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Cardiology > Cardio Small Groups > Flashcards

Cardio Small Groups Flashcards

1
Q

IMPORTANT CONCEPT 1: Atherosclerosis is a disease of?

A

Medium arteries, especially coronary and cerebral, and aorta.

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2
Q

IMPORTANT CONCEPT 2: The five step process to atherosclerosis is thought to begin with?

A

Endothelial injury.

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3
Q

IMPORTANT CONCEPT 3: An atherosclerotic plaque with a large loose atheromatous core and a thin fibrous cap is?

A

Vulnerable to rupture and superimposed thrombosis with severe consequences.

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4
Q

IMPORTANT CONCEPT 4: Thrombosis superimposed on rupture of a coronary atherosclerotic plaque is?

A

Especially likely to lead to total occlusion and transmural (full thickness) myocardial infarction.

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5
Q

Atherosclerosis:

A

Chronic inflammatory disease of tunica intima of medium and large arteries causing narrowing due to buildup of lipid followed by fibrosis.

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6
Q

Atheroma:

A

Earlier stage of atherosclerosis, with buildup of lipid and lipid-laden macrophages in tunica intima.

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7
Q

Vulnerable plaque:

A

Atherosclerotic plaque with a large loose atheromatous core and a thin fibrous cap, prone to rupture and occlusive superimposed thrombosis

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8
Q

IMPORTANT CONCEPT 1: Brief ischemia can provide ischemic preconditioning protection for subsequent ischemia, but longer ischemia can?

A

Stun myocytes rendering them temporarily unable to work and chronic ischemia can make them hibernate.

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9
Q

IMPORTANT CONCEPT 2: Myocardial infarction is?

A

Irreversible necrosis of heart muscle due to prolonged ischemia (longer than 20 minutes).

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10
Q

IMPORTANT CONCEPT 3: Contraction band necrosis is?

A

The form of irreversible myocyte injury associated with reperfusion.

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11
Q

IMPORTANT CONCEPT 4: Reperfusion injury is the?

A

Perverse damage caused by restoring blood flow to previously injured tissue.

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12
Q

Stunned myocytes:

A

Myocytes injured by acute ischemia, which look normal microscopically, but need time to repair before they work normally again.

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13
Q

Hibernating myocytes:

A

Chronically ischemic myocytes, which have cleared cytoplasm due to catabolism of their contractile proteins and need time to regenerate their contractile proteins before they work normally again.

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14
Q

Myocytolysis:

A

The light microscopic appearance of hibernating myocytes.

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15
Q

Ischemic preconditioning:

A

Resistance to mild-moderate ischemia due to induction of protective proteins by brief episodes of ischemia.

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16
Q

Contraction band necrosis:

A

Dead myocytes with dense hypereosinophilic transverse bands of hypercontracted sarcomeres, associated with reperfusion.

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17
Q

No reflow phenomenon:

A

Failure of relieving obstruction at the arterial level to restore blood flow, attributed to microvascular obstruction or edema.

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18
Q

Reperfusion injury:

A

Hemorrhage and other injurious phenomena associated with bringing oxygen and calcium to injured tissue, attributed to reactive oxygen species and metabolic effects of calcium

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19
Q

IMPORTANT CONCEPT 1: Aortic aneurysms are?

A

Familial

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20
Q

IMPORTANT CONCEPT 2: Aortic dissection is?

A

Medical or sometimes surgical emergency.

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21
Q

IMPORTANT CONCEPT 3: History and physical examination is all you should need to diagnose?

A

Peripheral arterial disease.

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22
Q

IMPORTANT CONCEPT 4: Acute arterial occlusion is manifested by the five Ps?

A

Pain, pallor, paralysis, paresthesia and pulselessness, and is a surgical emergency.

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23
Q

IMPORTANT CONCEPT 5: The most essential aspect of the treatment of Buerger disease is?

A

Getting the patient to quit smoking.

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24
Q

Aneurysm:

A

Abnormal localized dilatation (outpouching) of an artery, vein or heart.

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25
Q

Pseudoaneurysm:

A

Contained ruptures of the tunica intima and media and sometimes even adventitia of an artery.

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26
Q

Aortic dissection:

A

A catastrophic tear of the tunica intima letting luminal blood under high pressure into the tunica media, where it tunnels a second lumen.

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27
Q

Claudication:

A

Ischemic pain of the periphery, usually the legs, usually the calves, usually intermittent, usually brought on by exertion and relieved by rest.

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28
Q

Buerger disease:

A

Thromboangiitis obliterans, a chronic thrombosing inflammatory disease of small and medium arteries and veins of arms and legs.

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29
Q

IMPORTANT CONCEPT 1: Palpable purpura are a classic sign of?

A

Vasculitis

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30
Q

IMPORTANT CONCEPT 2: It behooves physicians who prescribe medications that cause hypersensitivity angiitis to?

A

Recognize it and stop the drugs.

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31
Q

IMPORTANT CONCEPT 3: Steroid therapy for temporal arteritis can?

A

Save elderly white females from blindness.

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32
Q

IMPORTANT CONCEPT 4: Prompt diagnosis and treatment of Kawasaki disease can?

A

Save babies from chronic heart disease or death.

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33
Q

The seven most common complications of myocardial infarction are?

A

(1) cardiac arrhythmias, (2) heart failure, (3) mural thrombus formation, (4) cardiac rupture, (5) pericarditis, (6) aneurysm formation and (7) papillary muscle rupture.

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34
Q

IMPORTANT CONCEPT 5: When heart failure occurs as a complication of acute myocardial infarction?

A

It is important to differentiate the patients who will benefit from diuresis, volume expansion or neither.

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35
Q

Vasculitis:

A

Heterogeneous group of uncommon, primarily autoimmune, occasion-nally life-threatening diseases, having in common inflammation of blood vessels.

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36
Q

Hypersensitivity angiitis:

A

An acute necrotizing inflammatory disease of the smallest blood vessels (arterioles, capillaries, venules), especially in the skin.

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37
Q

Temporal arteritis:

A

Giant cell arteritis, a granulomatous inflammatory disease of medium and larger arteries, especially in the head, in elderly white females.

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38
Q

Kawasaki disease:

A

Mucocutaneous lymph node syndrome, an acute childhood primary vasculitis of medium arteries, especially coronaries.

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39
Q

Mural thrombus:

A

Blood clot that forms on the lining of the heart or aorta over an abnormality in the wall, like a “mural” painting on a wall.

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40
Q

Cardiac tamponade:

A

Impaired cardiac filling and function due to something in the pericardial sac compressing it (blood, other fluid or fibrous adhesions).

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41
Q

IMPORTANT CONCEPT 1: A 200 ml hemopericardium from a ruptured myocardial infarction can?

A

Be fatal, but a 2000 ml chronic pleural effusion can be tolerated.

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42
Q

IMPORTANT CONCEPT 2: Jugular venous distention, muffled heart sounds and hypotension are?

A

Beck’s triad of physical findings of cardiac tamponade.

43
Q

IMPORTANT CONCEPT 3: The diagnostic criteria for acute pericarditis are any two of the following:

A

Typical chest pain, pericardial friction rub, suggestive EKG changes and pericardial effusion.

44
Q

Myopericarditis:

A

Simultaneous inflammation of myocardium and pericardium, commonly attributed to viral infection.

45
Q

Beck’s triad:

A

Jugular venous distention, muffled heart sounds and hypotension, signs of cardiac tamponade.

46
Q

Pulsus paradoxus:

A

An exaggeration of the normal decrease in blood pressure with inspiration >10 mm Hg systolic, associated with cardiac tamponade or asthma.

47
Q

Pericardial friction rub:

A

Superficial scratchy or squeaking sound, frequently triphasic, associated with acute pericarditis.

48
Q

IMPORTANT CONCEPT 1: Decompensation can cause hypertrophic or restrictive cardiomyopathy to?

A

Take on features of dilated cardiomyopathy.

49
Q

IMPORTANT CONCEPT 2: Hypertrophic cardiomyopathy is?

A

Simultaneously a structural and functional disease.

50
Q

IMPORTANT CONCEPT 3: Hypertrophic cardiomyopathy is the most common cause of?

A

Sudden death of American athletes under age 35.

51
Q

IMPORTANT CONCEPT 3: Atherosclerotic cardiovascular disease is the most common cause of?

A

Sudden death of American athletes over age 35.

52
Q

IMPORTANT CONCEPT 4: Cardiac amyloidosis is primarily?

A

A disease of older adults who present with heart failure.

53
Q

IMPORTANT CONCEPT 5: Cardiac sarcoidosis is primarily a disease of?

A

Young African Americans who present with arrhythmias.

54
Q

IMPORTANT CONCEPT 6: As a general principle, some cardiomyopathies are more likely to?

A

Heart failure and others with arrhythmias.

55
Q

Cardiomyopathy:

A

Heterogeneous group of myocardial diseases associated with mechanical and/or electrical dysfunction of the heart.

56
Q

Hypertrophic cardiomyopathy:

A

Group of genetic diseases with hypertrophy as a compensatory mechanism for mutations in genes encoding contractile proteins of the cardiac sarcomere.

57
Q

Idiopathic dilated cardiomyopathy:

A

Wastebasket category of nonspecific end-stage heart disease with cardiac dilatation and heart failure and no cause evident.

58
Q

Cardiac myxoma:

A

Benign gelatinous mesenchymal neoplasm of endocardium.

59
Q

IMPORTANT CONCEPT 2: The five major categories of the factors determining the heart’s function as a pump, the cardiac output, are?

A

(1) preload, (2) afterload, (3) contractility, (4) compliance and (5) heart rhythm.

60
Q

IMPORTANT CONCEPT 3: Heart failure is the most common?

A

Hemodynamic disorder, by far, and has a wide array of etiologies and pathogenic mechanisms.

61
Q

IMPORTANT CONCEPT 4 The two most specific symptoms of heart failure?

A

Paroxysmal nocturnal dyspnea and orthopnea.

62
Q

IMPORTANT CONCEPT 4: The two most common nonspecific symptoms of heart failure?

A

Dyspnea and fatigue are the two most common.

63
Q

IMPORTANT CONCEPT 5: Serum B-type natriuretic peptide is a biomarker of?

A

Heart failure and the level correlates with the severity of the heart failure.

64
Q

IMPORTANT CONCEPT 6: The atrial gallop of hypertensive heart disease sounds like?

A

Tennessee

65
Q

IMPORTANT CONCEPT 7: Differentiating hypovolemic shock from cardiogenic shock is crucial because the treatments are?

A

Opposite and mistaken diagnosis and treatment for one can be fatal for a patient who has the other.

66
Q

Hemodynamics:

A

The flow of blood.

67
Q

Systole:

A

The blood pumping phase of the cardiac cycle

68
Q

Diastole:

A

The chamber filling phase of the cardiac cycle

69
Q

Preload:

A

The ventricular wall tension at the end of diastole (degree of myocyte stretch) determined by end-diastolic volume, reflected in end-diastolic pressure.

70
Q

Afterload:

A

The resistance the ventricle must overcome to pump its contents, determined by systolic blood pressure, reflected in ventricular systolic pressure.

71
Q

Myocardial contractility:

A

Inotropic state determining the portion of the force of contraction independently of preload and afterload.

72
Q

Compliance:

A

The distendibility of the ventricle, determining the ease of filling it and, indirectly, the amount of filling and hence the amount of blood pumped.

73
Q

Heart failure:

A

Inability of the heart to pump sufficient blood to meet the needs of the body.

74
Q

B-type natriuretic peptide:

A

A hormone secreted in heart failure in proportion to the severity.

75
Q

IMPORTANT CONCEPT 1: Calcific aortic stenosis presents with?

A

(SAD) Syncope, Angina, or Dyspnea and valve replacement after the development of symptoms greatly improves survival.

76
Q

IMPORTANT CONCEPT 2: 25% reduction of forward stroke volume from the normal of 100 ml to 75 ml is associated with?

A

Clinical manifestations of heart failure.

77
Q

IMPORTANT CONCEPT 3: Mitral valve prolapse is the most common?

A

Valve disease in the US and usually benign.

78
Q

IMPORTANT CONCEPT 4: Surgical valve replacement for chronic valve disease is not a pure cure, but rather more like?

A

The replacement of one chronic disease with another, on the average lesser one.

79
Q

IMPORTANT CONCEPT 5: Marantic (non-bacterial thrombotic) endocarditis is?

A

The deposition of blood clot on heart valves, important because it is common, frequently embolizes and is the precursor to infective endocarditis.

80
Q

IMPORTANT CONCEPT 6: Infective endocarditis is infection of thrombi on heart valves, important because prompt diagnosis?

A

Decreases the mortality from 100% to 20%.

81
Q

IMPORTANT CONCEPT 7: If you astutely diagnose infective endocarditis, don’t wait for the echocardiographic confirmation?

A

Get the blood cultures, put “suspect endocarditis” on the microbiology laboratory requisition and start the antibiotic therapy.

82
Q

Mitral valve prolapse:

A

Billowing of redundant mitral valve into the left atrium during systole.

83
Q

Rheumatic heart disease:

A

Immune-mediated inflammation of the heart, especially valves, triggered by group A streptococcal infection.

84
Q

Libman-Sacks endocarditis:

A

Autoimmune inflammation of the heart valves as part of systemic lupus erythematosus.

85
Q

Marantic endocarditis:

A

Non-bacterial thrombotic endocarditis, the deposition of blood clot on heart valves.

86
Q

Vegetations:

A

Colorful misnomer for blood clots on heart valves.

87
Q

Osler nodes:

A

Pea-sized tender nodules in fingers and toes from infected thromboemboli from infective endocarditis.

88
Q

Janeway lesions:

A

Hemorrhages on the palms or soles from infected thromboemboli from infective endocarditis.

89
Q

IMPORTANT CONCEPT 1: The most common cause of right heart failure is?

A

Left heart failure.

90
Q

IMPORTANT CONCEPT 2: Cor pulmonale is right heart disease caused by?

A

Pulmonary hypertensive diseases, especially emphysema, embolism and interstitial lung disease.

91
Q

IMPORTANT CONCEPT 3: Leg edema, hepatomegaly, ascites and jugular venous distention can all be manifestations of?

A

Right heart failure.

92
Q

IMPORTANT CONCEPT 4: Small patches of myocardial disease, especially scarring, are?

A

A common anatomic substrate for fatal reentrant ventricular tachycardia.

93
Q

IMPORTANT CONCEPT 5: A cardiac arrhythmia, especially heart block, in a young African American suggests?

A

The possibility of cardiac sarcoidosis.

94
Q

IMPORTANT CONCEPT 6: A prolonged QT interval, corrected QT (QTc), over 440 milliseconds is a signal of?

A

Dangerous heart disease.

95
Q

IMPORTANT CONCEPT 7: Sudden cardiac death of an infant, child or young adult is commonly due to?

A

Familial disease and accurate diagnosis can yield life-saving interventions for other family members.

96
Q

Cor pulmonale:

A

Heart disease caused by lung disease.

97
Q

Arrhythmia:

A

Disturbance in heart rhythm due to deranged cardiac electrical signaling.

98
Q

PR interval:

A

Time from start of P wave to end of QRS, normally 120-200 ms, indicative of conduction block around AV node if prolonged.

99
Q

QT interval:

A

Time from start of QRS to end of T wave, normally <440 ms, dangerous if prolonged due to risk of ventricular tachyarrhythmias.

100
Q

Atrial fibrillation:

A

Arrhythmia of chaotic atrial activation at a rapid rate causing an irregular heart rhythm due to variable conduction through the AV node.

101
Q

Ventricular fibrillation:

A

Immediately life-threatening arrhythmia of chaotic ventricular activation at a rapid rate with lack of cardiac pumping.

102
Q

Channelopathy:

A

Heart disease of arrhythmias due to defective cardiac myocyte ion channels, usually due to genetic mutations.

103
Q

Torsades de pointes:

A

A polymorphic ventricular tachycardia with variation in QRS size and shape, creating an outline resembling a twisted ribbon on EKG

Cardiology (10 decks)

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