Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UworldSUN > cardio > Flashcards

cardio Flashcards

1
Q

HDL is too high, what is a cardioprotective drug?

A

statins. don’t focus on HDL or triglycerides, give HMGCoA inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

recently pregnant mother with symptoms of heart failure, dx?

A

Peripartum dilated cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does heart failure after doxorubicin affect the LVEDV and the RA pressure?

A

increases both. doxorubicin is dilated cardiomyopathy which is most common cardiomyopathy, systolic HF. LVEDV increases because EF decreases, and RA because of RV being affected as well as back up from left heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

constipation and AV block

A

verapamil and diltiazem (class IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

complete heart block on ECG, what is mechanism of pathology?

A

degenerative changes in AV node (ischemia, infection with spirochetes, infiltrative)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does nitrates work?

A

release of cGMP and dephyosphorylation of myosin, smooth muscle relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

S3 S4 explain

A

S3 is atrial kick, rapid ventricular filling in compliant LV wall, S4 is stiff wall, blood hitting it in restrictive cardiomyopathy/diastolic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

AFib, heart failure patient with visual difficulties, GI disturbances, hyperkalemia, drug?

A

digoxin- similar to amiodarone SE profile but with hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

atenolol affects what receptors how?

A

selective B1 antagonist, affects heart and kidney, not vascular sm muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

myxomatous changes with pooling of proteoglycans in the media is due to what condition and cause?

A

aortic dissection, Marfan’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what collagen type after MI?

A

type I, bone + tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Inferior MI, RCA occlusion, chest and lung clear, what is cardiac output, PCWP, CVP? up or down

A

down, down, up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

blue baby with PDA, Echo shows anterior aorta, dx and what is the embryological process that went wrong?

A

transposition of the great arteries, spiraling. if septation then it is truncus arteriosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

viagra, NO work similarly to what substance in body?

A

ANP,BNP, via cGMP level increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ejection fraction equation and stroke volume equatino

A

SV/LVEDV, EDV-ESV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fatigue, dyspnea, orthopnea with TTN gene or beta myosin gene, what is the dx for both?

A

DCM and HCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

increased pressure requred for the same amount of volume in the EDV, what is diagnosis? and cause?

A

diastolic heart failure due to restrictive/infiltrative cardiomyopathy caused by transthyretin deposition (in amyloidosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

where is great saphenous vein harvested from in CABG?

A

near the pelvic triangle, inferiorlateral to pubic tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

elevation of homocysteine increases risk of what?

A

thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

potassium efflux is prolonged, what class of drugs and mnemonic?

A

Class 3, AIDS (amiodarone, ibutilide, dofetilde, sotalol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

femoral cannulation above the inguinal ligament leads to?

A

retroperitoneal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

common site for AFlutter? how about AFib?

A

cavotricuspid isthmus, pulmonary vein ostia (where it enters)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

severe AS, decreased cardiac output, 90/60, pulmonary edema, no changes on ECG except atrial fibrillation, diagnosis and mechanism?

A

AS causing LVH and atrial fibrillation, which prevents atrial contraction into ventricles, lowering cardiac output = sudden decrease in cardiac left ventricular preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how do bb help in a patient with thickened intervententricular septal hypertrophy?

A

because of HOCM, outflow tract obstruction which is worse with decreased preload, so bb help increase preload by slowing heart and reducing contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

which chamber is closest to esophagus

A

LA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

septic shock- what is CVP, PCWP, Cardiac index, SVR, SvO2(mixed venous return), temperature?

A

low low high low high, low or high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

endocarditis, gram pos cocci, catalase negative, bile and sodium 6.5% resistant, what is procedure that leads to this guy being introduced?

A

cystoscopy (enterococcus -faceium/faecalis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

hemosiderin in lungs, what is pathology?

A

LV failure, causing backup of blood in lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

aortic stenosis due to calcifciations, what type of calcification and mechanism?

A

dystrophic calcification, damaged, necrosed tissue acts as nidus for calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

beck’s triad for what?

A

hypotension, elevated JVP, muffled heart sounds, for cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

MI heart suddenly regains some function after PCI, why?

A

hibernating myocardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

RHF symptoms, CT scan shows thickened pericardiumm, dx?

A

constrictive pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

inferior MI, bradycardia, mechanism? what drug do you give?

A

inferior MI leads to nodal ischemia because RCA provides the nodes. give atropine, because anticholinergic effect will counter the bradycardia and the increased vagal tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

QRS prolongation drug, not much effect on QT interval, which part of depolarization does it effect and what class of drug?

A

class IC, phase 0 (depolarization, opening of sodium channels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

trastuzumab effect on heart

A

blocks HER2 which protects heart from oxidative stress, so reduced cardiac contractility with no fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

esmolol given, which part of PQRST does it affect and how?

A

PR interval because Bb slow down AV node conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

fever, joint pain, rash, ANA positive. what drug?

A

procainamide and hydralazine isoniazid also (drug induced lupus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

smoker, raynauds, vasculitis, dx and histo features?

A

buerger’s disease; segmental vessel vasculitis extending to contiguous veins and nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

chronic COPD leading to chronic heart failure, what compensatory change prevents development of edema?

A

increased lymphatic uptake

40
Q

one sided swelling of face and arms from a smoker, where is the blockage?

A

brachiocephalic. SVC on one side only

41
Q

corrigan and duzeiz sign, what is relative aortic and LV systolic and diastolic pressures?

A

aortic = elevated systolic, low diastolic. LV= elevated systolic, increased diastolic

42
Q

what is viscious cycle components (2) in heart failure?

A

sympathetic activation due to baroreceptors and RAAS activation

43
Q

Pharyngeal arches mnemonic

A 
Gambling if you don't study these:
1 man
Fucked 2 Strippers
In 3 Great Styles
but don't tell
4 always remember to say That what happens in vagus
recurs in vagus
44
Q

CVP is high, PCWP is low, patient with recent MI with syncope. causes?

A

Right ventricular failure

45
Q

25mmHg and 2 mmHg –> 25 mmHg and 10 mmHg, where are the measurements being taken

A

RV and PA

46
Q

what causes BNP release and what two things does it do?

A

stress of ventricular wall, vasodilation and diuresis

47
Q

constrictive pericarditis, what sign do you expect to see?

A

kussmaul’s sign (rise in JVP during inspiration), pulsus paradoxus (drop in SBP during inspiration)

48
Q

what is behind the esophagus in thorax?

A

descending aorta

49
Q

norepinephrine effects and mechanism/second messenger

A

a1 and a2 stimulation, using IP3, causing vasoconstriction; and B1 stimulation, using increased cAMP, causing cardiac heart rate increase

50
Q

AV fistulas lead to what kind of pressure volume loop?

A

high EDV, lower afterload (load ventricle has to pump against)

51
Q

dobutamine moa and effect

A

Gs protein adenylate cyclase activation leading to rise in cAMP, and Ca++ in heart, and vasodilation. increases contractility

52
Q

phenoxybenzoamine uses, mechanism

A

pheochromocytoma, a blocker as irreversible inhibitor

53
Q

prinzmetal trigger and treatment

A

dihydroergotamine or triptans, treatment is CCB or nitrates

54
Q

continuous murmur in child, palpable thrill below clavicle, what embryological origin is the structure?

A

sixth aortic arch (PDA)

55
Q

young woman with a stroke, and on oral contraceptives, bubble study shows patent foramen ovale, what is dx?

A

paradoxical embolism to the brain, from PFO with patient on oral contraceptives

56
Q

fever, joint pain, rash, ANA positive. what drug?

A

procainamide and hydralazine isoniazid also (drug induced lupus)

57
Q

clubbing and cyanosis in the toes, childhood heart condition, dyspnea now. dx and differential?

A

PDA, ddx coarctation (the infant form) where coarctation lies after subclavian but before PDA

58
Q

what is pathophysiology of AAA? how about aortic dissection in marfans? and thoracic aneurysm in syphillis?

A

chronic transmural inflammation because atherosclerotic plaques increase diffusion barrier for O2 and cause inflammation, which means MMP and elastase are secreted by inflammatory cells to destroy ECM and weaken wall/ cystic degeneration of media, syphillis is vasa vasorum endarteritis

59
Q

what is made by endothelial cells to oppose platelet aggregation, and what does it specifically oppose? and what does kallikrein do?

A

Prostacyclin–> TXA2. kallikrein- turns kininogen to bradykinin. maybe plays a role in fibrinolytic pathway

60
Q

death 5 days after MI, what is most likely cause a=nd symtpoms and time frame?

A

Left ventricular free wall rupture, chest pain, tamponade, shock, severe hypotension in 5-14 days after AMI

61
Q

prolonged QRS interval on treadmill test, with preserved QTc, what is drug? what is use-dependence?

A

flecainide, class 1C, use-dependence means the faster a heart is beating the more effect the drug will have

62
Q

dyspnea, edema, =======fistula between aortacough with recent hoarseness, cause?

A

ortner’s syndrome, LA enlargement causing neurapraxia (failure of nerve conduction due to blunt injury to nerve)

63
Q

mechanism of prinzmetal variant angina?

A

hyperreactivity of coronary artery smooth muscle because defective production of NO by endothelial cells, which means vagal tone (acetylcholine) takes over and vasoconstricts

64
Q

what drug increases cardiac contractility and decreases TPR?

A

isoretinoin- B1 equals B2,

65
Q

fistula between aorta and RV, when does blood flow and where?

A

aorta to RV, continuously. because 120/80 in aorta, 25/5 in RV, 25/10 in PCWP

66
Q

polyarteritis nodosa, what vessels does it spare?, appearance on histo?

A

pulmonary, string of pearls

67
Q

dobutamine effect on normal myocardium and on a patient with angina? and what is mechanism of pathology?

A

B1 agonists, mimics exercise, so transient increase in heart rate and contractility, which means ejection fraction also increases. in patient with angina, OXYGEN SUPPLY AND DEMAND MISMATCH leads to decreased EF

68
Q

Mechanism of alteplase and why it’s risky

A

binds fibrin and converts plasmin to plasminogen, risky because of intracerebral hemorrhage risk

69
Q

mitral valve calcification and vegetation but no bacterial organism, what is dx and common causes?

A

NBTE non-bacterial thrombotic endocarditis, caused commonly by advanced malignancy (hypercoagulable state and proinflammatory state) and SLE

70
Q

2 SE of ACEi therapy

A

first dose hypotension and reduced GFR

71
Q

what exacerbates S3? and why?

A

end expiration, because it decreases lung volume and brings heart closer to chest, and also cause left-sided murmurs are worse on expiration because it causes return of blood from lungs to left atrium

72
Q

JVP on cardiac cycle stages

A

a,c,x,v,y (atrial contraction, RV contraction and tricuspid bulging into RA, x descent is tricuspid going down, v is right atrial villing, and y descent is RA emptying into RV

73
Q

two places that bear the greatest atherosclerotic burden?

A

coronary and lower abdominal aorta

74
Q

beta blocker toxicity, what do you give and how does it work?

A

glucagon, cAMP, raises Ca release, increases heart rate and contractility

75
Q

lipofuschin what is it aresult of?

A

lipid peroxidation

76
Q

aortic dissection two prereqs and histological feature

A

tear in intima, preexisting weakness in media. cystic degeneration of media, being replaced by MMP

77
Q

chest pain, dysphagia and hoarsenss, and dies of hypotension later, dx?

A

ruptured thoracic aortic anueyrsm

78
Q

where is SA and AV node located?

A

SA- junction of SVC and RA, AV- septal cusp of tricuspid valve

79
Q

eccentric and concentric hypertrophy, explain and give example

A

eccentric- adding in series (dilated cardiomyopathy, systolic HF), concentric- adding in parallel (HFpEF, HOCM)

80
Q

describe the carotid sinus reflex, what is afferent/efferent limb?

A

arterial stetch–> afferent- glossopharyngeal, efferent –>vagus, lowers BP and CO

81
Q

highest predisposing factor to IE in developed, developing countries?

A

mitral valve prolapse/rheumatic heart disease

82
Q

major determining factor for symptom severity in TOF?

A

pulmonary stenosis, because that determines cyanosis or not

83
Q

HLD drugs moa- fibrates, ezetimibe, statins, omega 3

A

fibrates and omega 3- decrease VLDL production by activating PPAR-a and increase HDL by activating LPL. ezetimibe blocks intestinal absorption of cholesterol. statins inhibit HMG CoA, blocking production of cholesterol in liver,

84
Q

person treated for systolic HF, nausea, vomiting, stomach upset, dizziness, anorexia, visual distrubance, what is causing and what is complication?

A

digoxin, arrhtyhmia

85
Q

post MI drug that exacerbates ischemia? what do you not give in a specific MI context?

A

arterial vasodilator (adenosine, dipyridamole) that leads to coronary steal syndrome. also don’t give nitrates in inferior MI (RV is dependent on preload)

86
Q

what are conditions that can cause pulsus paradoxus?

A

COPD and asthma, because lungs are so compliant, drop is significant

87
Q

loading dose and maintenance dose equation

A

Vd x Cpss, CL x Cpss (divide by bioavailability if not intravenous

88
Q

why is class 1b good for ischemic heart? and 1c bad for ischemic heart?

A

because ischemic heart has delayed transition to resting state, so 1b drugs bind preferentially to those areas. 1c has strong use dependence, strongly binds, so can lead to arrhythmic events

89
Q

in AF, what determines rate of ventricular contraction?

A

AV node refractory period. AF is atrium firing like crazy but does not all reach ventricle because of AV node refractory period

90
Q

what cells help in development of atheroma?

A

platelet, activated macrophages, endothelial cells

91
Q

irreversible sign of cell injury?

A

vacuolizaition onf mictrochondria

92
Q

what structures blocks outflow in HOCM

A

mitral valve and septal hypertrophy

93
Q

mvmt of calcium in contraction and relaxation

A

L-type Ca open, enteres, RyR senses Ca and opens sarcoplasmic reticulum gate to send. then SERCA and Na/Ca exchanger promotes outflow of Ca into SR and extracelluarly

94
Q

hematuria, ischemic stroke, lactate is high, CT of abdo shows lucency in kidney, dx?

A

renal infarct

95
Q

murmur best heard on leaning forward, crescendo-decrescendo- where is the murmur loudest?

A

AR is loudest right after closure of aortic valve, when pressure difference is the highest

UworldSUN (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions