hypertrophy ->SV in to maintain CO but overtime, eccentric hypertrophy ->SHF
Artherosclrotic plaque fibrous cap made by?
Artherosclrotic plaque fibrous cap made by? SM cells( if die less fibrous cap -> hi rupture risk)
- Drug causes of prolonged QT? 6 ABCDE Most patents with congenital LQTS(what channel?) do not have TdP until meet _. FA 292 drugs that dec k, mg, ca cause torsades Romano for dorminant no deafness
- Causes of prolonged QT? electrolyte abnormalities( antiemetics), TCA +Anitpsy, macrolide + floro, zaoles;; Most patents with congenital LQTS(delayed rectifiy) do not have TdP until meet meds.
Subclavian steal? _ Occlusion in subclavian cause _ blood flow in vertebral artery to feed subclavia.
Subclavian steal? Proximal Occlusion in subclavian cause retrograde blood flow in vertebral artery to feed subclavia.
2070 Jugular venous tracing graph(equivalent to atrial pressures) which part is for atrial contraction? Absent in ?
2070 Jugular venous tracing graph(equivalent to atrial pressures) which part is for atrial contraction? A. Absent in ? a.fib
Antiartyhmics lidocain ? dofetilide?
lidocain blocks V. gated Na, class 1B anti-aryth
PPI omeprazole mech?
omeprazole block nak atpase mech?
FA
week 4 loop heart and beat
saorticopulm septal defects due to failure of nerual crest migration
v’SD due to membranous septum
allaNtois/ UmbiLicus is median/ medial
umbilicus=baby( so vein goes towards baby)
La enlargement dysphagia/horseness due to eso/left recurrent laryngeal
Heart has 3 layers: fibrous + serous(parietal + visceral layer)
PDA feeds : AV node (dependent on
dominance), posterior 1/3 of interventricular
septum, posterior 2/3 walls of ventricles, and
posteromedial papillary muscle.
acidosis inc contractility
AS vrs AR= syncopy, angina, dyspnea(SAD) vrs head bobbing, hyperdynamic pulse
AV block: 2nd degree( 1/2 dropped beats with/wiithout inc PR interval
Artherosclerosis in: abd aorta, coronary artery, pop, carotid
Abdominal aortic aneurysm from artheriosclerosis all of rest from HTN, CT disease
Slow growth rate of plaques allow _ vessel development( thick fibrous caps _ rupture)
Slow growth rate of plaques allow collateral vessel development( thick fibrous caps prevent rupture)
Familial DCM affects TTN gene and _ sarcomere -> dorm dilated heart heart can develop _ thrombus or sudden cardiac death due to _ arhythmia.
Familial DCM affects TTN gene and titin sarcomere -> dorm dilated heart heart can develop mural thrombus or sudden cardiac death due to v.arhythmia.
Best measure for degree of mitral stenosis? What indicates sever stenoisi?
Best measure for degree of mitral stenosis? What indicates sever stenoisi? A2-to OS interval( aortic valve closure to opening snap interval); shorter interval indicates severe
Heart sounds(10)
Heart sounds(10)
