Cardio Review Flashcards
Name the Murmur
- Wide Fixed S2
Atrial Septal Defect
Name the Murmur
- Continuous Machine-LIke
Patent Ductus Arteriosis
Name the Murmur
- Harsh Holosystolic
Ventricular Septal Defect
Name the Murmurs
- Systolic
MR. ASS
- Mitral Regurg
- Tricuspid Regurg.
- Aortic Stenosis
- Pulm. Stenosis
*also, VSD, ASD, and HOCM
Name the Murmurs
- Diastolic
- Mitral Stenosis
- Tricuspid Stenosis
- Aortic Regurg.
- Pulm Regurg.
Name the Murmur
- head bobbing
Aortic Regurg.
What valve closes during the first heart sound?
Mitral Valve
(tricuspid also closes)
- isovolumetric contraction
GOAL IN INCREASE LV PRESSURE
What valve closes during the second heart sound?
Aortic Valve
(pulm. valve also closes)
- isovolumetric relaxation begins
DECREASE PRESSURE IN VENTRICLES
Hand Grip INCREASES intensity of what murmurs?
- Mitral Regurg.
- Aortic Regurg.
- VSD
increases afterload
Hand Grip DECREASES intensity of what murmurs?
- HOCM
increases afterload
Valsalva/Standing up INCREASES intensity of what murmurs?
HOCM
increases preload
Valsalva/Standing up DECREASES intensity of what murmurs?
All except HOCM
Name the Heart Issue:
- pericardial friction rub
pericarditis
Name the Heart Issue:
- pericardial knock
constrictive pericarditis
Name the Heart Issue:
- palpable heave at apex
Left Ventricular Hypertrophy
Name the Heart Issue:
- left parasternal lift
Right Ventricular Hypertrophy
What does this embryonic structure give rise to?
- Truncus Arteriosus
- ascending aorta
- pulmonary trunk
What does this embryonic structure give rise to?
- Primitive Atrium
- trabeculated part of left and right atria
What does this embryonic structure give rise to?
- left horn of sinus venosus
- coronary sinus
Heart Defect In…
- Turner’s Syndrome
- Bicuspid Aortic Valve
(coarctation of aorta)
Heart Defect In…
- Marfan’s Syndrome
- Cystic Medial degeneration of the aorta
- Aortic regurg.
Heart Defect In…
- Infant of a diabetic mother
- transposition of great vessels
Heart Defect In…
- 22q11 Deletion (DiGeorge)
- Truncus arteriosus
- Tetralogy of Fallot
Heart Defect In…
- Down Syndrome
- ASD, VSD
Heart Defect In…
- Congenital Rubella
- Septal Defects
- PDA
- Pulm. Artery Stenosis
What is a plaque in a blood vessel wall?
atheroma
What is a plaque that has lipid-laden histocytes on/near the eyelids?
xanthomas
MOA of HMG-Coa Reducatase Inhibitors
inhibits cholestrol precursor (mevalonate)
statins
MOA of Niacin
- activates hormone sensitive lipase
- reduces VLDL synthesis
MOA of Bile Acid Resins
- blocks intestinal bile reabsorption
MOA of Ezetimibe
- blocks brush border cholesterol absorption
SE of Niacin
- facial flushing
Name the class of drug:
- norepinephrine
- phenylephrine
alpha 1 agonist
Name the class of drug:
- clonidine
alpha 2 agonist
Name the class of drug:
- norepinephrine
- isoproterenol
- dobutamine
beta 1 agonist
Name the class of drug:
- isoproterenol
- albuterol
beta 2 agonist
Name the class of drug:
- ACH
- nicotine
- carbachol
nicotinic cholinergic agonist
Name the class of drug:
- ACH
- muscarine
muscarininc cholinergic agonist
Name the class of drug:
- phenoxybenzamine (irreversible)
- phentolamine
- prazosin
alpha 1 antagonist
Name the class of drug:
- propanolol
- metoprolol
beta 1 antagonist
Name the class of drug:
- propanolol
- butaxamine
beta 2 antagonist
Name the class of drug:
- atropine
muscarinic cholinergic antagonist
Name 4 HTN drugs that are safe to use in pregnancy.
- hydralazine
- labetalol
- nifedipine
- methyldopa
What type of patients are B-Blockers contraindicated in?
- COPD (bronchospasms)
- Diabetics (blocks hypoglycemia)
- hyperkalemic pts. (increases K+)
What type of patients are ACE-inhibitors contraindicated in?
pregnancy
First step in reperfusion injury mechanism.
- oxygen free radical generation
(by endothelial cells)
Histology 4-12 Hours after MI
- wavy fibers
Histology 28-48 Hours after MI
- neutrophilic infiltrate
- coag. necrosis
Histology 3-10 Days after MI
- MACROPHAGES
Histology 2 Weeks after MI
- granulation by macrophages
C/I for Labetalol
Bradycardia
Short acting drug for HTN emergency
Nitroprusside
SE of Nitroprusside
Cyanide Poisoning
Best drug to treat HTN and BPH
- Prazosin
Best drug to treat HTN and Osteoporosis
- Hydrochlorothiazide
Best drug to treat HTN and Recurrent Ca Stones
Thiazides
Best drug for HTN and DM
- ACE inhibitors
- ARBS
Arrows:
ACE Inhibitors
Renin, AT I, AT II, Bradykinin, Aldosterone, K+
Increase
- Renin
- AT I
- Bradykinin
- K+
Decrease
- AT II
- Aldo
Arrows:
ARBS
Renin, AT I, AT II, Bradykinin, Aldosterone, K+
Increase
- Renin
- AT I
- AT II
- K+
Decrease
- Aldo
- Bradykinin
MOA of milrinone
PDE-3 Inhibitor
SE of Statins
- muscle pains/cramps
DOC for decreasing HDL
Niacin
MOA of nicotinic acid
- increases HDL
- activates hormone sensitive lipase
What type of murmur can rheumatic fever cause?
Mitral Stenosis
Low Voltage QRS
cardiac tamponade
How to treat rheumatic fever?
PCN
Shifting Sinusoidal Waveforms
- Torsades
treatment: magnesium
Supraventricular Tachycardia in a 15 y/o
Wolff-Parkinson White Syndrome
Treatment for Cyanide Poisoning
- Vitamin B12
- Sodium Thiosulfate
DOC for a pt with Hypertension and Asthma
- Calcium Channel Blockers
- ARBS
DOC for a pt with Hypertension and Raynauds
Calcium Channel Blockers
Name the diabetic agents that are cardioprotective
- SGLT-2 inhibitors (flozins)
- GLP-1 analogs (glutides)
SE of Digoxin
- yellowing of vision
- nausea
- vomitting
Acute Management of MI
M - morphine
O - oxygen
N - nitroglycerin
A - aspirin
B - beta-blocker
Treatment for propanolol overdose
- atropine
- saline
- glucagon
SE of Quinidine
- Tinnitus/Vertigo
- Prolonged QT
SE of ibutilide/dofetilide
Prolonged QT
What Beta Blocker increases QT interval?
Sotalol (Class III anti-arrhythmic)
SE of Fibrates (i.e. gemfibrozil)
- myopathy/myalgias
- gallstones
SE of Statins (i.e. atorvastatin)
- myopathy
- hepatotoxicity
A pt is started on a new medication to tx his hypertension 2 months ago, now he comes in complaining of occasional dizziness, flushing, & persistent swelling of his feet for the past week. Exam shows 3+ pitting edema. What drug is he taking?
Amlodipine (Ca channel blockers)
Treatment for Wolff-Parkinson White Syndrome
Procainamide
Name the CYP 450 Dependent Meds
WEPT-D
- Warfarin
- Estrogen (OCPs)
- Phenytoin
- Theophylline
- Digoxin
Which lipid lowering agent increases triglycerides on labs?
Bile acid resins
MOA of Digoxin
- Directly inhibits Na/K ATPase
Treatment for Stanford Type B Aortic Dissection
Esmolol
What type of valvular disease is seen in EDS (Ehlers-Danlos Syndrome)?
Mitral regurg/MVP (chordae tendinae rupture
Embryologic derivative of cardinal veins
Superior Vena Cava
Snowman (Figure 8) appearance is associated with what heart defect?
TAPVR - Total Anomalous Pulmonary Venous Return
What supplies the SA and AV nodes of the heart?
SA/AV nodal branch off Right Coronary Artery
What antiarrythymics modify Phase 0?
Class 1A antiarrhythimics
Heart has a plop sound - what disease?
Atrial myxoma
Delta Wave?
Wolff-Parkinson White Syndrome
What is the name of the reentrant pathway?
Bundle of Kent
Lithium causes what heart defect….
Ebstein’s Anomaly
(atrialization of the ventricle)
Sawtooth P waves on EKG
atrial flutter
Treatment: anticoagulant
Pseudo-right bundle branch block
- AD in Asian Males
Brugada Syndrome
Dizziness + Syncope; Bradycardia with a Pause
Sick Sinus Syndrome
location: degeneration of SA node
Vegetations on BOTH sides of the valve
Libbman-Sacks Endocarditis (SLE)
Most common cardiac tumor in adults
METASTISIS
benign, gelatinous mass (GAGS) in heart
Myxoma
(produces IL-6)
Breathe In; BP drops (> 10 mm Hg)
Pulsus Paradoxus
TTN gene
Dilated Cardiomyopathy
“dropped beat”
P wave –> Absent QRS
Mobitz Type II
- P waves keep getting longer
- drop QRS
Mobitz Type I
P waves and QRS don’t align but
30 seconds later, they align and never see it again; How do you treat?
Pacemaker!!
