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Cardiology Flashcards

1
Q

What organs have resistance in series?

A

Liver and Kidneys

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2
Q

What organs have resistance in parallel?

A

All the rest of the organs (except liver and kidneys)

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3
Q

What organ has the highest AVO2 Difference at rest?

A

heart

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4
Q

What organ has the highest AVO2 difference after excercise?

A

Muscle

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5
Q

What organ has the highest AVO2 difference after a meal?

A

GI tract

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6
Q

What organ has the highest AVO2 difference during a test?

A

Brain

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7
Q

What organ has the lower AVO2 difference?

A

Kidney

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8
Q

Where does a Type A thoracic aortic dissection occur?

A

Ascending Aorta, (occurs in Cystic medial necrosis and Syphilis)

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9
Q

Where does a Type B thoracic aortic dissection occur?

A

Descending Aorta, (occurs in trauma and Atherosclerosis)

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10
Q

In what layers does a true aortic aneurysm occur?

A

Intima, media, and adventitia

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11
Q

In what layers does a pseudo aortic aneurysm occur?

A

Intima and media layers

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12
Q

What is pulse pressure?

A

Systolic minus diastolic pressure

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13
Q

What vessel has the thickest layer of smooth muscle?

A

Aorta

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14
Q

What vesels have the most smooth muscle?

A

Arterioles

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15
Q

What vessels have the largest cross-sectional area?

A

Capillaries

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16
Q

What vessel has the highest compliance?

A

Veins

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17
Q

What vessels have the highest capacitance?

A

Veins and Venules

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18
Q

What is your maximum heart rate?

A

220 minus the person’s age

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19
Q

What is stable angina?

A

Pain with exertion that is relieved with rest (Athersclerosis MCC)

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20
Q

What unstable angina?

A

Pain at rest (transient clots MCC)

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21
Q

What is Prinzmetal’s angina?

A

Coronary Artery Spasm

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22
Q

What is Amyloidosis and what stain is used?

A

Amyloid deposits that stain Congo red: Apple-Green Birefringence (AA-chronic disease)

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23
Q

What is hemochromatosis?

A

Iron deposits in organs

leads to hyperpigmentation, bronze diabetes, and arthritis

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24
Q

What is cardiac tamponade?

A

Pressure equalized in all 4 chambers, quiet Precordium, no pulse or BP, Kussmaul’s Sign, Pulsus Pardoxus (Decrease in BP greater than 10 mm Hg with inspiration)

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25
Q

What is transudate?

A

An effusion with mostly water
If too much water: Heart or Renal failure….
Or not enough protein: Cirrhosis (can’t make protein), and Nephritic Syndrome (spilling out protein in urine)

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26
Q

What is exudate?

A 
Effusion of mostly protein
Too much protein: Will have ---
Purulent (from Bacteria),
Hemorrhagic (from trauma, CA, PE)
Fibrinous (from collagen vascular disease), Granulomatous (non-bacterial)
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27
Q

What is systole?

A

Ejection of blood from the heart, Decreased blood flow to Coronary arteries, more extraction of Oxygen Phase 1 Korotkoff

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28
Q

What is diastole?

A

Heart ventricles filling
increased blood to Coronary arteries
less extraction of oxygen
Phase 4 and 5 Korotkoff

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29
Q

What are the only arteries with deoxygenated blood?

A

Pulmonary and umbilical arteries

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30
Q

What murmur has a water hammer pulse?

A

Aortic regurgitation

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31
Q

What murmur has Pulsus Tardus?

A

Aortic stenosis

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32
Q

What cardiomyopathy has Pulsus Alternans?

A

Dilated cardiomyopathy

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33
Q

What disease has pulsus bisferiens?

A

IHSS- Idiopathic Hypertrophic Subaortic Stenosis

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34
Q

What murmur has an irregular-irregular pulse?

A

A fib (no P waves)

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35
Q

What murmur has a regular-irregular pulse?

A

PVC

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36
Q

What sound radiates to the neck?

A

Aortic stenosis

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37
Q

What sound radiates to the axilla?

A

Mitral regurgitation

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38
Q

What sound radiates to the back?

A

Pulmonic stenosis

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39
Q

Boot-shape on x-ray?

A

RVH

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40
Q

Banana-shape on x-ray?

A

IHSS

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41
Q

Egg-shape on x-ray?

A

Transposition of the great arteries

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42
Q

Snowman-shape on x-ray?

A

Total anomalous pulmonary venous return

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43
Q

What disease has a “3” shape on x-ray?

A

Coarctation of the aorta

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44
Q

What is the Osler-Weber-Rendu?

A

AVM (Atrial-Venous Malformation)
in lung, GI, CNS
the AVM sequesters platelets and causes acquired Telangiectasia’s

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45
Q

What is VHL?

A

Predisposes individuals to bnign and malignant tumors, AVM in the head, and retina (AD inheritance in Chromosome 3)

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46
Q

What CA risk does VHL have?

A

RCC

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47
Q

When do valves make noise under normal physiology?

A

When the valves close

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48
Q

What valves make noise at the end of diastole?

A

Mitral and Tricuspid

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49
Q

What murmurs occur during systole?

A

Holosystolic or pansystolic

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50
Q

What are the Holosystolic murmurs?

A

Tricuspid Regurg
Mitral Regurg
VSD

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51
Q

What are the Systolic Ejection Murmurs?

A

Aortic Stenosis, Pulmonic Stenosis, Hypertrophic Cardiomyopathy

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52
Q

What valves make noise at the end of systole?

A

Aortic and Pulmonic

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53
Q

What are the sounds made from diastolic murmurs?

A

Blowing and rumbling

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54
Q

What are the Diastolic Blowing murmurs?

A

Aortic regurgitation, pulmonic regurgitation

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55
Q

What are the diastolic rumbling murmurs?

A

Tricuspid Stenosis

Mitral Stenosis

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56
Q

What are the continuous Murmurs?

A

PDA or AVM’s

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57
Q

What has a friction rub while breathing?

A

Pleuritic

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58
Q

What has a friction rub while holding breath?

A

Pericarditis

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59
Q

What does a mid-systolic click tell you?

A

MVP- Mitral valve prolapse

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60
Q

What does an ejection click tell you?

A

Aortic or Pulmonic Stenosis

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61
Q

What does an opening snap tell you?

A

Mitral or Tricuspid Stenosis

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62
Q

What does S-2 splitting tell you?

A

Normal on inspiration

Pulmonic valve closing later

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63
Q

What does a wide S-2 split tell you?

A

Increases Oxygen
Increased right ventricular volume
Delayed pulmonic vlave opening

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64
Q

What does fixed wide S-2 splitting tell you?

A

ASD

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65
Q

What does a paradoxical S-2 split tell you?

A

Aortic Stenosis or LBBB

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66
Q

What is cor-pulmonale?

A

Pulmonary HTN leads to Right ventricular failure

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67
Q

What is Eisenmenger’s Syndrome?

A

Physiological shunt from left to right now changes right to left

68
Q

What is transposition of the great arteries?

A

Aorticopulmonary septum did not spiral, most common congenital cyanotic heart disease in the first month of life (Neural crest cell migration problem)

69
Q

What is Tetralogy of Fallot?

A

Overriding aorta: Aorta sits on intraventricular Septum giving rise to a VSD, this in turn causes Pulmonary Stenosis and ultimately right heart failure (boot shape x-ray)

70
Q

What is Total Anomalous Pulmonary return?

A

All pulmonary veins enter into the right atrium (Snowman x-ray)

71
Q

What is Truncus arteriosus?

A

Spiral membrane did not develop, there is one Aortic Pulmonary trunk, mixed blood, needs PDA

72
Q

What is Epstein’s anomaly?

A

Small right ventricle and very large right atrium (in fetus due to mom taking Lithium during pregnancy)

73
Q

What Kidney complications can Lithium cause to the person taking the drug?

A

Destroy the collecting ducts V2 aquaporin receptors, causing Nephrogenic DI

74
Q

What are theh Renin-angio system effectors?

A

ACE inhibitors and ARBs

75
Q

What are the ACE inhibitors?

A

Captopril, Enalapril, Fosinopril, Lisinopril

76
Q

What is the MOA of ACE inhibitors?

A

Inhibits conversion of Ang I to Ang II, decreases Ang II

77
Q

What are the Indications for ACE inhibitors?

A

HTN, CHF, post MI and vasodilation

78
Q

What are the adverse effects of ACE inhibitors?

A

Hyperkalemia, cough, angioedema

contraindicated in pregnancy (fetal renal malformations)

79
Q

What is the MOA of ARBS?

A

Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II

80
Q

What are the indications for Losartan?

81
Q

What are the adverse effects of Losartan?

A

Fetal renal toxicity

Hyperkalemia

82
Q

What are the sympathoplegics?

A

Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine

83
Q

What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?

A

Selective B1-Blockers

84
Q

What is the MOA of Propranolol, Timolol?

A

B1 and B2 Blockers

85
Q

What is the MOA of Carvedilol?

A

Alpha and B-Blocker

86
Q

What are the indications for B-blockers

A

HTN, Angina, MI, Antiarrhythmic

87
Q

What are the adverse effects of B-blockers?

A

Impotence, asthma, bradycardia, AV block, heart failure, sedation, sleep alterations

88
Q

What is the MOA of Prazosin?

A

Alpha 1-Blocker, vasodilation, decreases TPR

89
Q

What are the indications for Prazosin?

A

Pheochromocytoma, HTN

90
Q

What are the adverse effects of Prazosin?

A

Orthostatic Hypotension

91
Q

What is the MOA of Clonidine?

A

Alpha 2 agonist = decreases peripheral resistance

92
Q

What are the indications for Clonidine?

A

HTN
Smoking
Cocaine
Heroin withdraw

93
Q

What are the adverse effects of Clonidine?

A

Drowsiness, dry mouth, and rebound HTN after abrupt withdraw

94
Q

What is the MOA of Methyldopa?

A

Alpha 2 agonist = decreases peripheral resistance

95
Q

What are the indications for Methyldopa?

96
Q

What are the adverse of Methyldopa?

A

Sedation and Hemolytic Anemia

(+) Coombs test

97
Q

What is the MOA of Hexamethonium?

A

Nicotinic Ganglionic blocker

98
Q

What are the adverse effects of Hexamethonium?

A

Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction

99
Q

What is the MOA of Reserpine?

A

Prevents the storage of monoamines in synaptic vesicle

100
Q

What are the indications for Reserpine?

101
Q

What are the adverse effects of Reserpine?

A

Mental depression

102
Q

What is the MOA of Guanethidine?

A

Interferes with norepinephrine release

103
Q

Whata re the indications for Guanethidine?

A

Severe HTN

104
Q

What are the adverse effects of Guanethidine?

A

Contraindicated in patients taking TCA’s

105
Q

What are the Vasodilators?

A

Hydralazine, Minoxidil, Nifedipine, Verapamil, Nitroprusside, Diazoxide

106
Q

What is the MOA of Hydralazine?

A

increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction

107
Q

What are the indications for Hydralazine?

A

Severe HTN, 1st line treatment for HTN in pregnancy

108
Q

What are the adverse effects of Hydralazine?

A

Compensatory tachycardia, fluid retention, Lupus like syndrome, contraindicated in Angina/CAD because of compensatory tachy

109
Q

What is the MOA of Minoxidil?

A

K+ channel opener, hyperpolarizes and relaxes smooth muscle

110
Q

What are the adverse effects of Minoxidil?

A

Hypertrichosis and Pericardial Effusion

111
Q

What is the MOA of Nifedipine and verapamil?

A

Ca+ channel antagonists

112
Q

What are the indications for Nifedipine and verapamil?

A

HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud’s

113
Q

What is the MOA of Nitroprusside?

A

Direct release of NO, increases cGMP, vasodilator

114
Q

What are the indications for Nitroprusside?

A

Hypertensive emergency, CHF, Angina

115
Q

What are the adverse effects of Nitroprusside?

A

Cyanide Toxicity, hypotension, short acting

116
Q

What is the MOA of Diazoxide?

A

K+ channel opener, hyperpolarizes and relaxes smooth muscle

117
Q

What are the indications for Diazoxide?

118
Q

What are the adverse effects of Diazoxide?

A

Hypoglycemia (reduces insulin release) and hypotension

119
Q

What are the HMG-CoA reductase inhibitors?

A

Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin

120
Q

What are the indications for HMG-CoA reductase inhibitors?

A

Strong decrease LDL
Decrease Triglycerides
Increase HDL

121
Q

What are the adverse effects of HMG-CoA reductase inhibitors?

A

Hepatotoxicity (increase LFT’s)

Rhabdo

122
Q

What is the MOA of Niacin?

A

Inhibits lipolysis in adipose tissue

reduces hepatic VLDL secretion into circulation

123
Q

What are the indications for Niacin?

A

Decrease LDL and Triglycerides

Strong increase HDL

124
Q

What are the adverse effects of Niacin?

A

Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia

125
Q

What are the Bile acid resins?

A

Cholestyramine
Colestipol
Colesevelam

126
Q

What is the MOA of Bile Acid resins?

A

Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more

127
Q

What are the indications for Bile Acid Resins?

A

Slightly increase HDL and triglycerides

Decrease LDL

128
Q

What are the adverse effects of Acid Resins?

A

Tastes bad and causes GI discomfort
bile decreases absorption of fat soluble vitamins
cholesterol gallstones

129
Q

What are the cholesterol Absorption blockers?

130
Q

What is the MOA of Ezetimibe?

A

Prevents cholesterol reabsorption at small intestine brush border

131
Q

What are the indications for Ezetimibe?

A

Decrease LDL

132
Q

What are the adverse effects of Ezetimibe?

A

Rare increase LFT’s

133
Q

What are the Fibrates?

A

Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate

134
Q

What is the MOA of FIbrates?

A

Upregulate LPL, increase triglyceride clearance

135
Q

What are the indications for fibrates?

A

Strong decrease of triglycerides
slight decrease of LDL
slight increase in HDL

136
Q

What are the adverse effects of fibrates?

A

Myositis, hepatotoxicity (increase LFT’s) cholesterol gallstones

137
Q

What is the MOA of Digoxin?

A

Direct inhibition of Na+/K= ATPase leads to indirect inhibition of Na+/Ca2+ exchanger, positive inotrope, stimulates vagus nerve

138
Q

What are the indications for digoxin?

A

CHF (increase contractility)
A fib (decrease conduction at the AV node)
depression of the SA node

139
Q

What are the adverse effects of Digoxin?

A

Cholinergic, ECG: icnrease PR, decrease QT worsened by renal failure
Quinidine displaces Digoxin from tissue binding sites

140
Q

What is the MOA of Nesiritide?

A

Recombinant BNP, increase in cGMP and vasodilation

141
Q

What are the indications for Nesiritide?

A

Acute decompensated heart failure

142
Q

What are the adverse effects of Nesiritide?

A

Hypotension

143
Q

What are the Class IA antiarrhythmic?

A

Quinidine, Procainamide, Disopyramide

144
Q

What is the MOA of Class IA antiarrhythmic?

A

Na+ channel blocker

145
Q

What are the indications for the Class IA antiarrhythmic?

A

Increase AP duration, icnrease effective refractory period (ERP) QT interval, affect reentrant and ectopic SVT and ventricular tachy

146
Q

What are the adverse effects of the Class IA antiarrhythmic?

A

Quinidine: Cinchonism
Procainamide: Torsades de Pointes

147
Q

What are the Class IB antiarrhythmic?

A

Lidocaine, Mexiletine, Tocainide

148
Q

What is the MOA of Class IB antiarrhythmic?

A

Na+ channel blocker

149
Q

What are the indications for the Class IB antiarrhythmic?

A

Decrease AP duration, acute ventricular Arrhythmias, local anesthesia

150
Q

What are the adverse effects of the Class IB antiarrhythmic?

A

CNS stimulation and depression
Cardiovascular depression
Hyperkalemia increases toxicity

151
Q

What are the Class IC antiarrhythmic?

A

Flecainide, Encainide, Propafenone

152
Q

What is the MOA of Class IC antiarrhythmic?

A

Na+ channel blocker

153
Q

What are the indications for Class IC antiarrhythmic?

A

Ventricular tachy progressing to V. fib, last resort

154
Q

What are the adverse effects of Class IC antiarrhythmic?

A

Prolongs refractory period in AV node Hyperkalelmia increases toxicity

155
Q

What are the K+ channel blockers?

A

Sotalol, Ibutilide, Bretylium, Amiodarone

156
Q

What is the MOA of the K+ channel blockers?

A

Increase AP duration, increase effective refractory period (ERP), increase QT interval

157
Q

What are the indications for the channel blockers?

A

WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism

158
Q

What are the Ca2+ channel blockers?

A

Verapamil, Diltiazem

159
Q

What is the MOA of the Ca2+ blockers?

A

Decreases conduction velocity of the AV node, increases ERP and PR interval

160
Q

What are the indications for the Ca2+ channel blockers?

A

SVT/ prevent nodal arrhythmias

161
Q

What are the adverse effects of the Ca2+ channel blockers?

A

Flushing, edema, constipation, CHF, AV block

162
Q

What is the MOA of adenosine?

A

Increase K+ efflux, hyperpolarizes the cell

163
Q

What are the indications for adenosine?

A

Dx. and tx. of AV nodal arrhythmias

164
Q

What are the adverse effects of adenosine?

A

flushing, hypotension, and chest pain

very short acting

165
Q

What is the MOA of Potassium on the heart?

A

Depresses ectopic pacemaker in hypokalemia

166
Q

What are the indications for administering Potassium?

A

Digoxin toxicity, activated charcoal: binds digoxin in the intestine
Digibind: binds to digoxin in the bloodstream

167
Q

What are the indications from Magnesium?

A

Effective in Torsades and Dig toxicity

WPC (16 decks)

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