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Internal Medicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Mitral valve prolapse / floppy valve sydrome / barlow syndrome

A

Balooning of mitral valve leaflets - pushed higher. Than its normal , extra stress on chorda tendinae & pappilary muscles - resulting in subendocardial ischemia - hypoxia

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2
Q

Causes of mitral valve prolapse

A

Myxomatous degeneration of mitral valve tissue
Type 3 collagen defect
Broken myofibrils
. End result is valve bulges up causing primary mitral regurgitation

- connective tissue disorder 
A) marfans syndrome  
. Chr 15 defect 
. Fibrilin 1 
. Arachanodactyly 
. Mortality d/ t aortic dessection 
  B) ehler danlos syndrome 
   C) osteogenisis imperfecta

-

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3
Q

Causes of mitral valve prolapse

A

Straight back syndrome
- thoracic kyphosis - antero poster diameter of chest is less

  • rheumatic fever ( aschkoff body ) dilated cardiomyopathy
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4
Q

Pathphysiology of mitral valve prolapse ?

A

1 ) auscultatory findings - mid systolic click
- due to extra tension on chorda tendinae pressure develops in middle of systole
2 ) ischemic damage in subendocardial area causing ventricular arythmia complaints of chest pain

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5
Q

Clinical features of mitral valve prolapse ?

A

1) asymtomatic
2) chest pain substernal
3) palpiations due to premature ventricular contractions
4) infective endocarditis
5 ) transient ischemic attack - platelet plugs fibrin deposits
6 ) sudden cardiac death - MR , LVF

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6
Q

On auscultation in mvp ?

A

After s1 ejection click - mid systolic clicks
Chordate tendinae may be damaged & MR will be developing blood leaks from LV - LA
- sound of this blood leaking will be heard mid systolic clicks - late systolic crescendo descendo murmur

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7
Q

Murmur in mitral valve prolapse

A

Late systolic murmur

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8
Q

Murmur in aortic / poulmonary stenosis

A

Ejection systolic murmur

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9
Q

Murmur on squating and standing in mvp becomes

A

Shorter - squating

Larger - standing

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10
Q

Posterior leaflet defect in mvp ?

A

Bllod moves anteriorly murmur radiates to base

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11
Q

Anterior leaflet defect in mvp

A

Bloodmoves posteriorly murmur radiates to axilla/ back

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12
Q

Treatment for mvp

A

1 . Beta blockers
2. Profylaxis - infective endocarditis
3 . Mitral valve repair to prevent regurgitation
4 .

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13
Q

Golden period of MI ?

A

1st hour

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14
Q

Causes of sudden cardiac. Death in post MI. Patients. & toc. ?

A

1) tachyarythmia - vf
Toc - defibrillation
2) bradyarythmia - mobitz 2 heart block
Toc - atropine - to accelerate heart

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15
Q

Patient with st elevation MI , thrombus in right coronary artery evaluation ?

A

St elevation in leads 2, 3 , avf ( inferior leads ) - helps in identifying inferior wall mi , min st elevation should be
> 2mm males
> 1.5 mm females
Troponin 1 rise shows increasing trend

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16
Q

Troponin value usually starts doubling by ?

A

3 - 4 hours

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17
Q

Pci ( baloon angioplasty ) procedure ?

A

Ideally done within 90 min ,
Guidewire will be navigated from radial artery - subclavian artery - root of aorta - right coronary artery - steered tgrough thrombus - inflate - destroy the clot - revascularization obtained

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18
Q

To prevent development of atgerosclerosis from progressing further we have to give ?

A

Statins

Deployment of stent

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19
Q

What are drug eluting stent

A

They are coated with medicines that will prevent the restenosis
- it is coated with 2 medicines
Everolimus
Zoterolimus

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20
Q

Advantages of drug eluting stent ?

A

Modify atherosclerotic process

Prevent development of stenosis

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21
Q

Biodegradable stents ?

A

Get incoparated in walls of blood vessels

22
Q

Rotatory atherectomy ?

A

For patients with chronuc stable angina

Thrombus will ne removed so stent can be deployed

23
Q

To check characyer of pulse ?

A

Carotid artery

24
Q

To check rate / rythm ?

A

Radial artery

25
Q

In children if palpable then ?

A

Femaral can be used

26
Q

Max pressure pulse wave form where ?

A

Middle of systole

27
Q

Dichrotic notch present after

A

S2

28
Q

Pulsus tardus / anachrotic pulse ?

A

Slow rising pulse with less amplitude ! The duchrotic notch may not be recorded thats why anachrotic pulse

29
Q

Pulse in aortic regurgitation ?

A

Collapsing pulsr , corrigan pulse , water hammer pulse

30
Q

Anachrotic pulse

A

Aortic stenosis

31
Q

Bisfiriens pulse

A

Hocm

32
Q

Corrigan / collapsing/ water hammer pulse

A

Aortic regurgitation

33
Q

Dicrotic pulse

A

Dilated cardiomyopathy

34
Q

Pulsus alterance

A

Lvf , alternate weak and strong pulse

35
Q

Irregularly irregular pulse

A

Artirial fibrillation

36
Q

Pulsus paradoxus

A 
Found in hypotensive state - dissapears in inspiration
Cardiac tamponade 
Inf wall mi 
Severe copd 
Status asthmaticus 
Pregnancy
37
Q

Irregularly irregular breathing

A

Biots breathing

38
Q

Irregularly irregular pulse

A

Artirial fibrillation

39
Q

Murmur in mitral stenosis

A

Mid diastolic murmur

40
Q

Peak at middle of diastole has small secondary spike called as

A

Pre systolic accentuation

41
Q

Secerity of mitral stenosis decided by

A

Length of murmur

42
Q

Contraindications of pmbv

A

Calcified severe ms, severe ms + mr , severe ms + left atrial appendage thrombi

43
Q

Early diastolic murmur seen in

A

Graham steel , ar mild , pr mild

44
Q

Mid diastolic murmur seen in

A

Ms , austin flint , flow murmur

45
Q

Late diastolic murmur seen in

A

Rheumatic carditis , carley coomb murmur

46
Q

Ejection systolic murmur seen in

A

As , ps , hocm

47
Q

Pan systolic murmur seen in

A

Mr , tr , vsd

48
Q

Late systolic murmur seen in

A

Mitral valve prolapse

49
Q

All murmurs decrease in intensity with valsalva / standing / amyl nitrate inhalation due to reduction of venous return except ?

A

Hocm - louder

Mvp - louder

50
Q

All murmurs increase in intensity with situps hand grip except

A

Hocm - softer

Mvp - shorter

Internal Medicine (1 decks)

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