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Asem > Cardio > Flashcards

Cardio Flashcards

1
Q

Name Pharyngeal( arches, aortic arch, pouches )?

A

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

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2
Q

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.

A

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.

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3
Q

Systolic HF what causes decomepensation? Chronic _overload->eccentric hypertrophy-> in volume but dec EF

A

Systolic HF what causes decomepensation? Chronic volume overload->eccentric hypertrophy-> in volume but dec EF

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4
Q

Hypertrophic/dilated heart looks like?

A

Hypertrophic/dilated heart looks like?

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5
Q
  1. Pulses paradoix? How calculate? Indicates what type of disease(3)?
A

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) !

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6
Q

Pulmonary edema and lung compliance? Pulmonary edema => _ surface tension( diluted surfactant) - + restrictive edema->_ lung compliance; Pulm edema presents as _ lung disease

A

Pulmonary edema and lung compliance? Pulmonary edema => inc surface tension( diluted surfactant) - + restrictive edema->decrease lung compliance; Pulm edema presents as restrictive lung disease

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7
Q

LF/RH= _/ _edema

A

LF/RH= pulm/ systemic edema

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8
Q

Antiarthymic class 1A/B/C AP looks? _. —–adenosine acts via _channels and _

A

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

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9
Q

TTN gene for what protein in what disease? Genetics?

A

TTN gene for what protein in what disease? Genetics? for titin protein dorm mutation Familial dilated cardiomyopathy

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10
Q

Amlodipine side effect? amlodipine/amiodarone = CCB/ antiarth

A

Amlodipine side effect? Effects of vasodilation—Flushing, edema, dizziness; amlodipine/amiodarone = CCB/ antiarth

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11
Q

When deos most LV perfusion occur? So what is limiting factor( what affects it the most) for perfusion during times with hi HR( excercis)?

A

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

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12
Q

PAN? Spare? PAN( segmental, transmural,( like chrons) of arteries) spares lung artereis present with GI pain, ( also cardiac & kidney & skin purpura/livedo reticularis)

A

PAN? Spare? PAN( segmental, transmural,( like chrons) of arteries) spares lung artereis present with GI pain, ( also cardiac & kidney & skin purpura/livedo reticularis)

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13
Q

neprilysin breakdown _ & _ can treat _

A

neprilysin breakdown ANP & BNP can treat HF

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14
Q

glucagon( via GS) treats _ toxicity

A

glucagon( via GS) treats BB toxicity

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15
Q

Elastin how like rubber(2)? Elastin rbber-like due to lysly _ cross-linking(after _ acts as scaffold) and many hydrophobic aa.

A

Elastin how like rubber(2)? Elastin rbber-like due to lysly oxidase cross-linking(after fibrilin acts as scaffold) and many hydrophobic aa.

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16
Q

Most people are what heart dominance? Determined by?

A

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!

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17
Q

What does it mean to have decompensated HF? Decompensation occurs after what maladaptive compensations? Cause what murmur? murmur treated via?

A

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.

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18
Q

Nitropruside affect both a& v why?

A

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)

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19
Q

What vessel has least amount of o2 in body and why?

A

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

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20
Q

Class 3 vrs Class 1 antiarrythmic?

A

Class 3 vrs Class 1 antiarrythmic? Class 3 block K but some class 1 block K as well inaddition to Na

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21
Q

Atrial & ventricular action potential ions ?

A

Atrial & ventricular action potential ions ? for both na, Ca, K

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22
Q

septic shock hallmark? What must temperature be? hypovolumic shock has to do with effects of low _?

A

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

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23
Q

Frank-Starling graph determined by 5 parameters looks like? How would nitroprusside look like?

A

Frank-Starling graph: Graph on Frank stling curve( P vrs Vol of LV) Afterload, preload, contractility, compliance SV.

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24
Q

hypovolumeia symptoms( _ mucous membranes, _statis _tension so _) compensatory methods include _ urine sodium & _ Bun/creatinine Difference with ATN is prerenal azotemia

A

hypovolumeia symptoms( dry mucous membranes, osthostatis dizz/hypotension) compensatory methods include low urine sodium & elevated Bun/creatinine

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25
Q

Bosetan/eternercept? = is _ receptor antagonist (treat _)/ bind _ to inhib( treat _)

A

Bosetan/eternercept? = is endothelin receptor antagonist (treat PAH)/ bind TNF to inhib( treat inflam)

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26
Q

Digoxin toxicity is _ beats

A

Digoxin toxicity is premature beats

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27
Q

Coactation (seen in ? ) vrs PDA ? ………….Marfan associated with what heart defect( +) fratix is _ cardiamyopathty

A

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?

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28
Q

What cause HF to decompensate?

A

What cause HF to decompensate? RAAS pathway cause decompensated HF so that is why they are disease modifying meds.

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29
Q

skeletal/ smooth & cardiac susceptibility to CAB?

A

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.

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30
Q

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)

A

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)

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31
Q

CO calculate

A

CO = rate of oxygen consumption/ diff in arterial or venous gradient

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32
Q

ASD/PFO defect?

A

ASD/PFO= dysplasia/ incomplete fusion of atrial septa-f for fusion

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33
Q

Benefit of nitroprusside’s balanced vasodilation? maintaines _ & _

A

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

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34
Q

How does flow and resistance relate to vessel radius?

A

How does flow and resistance relate to vessel radius? R/flow is inversely/directly proportional to vessel radius to the 4th power

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35
Q

When doing a CV catheter to prevent infection?

A

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

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36
Q

acute pericarditis most common cause? Presents? On ECG?

A

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,

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37
Q

Example of a drug that causes inc in systolic + Diastolic BP yet dec in HR?

A

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

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38
Q

Hybernation myocardium due to? _ LV function(may present as _kinesis) to prevent myonecrosis due to _ischemia but _ gets rid of dysfunction.

A

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.

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39
Q

Biventricle pacemaker leads placed in RA/ RV/ LV @? Pacemaker may cause what valve problem?

A

biventricle pacemaker leads placed in RA/ RV/ LV @? Pacemaker may cause what valve problem? SA/ septum/ coronary sinus ; tricuspid regurg

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40
Q

TIA treat ? Side effect? .

A

with low(cox-1) dose asprin + bp control and statins; GI bleed

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41
Q

septal defects & tetralogy of fallot vrs PDA = _/lower _ cynosis

A

septal defects & tetralogy of fallot vrs PDA = whole/lower body cynosis

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42
Q

aortic dissection mainly due to? _ ->intimal tear ( _ is more for aneurysm formation) Mockeberg sclerosis is isolated _hypertension

A

aortic dissection mainly due to? hypertension ->intimal tear( atherosclerosis is more for aneurysm).. Mockeberg sclerosis is isolated systolic hypertension

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43
Q

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

A

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

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44
Q

Medications that cause hyperkalemia? are those that block_, nsaid(via _), glycosides(via _) Beta-blocker via _

A

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

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45
Q

1836 Isoproterenol causes? Name sympatomemics? Eisenmenger syndrome can happen with all _ to _ shunts.

A

1836 Isoproterenol causes? Name sympatomemics? B1&2 agonist so inc contractility and dec SVR Eisenmenger syndrome can happen with all left to right shunts.

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46
Q

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.

A

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.

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47
Q

Lipid lowering drugs? Best one? Mech and side effect?

A

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 .

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48
Q

Granulation tissue vrs scar? MI resolution? granulation after _ scar in a _

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.

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49
Q

Migratory(comes and goes) thrombophlebitis/troussearu syndrome indicates?

A

Migratory(comes and goes) thrombophlebitis/troussearu syndrome indicates? -> paraneoplastic visceral (pancrease, colon, lung) cancer

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50
Q

hypertrophy from hypertension is _.

A

hypertrophy from hypertension is reversible

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51
Q

Mortality benefits: drugs with effect on _pathway

A

Mortality benefits: drugs with effect on RAAS pathway

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52
Q

In systemic sclerosis(or creast) heart complication? What is heart on auscultation?

A

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

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53
Q

Heriditary PAH gene? On auscultation? On ECG?

A

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

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54
Q

fat/thrombo emoblisim=_/_ within thrombus

A

fat/thrombo emoblisim= fat globules, hemorrhage!

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55
Q

mannitol is _ dirutic that can cause pulmonary _!

A

mannitol is osmotic dirutic that can cause pulmonary edema!

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56
Q

ACEI effect on K? on creatine?

A

ACE inhib electrolyte side effects? hyperkalemia + hi creatine( due to low GFR)

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57
Q

digoxin toxicity? (3)

A

digoxin toxicity? Arrthymias, confusion, hyperk

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58
Q

symp&parasymp receptor locations

A

symp&parasymp receptor locations

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59
Q

BB carvedililol side effect?

A

carvedililol side effect? Hypoglycemia

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60
Q

loop direutics side effect?

A

loop direutics side effect? ototoxicity(1 other antibiotic)

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61
Q

hyaline arteriolosclerosis( due to normal _/_) looks like in kidney? vrs Multiple myloma deposits in kidney? _

A

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)

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62
Q

NSAID + acetaminophen kidney problems(2)? interstitial nephritis(via _) & ischemic papillary necrosis( via dec _)…. CKD itch due to _ toxins

A

NSAID + acetaminophen kidney problems? instertitial nephritis(via ozidative stress) & ischemic papillary necrosis( via dec PGE)…. CKD itch due to uremia toxins

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63
Q

Adenosine treats _ side effects?

A

Adenosine treats PSVT side effects are flushing, AV block, chest burning(broncospasm), hypotension

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64
Q

Delayed cerebral ischemia can happen about _after SAH due to _ so _ onset neuro deficits.. _improves to treat

A

Delayed cerebral ischemia can happen about 1 week after SAH due to vasospam so new onset neuro deficits..Nimodipine improves outcomes

65
Q

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)

A

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

66
Q

Neurosarcoidosis can present as mass effect of hypothalamic mass->_, _ vison defect; A lesion @ hypothalamus and pituitary stalk is diff from lesion within pituitary.

A

Neurosarcoidosis can happen; Mass effect of hypothalamic mass->headache, bitemp vision defect;A lesion @ hypothalamus and pituitary stalk is diff from lesion within pituitary.

67
Q

Left atrial enlargement can compress of _nerve->left vocal cord _ and _.

A

Left atrial enlargement can compress of left recurrent laryngeal nerve->left vocal cord paresis and horseness.

68
Q

Complete atrioventricular canal defect( ASD, VSD and common AV valve) seen in _ syndrome.

A

Complete atrioventricular canal defect( ASD, VSD and common AV valve) seen in Down syndrome.

69
Q

Cortisol has _effect on hormones( allow _effects); tachyphylaxis( means ?->rapidly developing _).

A

Cortisol has permissive effect on hormones( allow max effects); tachyphylazes( dec drug responsiveness with increasing dose=rapidly developing tolerance)

70
Q

Watershed zone infact in brain looks like? due to _

A

Watershed zone infact(bilateral wedge-striped strips parallel to interhemispheric fissue) due to hypoperfusion

71
Q

Hypertension induced retinopathy? _ necrosis of vessel with 3 ->_ hemorrhage, thick walls with arteriovenous _, foci of retinal _(cotton-wool spots),

A

Hypertension induced retinopathy: fibrinous necrosis of vessel->dot or flame shaped hemorrhage, thick walls with arteriovenous nicking, foci of retinal ischemia(cotton-wool spots),

72
Q

Neprilyisn inhibitors(sacubitril) ? Effect of BNP & ANP on kidney (3) adrenals(1) blood(2)

A

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)

73
Q

Viral myocarditis will presents as _ cardiomyopathy so decompensated _.

A

Viral myocarditis will presents as dilated cardiomyopathy so decompensated HF

74
Q

If with MI and acute sytolic murmur that resolves after restoring bld flow: MR due to _

A

If with MI and acute sytolic murmur that resolves after restoring bld flow: MR due to pap muscle rupture

75
Q

OCP’s not for those over _ or _ cause risk of thrombosis

A

OCP’s not for those over 35 or smokers cause risk of thrombosis

76
Q

Myoxmas( from LA) cause valve obstruction which worsen with certain_, mimic _ and can _.

A

Myoxmas( from LA) cause valve obstruction which worsen with certain positions, mimc MS and can embolise

77
Q

Hocm murmur gets better with inc LV blood volume : passive leg raise inc preload.

A

Hocm murmur gets better with inc LV blood volume ( inc with inc in afterload) : passive leg raise inc preload.

78
Q

ESA( Eythropoeisis stimulating agents) have risk of _ and _ events

A

ESA( Eythropoeisis stimulating agents) have risk of hypertension and thromboembolic events

79
Q

Artheroma: cells release PDGF( _, _, _)->sm recruit->_

A

Artheroma: cells release PDGF( endo, platelet, macro)->sm recruit->fibrin

80
Q

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

A

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

81
Q

Aortic stenosis formation? early/late progression.

A

Aortic stenois: early/late = like atherosclerosis ->/ fibroblast differentiate into OB to deposit bone matrix->calcification….murmur worse with things that inc LV bld volume

82
Q

Rheumatic fever/ MVP with regurg predispose to subacute IE( which can emboli) in _/ _nations

A

Rheumatic fever/ MVP with regurg predispose to subacute IE( which can emboli) in developing/ developed nations

83
Q

Concentric vrs eccentric hypertrophy on biopsy: _thick & _ LV volume/ _thick & _ LV volume = due _( hypertension, AS) / volume _( MR, AR)

A

Concentric vrs eccentric hypertrophy on biopsy: in thick & low LV volume/ low thick & inc LV volume = due pressure( hypertension, AS) / volume overload( MR, AR)

84
Q

Rodenticides similar to _toxicity so give _or _( faster)

A

Rodenticides similar to warfarin toxicity so give vit k or FFP( faster)

85
Q

After ischemic stroke(on CT looks _) -> neutron->microglia(_ due to lipids from myelin)

A

After ischemic stroke(hypodensity of CT) -> neutron->microglia(foamy due to lipids from myelin

86
Q

Absence of s3 can exclude severe chronic _.

A

Absence of s3 can exclude severe chronic MR

87
Q

Carotid sinus massage: _pressure-> _ firing-> _ PS tone on SA & AV node( meaning slow conduction time), can treat _

A

Carotid sinus massage: pressure-> inc firing-> in PS tone on SA & AV node( meaning slow conduction time), can terminate PSVTachycardia

88
Q

Stable angina when plaque obstructs >_ of lumen

A

Stable angina when plaque obstructs >70% of lumen

89
Q

Ischemia sec/ minutes/ more than 30 mins loose?

A

Ischemia: sec/ minutes/ more than 30 mins = loss of contractility due to decreasing ATP /+ reversible/ irrv injury

90
Q

Thoracic aortic aneurysm presents with chest/back pain and _ (eso, left recurrent laryngeal , phrenic = _, _ ,_) on CXR _

A

Thoracic aortic aneurysm presents with chest/back pain and compressions (eso/ left recurrent laryngeal , phrenic = dysphagia/ hoarsness, dyspnea) on CXR widened mediastinum

91
Q

2105 AR due to _/ _ best heard at RUSB/L 3rd IC space both @ end of _ with patient leaning _.

A

2105AR due to root dilation/ valvular pathology best heard at RUSB/L 3rd IC space @ end of expiration with patient leaning forward

92
Q

Diabetes drugs Thiazolidinediones mech? why delay in onset? ->

A

Thizolidinediones -> PPAR ( may have delay in onset cause a Trancription regulator) -> glut4 + adiponectin

93
Q

Idiopathic intracranial hypertension(_ cerebri) occurs in _ _ women due to _ ICP compressing optic nerves -> impaired axoplasmic _ and optic disc _ worsens with _ maneuver fundoscopy _ disk margins

A

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

94
Q

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

A

ACEI can cause first dose hypotension in patients with HF or volume depletion so try at low dosage first

95
Q

Irrversible ischemic injury in nuerons presents? 1day/1wk/1mth: _ to _ hrs(_ nissle bodies, cyto _, _, _ nucleus) /

A

Irrversible ischemic injury in nuerons: 12-24 hrs(loose nissle bodies, cyto eosinophilia, shrink, pyknosis=red equals dead

96
Q

Cystic medial degeneration is _changes with _ pooling->aortic _&_; seen in _ and _ that inhibit lysyl oxidase so low elastin

A

Cystic medial degeneration is myxomatous changes with proteoglycan pooling->aortic disssection & anneurysms; in marfans and peas that inhibit lysyl oxidase so low elastin

97
Q

_->Nutmeg liver looks like? _around centrilobular regions and_ periportal regions.

A

HF->Nutmeg liver looks like? Congestion around centrilobular regions and normal periportal regions

98
Q

Glycopyrrolate, hyocyamine, propantheline are anti_

A

Glycopyrrolate, hyocyamine, propantheline are antimuscarinics

99
Q

Initial hypoglycemia response in brain? _ &_ release if persists-> neurogenic/nuerglycopenic compensation =_ / _ Nonselective BB cause _glycemia so use b1 antago instead

A

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;

100
Q

HF acute/chronic lung findings?

A

HF acute/chronic lung findings? engorged capillaries with acelluar pink material/ heart failure cells

101
Q

Risk factors for neonatal Vit K bleeding?

A

Risk factors for neonatal Vit K bleeding? CFTR due to malabsorption and refusal of intramuscular vit K

102
Q

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

A

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

103
Q

Aflutter on ECG? target _ for radioablation

A

Aflutter: sawtooth pattern on ECG; target cavotricuspid isthmus for radioablation cause where reentrant loop is at

104
Q

WPW is _ wave and bypass at _ node. Findings on ECG 3 may cause?

A

WPW is delta wave and bypass at AV node; findings on ECG: short PR, prolong QRS, delta wave=kent may cause SVT

105
Q

Idiopathic ventricular tachycardia usually from_ FA 292 Brugada syndrome: Asians, with pseudo R.bundle branch block & v1-3 st elevation -> vtach

A

Idiopathic ventricular tachycardia usually from right ventricular outflow

106
Q

Afib from _; on ECG ? can be cause by _

A

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

107
Q

AV nodal reentrant tachy cardia: _ & _pathway @ AV node on ECG (2)? To ablate ?

A

AV nodal reentrant tachy cardia: slow & fast pathway @ AV node ; on ECG narrow QRS + retrograde p waves. ; target slow pathway for ablation

108
Q

_ treats acetaminophen overdose

A

N-acetycystein treats acetaminophen overdose

109
Q

Treacher-collins syndrome( _ pharyngeal arch disrupted) Second pharyngeal arch has _horn.

A

Treacher-collins syndrome( 1st & 2nd pharyngeal arch disrupted) Second pharyngeal arch has lesser horn( on top of greater horn)

110
Q

_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

A

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

111
Q

Posterior nose bleed from posterior sphenopalatine artery are too severe for treatment with cautery

A

Posterior nose bleed from posterior sphenopalatine artery are too sever for treatment with cautery

112
Q

Organophosphates are _ ACHE inbitiors so lead to cholinergic excess_ treat with( 2)

A

Organophosphates are irrv ACHE inbitiors so lead to cholinergic excess DUMBELS treat with pralidoxime +muscarinic antagonist

113
Q

Phenylephrine signal transduction?

A

Phenylephrine bind a1 which activates PLC->DAG/IP3(via ca)->PKC

114
Q

Nitrates deaminate cytosine, adenine and guanine to form _?

A

Nitrates deaminate cytosine, adenine and guanine to form uracil hypoxantine and xanthine

115
Q

Young person with HF symptoms after viral prodome suspect?

A

Young person with HF symptoms after viral prodome suspect? Viral myocardiatis-dilated SHF

116
Q

Lisonopril angioedema presents? Due to?

A

Lisonopril angioedema presents? Due to? Swelling of lips and tongue. Inc bradykinin which inc vascular perm

117
Q

What vessel can be compromised at 3rd part of duodenum?

A

What vessel can be compromised at 3rd part of duodenum? SMA

118
Q

What on aorta is most succeptible to damage in car accident?

A

What on aorta is most succeptible to damage in car accident? Isthmus because least mobile

119
Q

On PV curve of LV function, bottom line in means? relationship is direct or inverse?

A

On PV curve of LV function, bottom line in means? DHF( dec Compliance ie hypertrophy, amyloidosis)

120
Q

2108 heart sound audio. Listern to hear S3 occurs insetting of(2)? What happens first in MR?

s1 is what closure?

A

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

121
Q

Left upper sternal border and wide split S2 murmur?

A

Left upper sternal border and wide split S2 murmur? PS

122
Q
  1. Anticholinergic effects(5)?
A
  1. 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
123
Q

What type of antiarrythmic for Ventricular arrythmias? Mech?

A

What type of antiarrythmic for Ventricular arrythmias? Mech? Class IB binds bad(rapidly depolarizing ischemic V. fiber) not good ones

124
Q

Trigers for Prinzmetal angina(3)

A

Trigers for Prinzmetal angina(3) Cigarette smoking, cocian/amphetamines, dihydroegotamines/triptans

125
Q

ANP/BNP works via _ to vasodilate nesiritide is synthetic BNP/ANP

A

ANP/BNP works via guanylyl cyclase to vasodilate

126
Q

LMWH bind mostly _( but _ too)

A

LMWH bind FX but thrombin

127
Q

Theophylline toxicity(2)?

A

Theophylline toxicity: seizures and tachyarrythmia

128
Q

After TIA treat? 2

A

After TIA treat? 2 Risk factors (antiplatelets + statin)

129
Q

Amiadorone( antiarrythmic!) lengthen t wave on qrs??

A

Amiadorone( antiarrythmic!) lengthen t wave on qrs

130
Q

Major determinant of degree of Tetralogy of fallow cyanosis?

A

Major determinant of degree of Tetralogy of fallow cynosis? degree of RV outflow tract obstruction

131
Q

GLP-analogs mech? Weight side effect?

A

GLP-analogs mech? Weight side effect? Slow gastric emptying; weight loss

132
Q

Gemfibrozil mech? Side effect?

A

Gemfibrozil mech? Side effect? inc LPL -> dec TG Gallstones.

133
Q

ARB mech?

A

ARB mech? inhib Ang2 receptor(Renin is an enzyme, ACE in lungs)

134
Q

What are the heart sounds and what do they mean? ¾ normal when?

A

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)

135
Q

Hypertension associated with Valve _

A

Hypertension associated with Valve _ calcifications.

136
Q

Asymptomatic HF mainted via neurhuromonal mechs? 3

A

Via SNS & RAAS to inc volume retention & maintain perfusion but leads to cylcle of hypertension that worsen HF and cause decompensation( BNP’s help)

137
Q

Rhuematic heart disease is different from Infective endocarditis how?

A

Valver inflammatory damage PREDISPOSE to infective endocarditis(vegetations on valve ). Chordea tendina reupture is a COMPLICATION

138
Q

Endomyocardial fibroisis occurs where?

A

Endomyocardial fibroisis where? Tropics

139
Q

Maglignant( _/120) vrs chronic hypertension effect on blood vessels ? 2 vrs 1

A

Fibrinoid necrosis & hyperplastic arteriolosclerois vrs hyalination(diabetes + hypertension)

140
Q

In chronic HF, _ offsets acute pro-edema factors.

A

Lymphatic drainage.

141
Q

Factor X/2 inhitors? 3/3

A

Factor X,2 inhitors? X(rivaroxaban, apixaban, fondaparinux)/ argaroban, bivalirudin, Dabigatran

142
Q

Cardiac auscultatory locations? Pulmonic area: PS, ASD LSB: HCM, AR, PR LLSB: VSD

A

Cardiac auscultatory locations? USB & LSB

143
Q

3rd heart sound heart best at?

A

3rd heart sound heart best at? End of expiration

144
Q

Intermittent claudication is due to _

A

Intermittent claudication is due to Artheriolosclerosis stenosis

145
Q

Hypertrophic cardiomyopathy obstruction is from_

A

Hypertrophic cardiomyopathy obstruction is from mitral valve and septum!

146
Q

AAA incidence risk factors: (3) due to pathogenicity( hypertension will be _ risk)

A

AAA incidence risk factors: old, smoke, male due to transmural inflammation( hypertension will be rupture risk)

147
Q

!! 237 how do you maintain CO in Aortic regurg?

A

!! 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

148
Q

Artherosclrotic plaque fibrous cap made by?

A

Artherosclrotic plaque fibrous cap made by? SM cells( if die less fibrous cap -> hi rupture risk)

149
Q
  1. 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
A
  1. 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.
150
Q

Subclavian steal? _ Occlusion in subclavian cause _ blood flow in vertebral artery to feed subclavia.

A

Subclavian steal? Proximal Occlusion in subclavian cause retrograde blood flow in vertebral artery to feed subclavia.

151
Q

2070 Jugular venous tracing graph(equivalent to atrial pressures) which part is for atrial contraction? Absent in ?

A

2070 Jugular venous tracing graph(equivalent to atrial pressures) which part is for atrial contraction? A. Absent in ? a.fib

152
Q

Antiartyhmics lidocain ? dofetilide?

A

lidocain blocks V. gated Na, class 1B anti-aryth

153
Q

PPI omeprazole mech?

A

omeprazole block nak atpase mech?

154
Q

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

A
155
Q

Slow growth rate of plaques allow _ vessel development( thick fibrous caps _ rupture)

A

Slow growth rate of plaques allow collateral vessel development( thick fibrous caps prevent rupture)

156
Q

Familial DCM affects TTN gene and _ sarcomere -> dorm dilated heart heart can develop _ thrombus or sudden cardiac death due to _ arhythmia.

A

Familial DCM affects TTN gene and titin sarcomere -> dorm dilated heart heart can develop mural thrombus or sudden cardiac death due to v.arhythmia.

157
Q

Best measure for degree of mitral stenosis? What indicates sever stenoisi?

A

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

158
Q

Heart sounds(10)

A

Heart sounds(10)

Asem (9 decks)

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