Brainscape's Knowledge GenomeTM

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


See full index

Step 1 2019 First Aid Flashcards > Cardio - FA Phys/Patho p290 - 304 > Flashcards

Cardio - FA Phys/Patho p290 - 304 Flashcards

1
Q

Explain briefly what happens in each phase during myocardial action potential ?

A

Phase 0 - opening of voltage gated Na channels open, rapid upstroke and depol

Phase 1 - inactivation of voltage gated Na channels, voltage gated K+ channels begin to open

Phase 2 - plateau, Ca2+ influx, K+ efflux,

Phase 3 - repol by K+ efflux

Phase 4 - resting potential by high K+ perm

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

How is cardiac muscle action potential compare to skeletal muscle action potential?

A

Cardiac muscle action potential has a plateau, which is due to Ca2+ influx and K+ efflux.

ƒ Cardiac muscle contraction requires Ca2+ influx from ECF to induce Ca2+ release from sarcoplasmic reticulum (Ca2+-induced Ca2+ release).

ƒ Cardiac myocytes are electrically coupled to each other by gap junctions

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

Which phases of AP are not present in SA/AV node action potential?

A

There’s no phase 1 or 2

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

Which channel is responsible for phase 0 of SA node AP? What is phase 0?

A

opening of voltage gated Ca channels; upstroke

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

What are Na channels’ role in phase 0 of SA node?

A

None, Fast voltage gated channels are permanently inactivated here bc of the resting voltage of these cells is closer to zero than in ventricular myocytes

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

What part of the AP determines HR?

A

The slope of phase 4 in the SA node determines HR.

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

How does SNS activation increase HR?

A

Sympathetic stimulation inc the chance that If channels are open and thus inc HR.

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

Normal duration of PR interval?

A

<200 msec

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

List the following in order of speed of conduction: atria, ventricles, AV, bundle of his, purkinje fibers

A

Purkinje > atria > ventricles >Bundle of His> AV node

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

Normal duration of QRS?

A

<120 msec

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

U wave caused by?

A

hypokalemia, bradycardia

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

Which drugs cause long QT?

A

AntiArrythmics (Class Ia, III) Antibiotics (Macrolides - and not an antibiotic but also the HIV anti viral rx Protease inhbitors and anti- malaria Chloroquine) Anti”C”ychotics (haloperidol, Risperidone)\ AntiDepressants - TCAs Anti-Emetics - Odansetron

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

Other than drugs, what else can cause long QT?

A

dec K+, dec Mg2+, dec Ca2+, congenital abnormalities.

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

Long QT leads to? How to treat it?

A

Torsades de pointes; Tx = MgSO4

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

Which congenital long QT is more common?

A

Jervell and Lange-Nielsen (AR)

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

Which congenital long QT syndrome is associated with deafness?

A

Jervell and Lange-Nielsen

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

ECG pattern of Brugada syndrome?

A

ECG pattern of RBBB (wide QRS, slurred S, T irreg) + ST elevation esp in V1-V3

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

Brugada syndrome lead to a an inc risk of?

A

Vtach and SCD

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

What is underlying patho mech of WPW syndrome?

A

Abnormally fast conduction from atria –> ventricle, bypassing the AV node

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

ECG signs of WPW?

A

delta wave + wide QRS + short PR

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

ECG signs of 1st degree AV block?

A

prolonged PR (>200msec)

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

ECG signs of 2nd degree AV block, Mobitz I?

A

progressive lengthening of PR interval until a beat is dropped

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

ECG signs of 2nd degree AV block, Mobitz II?

A

Dropped beats not preceeded by progressively longer PR internals - can be 2 or more P waves to one QRS

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

How does one know that 2nd degree AV block has progressed to 3rd degree?

A

When atria and ventricle beat independent of one another - P waves and QRS not associated with each other.

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

How to treat 1st/ 2nd/ 3rd degree AV block?

A

1st - no Tx
2nd type II - pacemaker
3rd - pacemaker

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

Which infectious disease is associated with 3rd degree AV block?

A

Lyme Disease

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

Recombinant form of B type natriuretic peptide?

A

Nesiritide

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

Physiological effect of ANP?

A

Causes vasodilation and dec Na resorption at renal collecting tubule, VD of aff art and VC of eff art

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

ANP uses which 2nd messenger?

A

cGMP

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

What causes the release of ANP vs BNP

A

ANP - rel from atrial myocytes in response to inc blood vol and atrial pressure
BNP - rel from ventric myocytes in response to inc tension

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

Physiological effect of ANP?

A

Causes vasodilation and dec Na resorption at renal collecting tubule, VD of aff art and VC of eff art

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

Which nerves are afferent to the solitary nucleus from the carotid and aortic body?

A

Cn IX, X

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

Which CV disease associated with DeGeorge?

A

Persistent Truncus Arteriosus, Tetrology of Fallot

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

Due to failure of aorticopulmary septum formation?

A

Persistent Truncus Arteriosus

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

Due to failure of aorticopulmary septum to spiral?

A

Transposition of Great Vessels

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

What bedside maneuver would improve cyanosis in Tetrology of Fallot? why?

A

Squatting - inc systemic vasc resistence, dec R–> L shunt

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

Which congenital CV disease assoc with maternal mood disorder?

A

Ebstein anomaly - can be caused by Li exposure in utero if mother is bipolar

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

Cushing Reflex triad

A

hypertension, bradycardia, respiratory depression

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

Types of chemoreceptors and stimulators for them

A

Peripheral: lower Po2, lower pH, high PCo2 Central: changes in pH and PCo2 (brain interstitial fluid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What does PWCP measure (approximate)?

A

Left atrial pressure (<12mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Hypoxia’s effect on the Lung’s vessels

A

VC

42
Q

Metabolites that influence skeletal muscle during exercise

A

Adenosine, CO2, lactate, K, H

43
Q

Frequency of L-R shunt CV disease from most common to least?

A

VSD>ASD>PDA

44
Q

Which L-> R shunt assoc with Cri du Chat?

A

VSD

45
Q

Female patient with broad chest and widely spaced nipples and streak ovaries would likely have which Congenital CV disease

A

Preductal Coarctation of Aorta or Bicuspid Aortic valve - this woman has Turners

46
Q

Late cyanosis in lower extremities

A

PDA

47
Q

Assoc with notching of ribs

A

post ductal Coarctation of Aorta

48
Q

Assoc with clubbing of fingers and polycythemia?

A

Eisenmenger Syndrome

49
Q

In persistent truncus arteriosus, most patients have accompanying

A

VSD

50
Q

D-transposition of great vessels is due to what? What is the life expectancy of infants

A

failure of aorticopulmonary septum to spiral. Most infants die within the first few months of life.

51
Q

Tricuspid atresia is

A

Absence of tricuspid valve and hypoplastic RV

52
Q

What is the Tetralogy of Fallot

A

1 Pulmonary infundibular stenosis 2 RVH 3 Overriding aorta 4 VSD

53
Q

TAPVR Total anomalous pulmonary venous return is associated with

A

ASD and sometimes PDA to allow for right->left shunting to maintain cardiac output.

54
Q

Ebstein anomaly is seen if the mother has bipolar disease and ingested

A

Lithium exposure in utero

55
Q

A pt with a microdeletion of chromosome 7 would likely have what disease?

A

Supravalvular aortic stenosis, pt has Williams

56
Q

Mother has fever, infection, swollen lymph nodes and rash that travels down the body during pregnancy - child is at risk for?

A

Mother has rubella - PDA, Pulm a stenosis, septal defects

57
Q

Tall man with abnormally long arms are prone to which heart disorders?

A

MVP, Aortic regurgitation, thoracic aortic aneurysm

58
Q

What is a hypertensive urgency? What BP?

A

severe inc in BP - ≥ 180/ ≥120 mmHg

59
Q

Define HTN?

A

Persistent systolic BP ≥ 130mmHg and/ord diastolic BP ≥ 80 mmHg

60
Q

The renal a in fibromuscular dysplasia has what kind of appearence?

A

“string of beads” appearence

61
Q

What type of HTN can cause microangiopathic hemolytic anemia?

A

HTN emergency

62
Q

What happens to renal a in HTN that shows up on PAS stain?

A

renal artery hyalinosis

63
Q

VSD is seen in which 2 syndromes?

A

Fetal alcohol syndrome, Down’s syndrome

64
Q

Partial deletion of chr 7 will lead to what CV issue?

A

Supravalvular aortic stenosis.

65
Q

What thymus disorder is seen with truncus arteriosus, and tetrology of fallot? What chromosome?

A

DeGeorge syndrome - thymic aplasia; 22q11

66
Q

what type of arterioslerosis is seen in med sized arteries?

A

Monckeberg

67
Q

what are xanthomas?

A

plaques or nodules composed of lipid laden histiocytes in skin

68
Q

hypercholesterolemia can manifest what eye pathology earlier than the general population?

A

Corneal arcus?

69
Q

Pipestem appearence of an a. on an CXR is a sign of what?

A

Monckeberg - medial calcific sclerosis

70
Q

onion skinning of an artery is a proliferation of what cell type/which arteries?

A

smooth musc cells of small arteries and arterioles

71
Q

Essential hypertension or DB lead to what pathology of arteries?

A

small arteries and arterioles - hyaline arteriolosclerosis

72
Q

Why is there no obstruction of blood flow with Monckeberg arteriolosclerosis?

A

Affects tunica media, not intima, so lumen diam not affected

73
Q

Most common locations of atherosclerosis in order?

A

Ab aorta > Coronaries > Popliteal a > carotid a

74
Q

Syphilis associated with what type of cardiac pathology? Which stage of syphilis?

A

Thoracic aortic aneurysm, tertiary syphilis

75
Q

Which sexual genetic disorder could potentially lead to thoracic aortic aneurysm?

A

Turner’s (45, XO) bc of association with bicuspid aortic aneurysm

76
Q

Cystic medial degeneration associated with which cardiac pathology?

A

Thoracic aortic aneurysm

77
Q

Tobacco, cocaine, and triptans are associated with triggering which cardiac pathology?

A

Prinzmetal angina

78
Q

Mediastinal widening on CXR is a sign of ? (as a consequence of syphillis)

A

aortic dissection

79
Q

What is Coronary steal syndrome?

A

Giving vasodilators in a patient with coronary stenosis will cause the dilation of normal vessels and reduces the flow to area distal to the stenosis. This is the principal behind cardiac stress test.

80
Q

ECG signs of transmural vs subdendocardial MI?

A

transmural - ST elevation (STEMI), Q waves subendocardial - NSTEMI = ST depressions

81
Q

Diseases associated with sudden cardiac death

A

CAD, cardiomyopathy, heriditary ion channelopathies (long QT syndrome, Brugada syndrome)

82
Q

wavy fibers appear how soon after an MI?

A

4-24 hrs

83
Q

Biggest complication 1-3d post MI?

A

Postinfarction fibrinous pericarditis

84
Q

If one sees macrophages and mariginal granulation tissue, how many days post MI?

A

3-14d

85
Q

Major complications 3-14 days post MI?

A

free wall rupture –> tamponade papillary muscle rupture –> mitral regurge, IV septum rupture LV pseudoaneurysm

86
Q

What changes are seen in heart tissue in the first 4 hours post MI?

A

none

87
Q

First cardiac biomarker to rise post MI?

A

myoglobin

88
Q

Most specific cardiac biomarker post MI?

A

Cardiac troponin I

89
Q

Which cardiac biomarker is useful to determine if there was a re-infaction?

A

CK-MB, normally falls after 48hrs, so if high after that, sign of re-infarction

90
Q

Most common cause of death post MI?

A

Arrythmia

91
Q

V1 - V2 leads MI = which area of heart? artery?

A

anterior, over the septum - LAD

92
Q

V3- V4 leads MI = which area of heart? artery?

A

anterior side to the apex - distal LAD

93
Q

V5 - V6 leads MI = which area of heart? artery?

A

anterior side to lateral heart - LAD or L circumflex

94
Q

Leads I, aVL = which area of heart? artery?

A

lateral side - L circumflex

95
Q

Leads II, III, avF = area of heart? artery?

A

inferior heart - R circumflex

96
Q

What is Dressler syndrome?

A

Autoimmune, leads to fibrinous pericarditis

97
Q

When would a postinfarction fibrinous pericarditis occur post MI?

A

1-3 d post MI

98
Q

Which two complications of an MI can occur up to 14 days post MI?

A

Ventric free wall rupture, ventricular pseudoaneurysm formation (contained free wall rupture)

99
Q

Which complication can appear 2 weeks to months post MI?

A

True ventricular aneurysm

100
Q

When is the greatest risk for septal rupture post MI?

A

3-14 days post MI

Step 1 2019 First Aid Flashcards (63 decks)

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