Cardiology Flashcards

1
Q

S1 - S2 heart sound?

A

systoli

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2
Q

S2-S1 heart sound?

A

Diastoli

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3
Q

s1s2 holosystole murmur?
s1s2 cresendo-decresendo murmur?
s1-s2 late cresendo murmur?

A

mitral regurgitation
aortic stenosis
mitral collapse

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4
Q

what is s1?

A

mitral closure

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5
Q

what is s2?

A

aortic closure

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6
Q

what is s3?

A

rapid ventricular filling blood in HF ventricular overload

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7
Q

what ia s4?

A

forcefull atrial contraction due to ventricular stiffness or hypertrophy

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8
Q

when can S1 split?

A

RBBB due to delayed mitral closure

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9
Q

what is split s2?

A

inspiration decrease pulmonary artery pressure and pulmonary valve stays open longer

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10
Q

steps in describing murmurs?

that sound like real proper quality instruments

A
  1. Timing in heart cycle
  2. Shape
  3. Location of max intensity and radiation
  4. Radiation site
  5. Pitch (high, medium, low)
  6. Quality (blowing, harsh, musical, rumbling)
  7. Intensity (Levine scale)
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11
Q

Symptomes of aortic stenosis?

SAD

A

syncope
angina
dyspnea

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12
Q

most common cause of aortic stenosis?

A

calcification due to age > 60

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13
Q

Most common cause of mitral stenosis?

A
ischemic heart disease:
post MI 
MVP
LV dilation 
Also rheumatic fever and infective endocarditis
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14
Q

Describe a mitral prolaps murmur

A

late systolic crescendo starting with a mid systole click

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15
Q

what can cause mitral valve prolapse?

A

primary or secondary to Marfan or Ehlers-Danlos syndrome or rheumatic fever

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16
Q

describe mitral stenosis murmur?

A

lade diastole, opening snap followed by crescendo murmur

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17
Q

how can you asses severity of mitral stenosis when listening to the murmur?

A

the shorter the s1 –> opening snap, the more severe

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18
Q

causes of mitral stenosis?

A

mostly a late consequence of RF

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19
Q

ortner syndrom is?

A

hoarseness due to left recurrent laryngeal nerve palsy caused by mechanical affection of the nerve from enlarged cardiovascular structures.

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20
Q

Define CVD?

give examples

A

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels

  1. coronary heart disease
  2. cerebrovascular disease
  3. peripheral arterial disease
  4. rheumatic heart disease – damage to the heart
  5. muscle and heart valves from rheumatic fever,
  6. caused by streptococcal bacteria;
  7. congenital heart disease
  8. deep vein thrombosis and pulmonary embolism
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21
Q

primary and secondary CVD prevention?

A

Primary: High risk people prevention - lifestyle
Secondary: already PAD, CHD, TIA - lifestyle and drugs

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22
Q

ankle-brachial index value comfirming PVD?

A

< 0.9

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23
Q

types of hypertrophic cardiomyopathies?

A

HOCM

HCM

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24
Q

The Venturi effect?

A

Due to LVOT obstruction by the septal hypertrophy the increased P during systoli pusher the anterior leaflet of the mitral valve towards the outflow of blood. this causes mitral regurgitation and mimics aortic stenosis murmur upon asculatiton

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25
Q

heart sound heard in HOCM?

A

S4 gallop

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26
Q

why should you not give digoxin in HOCM?

A

decrease N/K ATPase –> decrease Na/ca exchange and increases intracellular Ca –> increased contractility

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27
Q

diagnosis of hypertrophic wall thickness?

A

> 15mm (if above 30mm high risk of sudden cardiac death)

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28
Q

Acute heart failure types and definition?

A

Acute heart failure: rapid onset of new or worsening signs and symptoms of heart failure

Acute decompensated heart failure (ADHF): acute heart failure due to decompensation of preexisting disease/cardiomyopathy (most common)

De novo heart failure: acute heart failure occurring for the first time in a patient without known cardiomyopathy (∼15% of cases)

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29
Q

types of CHF

A

HFrEF
HFpEF

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30
Q

normal ejection fraction?

A

50-70% normal
40-49% moderate
<40% severe

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31
Q

what decides of it is a reduced ejection or preserved ejection fraction heart failure?

A

Diastolic failure: pEF
Systolic failure: rEF

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32
Q

valves mostly effected by endocarditis?

A

left side of the heart - aortic and mitral

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33
Q

intravenous drug use endocarditis mostly effect witch valve?

A

tricuspid

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34
Q

endocarditis janeway lesions?

A

detached vegitations causing septic emboli in the soles and palms of the hands, also under the nail

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35
Q

Endocarditis Osler nodules

A

Ig complex aggregations causing subcutaneous nodules

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36
Q

main difference between viridans, epidermidis and aureus?

A
  1. aureus causes acute IE and attack healthy valves
  2. epidermidis causes subacute IE and attack prostetic valves
  3. viridans causes subacute IE and attack predamaged valves
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37
Q

what valvular disease presents mostly in infectious endocarditis?

A

Regurgitations

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38
Q

If there is a fever of unknown origin and a new heart murmur what should you think?

A

endocarditis

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39
Q

feautures of infectious endacarditis? FROM JANE

A

Fever, Roth spots, Osler nodes, Murmur, Janeway lesions, Anemia, Nail bed hemorrhage, and Emboli.

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40
Q

criteria to clinically diagnose infectious endocarditis?

A

Dukes criteris
2 main
1 main 3 minor
5 minor

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41
Q

physiological pericardial fluid?

A

50ml

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42
Q

causes of pericarditis

A

idiopathic
cocxaci virus
Dresslers syndrom
Uremic pericarditis

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43
Q

Ecco in pericarditis?

A

shows heart dancing in the pericardium

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44
Q

what is the name of draining fluis?

A

centesis

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45
Q

ECG in pericarditis?

A

starts as PR depression with ST elevation

then progress to flat or inverted T wave

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46
Q

what is constrictive pericarditis?

A

due to fibrin buildup after acute pericarditis it causes decreased CO and increased HR

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47
Q

what should you not give in restrictive pericarditis?

A

Beta blockers and calcium channel blockers should be avoided in constrictive pericarditis, as they may worsen heart failure by slowing a compensatory tachycardia!

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48
Q

pharmacology in pericarditis?

A

NSAIDS (asprin, ibuprofen)

Prednisone (Glucocorticoid antiinflammatory)

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49
Q

normal aortic opening?

A

3-4 cm2

Stenosis can be 1cm2

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50
Q

difference between mechanical aortic stenosis vs RF stenosis?

A

commissural fusion where the root of the valves fuse together

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51
Q

what type of anemia can aortic stenosis cause?

A

microangiopathic hemolytic anemia leading to chistocytes and hemoglobinuria

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52
Q

what does the heart do when there is decreased SV?

A

increases heart rate thus shorter diastole, this means less coronary filling time and decreased oxygen to the heart

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53
Q

what is pulse pressure?

A

difference between systolic and diastolic witch is normally 30-40 mmHg (S-D)

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54
Q

what can mimic mitral stenosis?

A
endocarditis with mitral vegitations 
atrial myxoma (neoplasia)
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55
Q

normal mitral valve area?

A

4-6cm2
below 1.5 is severe stenosis
seen on TTE

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56
Q

best diagnosis for mitral stenosis?

A

TTEcco

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57
Q

types of hypertention

A

Primary - no known cause
Secondary - due to underlying cause

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58
Q

what is hypertensive crisis?

A

Systolic > 180
Diastolic > 120

HT emergency (end organ failure)

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59
Q

what is defined as Hypertension by 2020 ACC/AHA?

A

140/90

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60
Q

what is resistant hypertension?

A

hypertension that remains uncontrolled (≥ 130/80 mm Hg) despite treatment with ≥ 3 anti hypertensives OR requires ≥ 4 medications to be controlled

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61
Q

what is ambulatory BP management?

A

The periodic measurement of blood pressure via a portable sphygmomanometer while a patient carries out routine daily activities. Typically obtained across a 24-hour period.

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62
Q

what is home BP measurment?

A

The self-measurement of blood pressure by a patient at periodic intervals outside of a clinical setting. May be used to confirm the diagnosis of hypertension and monitor anti hypertensive treatment.

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63
Q

thiazide diuretic?

A

hydrochlorothiazide

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64
Q

dihydropyridin CCB?

A

Nifedipine

Amlodipine

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65
Q

Non Dihydropyridine CCB?

A

Verapamil
Diltiazem

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66
Q

epithelial sodium channel blocker?

A

Amiloride

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67
Q

aldosteron antagonists?

A

Spironolactone

eplerenon

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68
Q

Direct peripheral vasodilators? which is good for pregnancy?

A

Hydralazine (pregnancy)

Minoxidil

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69
Q

causes of secondary hypertension?

A
renal artery stenosis 
cushings 
Conn's 
estrogen 
hyperthyroidism 
aorta coarctation
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70
Q

the main drug groups in HT treatments?

A
Thiazides 
CCB 
ACEI
ARB 
B-blockers
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71
Q

earliest sigh of hypertension on heart?

A

S4 due to LV hypertrophy

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72
Q

mechanical valve drugs?

A

Warfarin + Aspirin lifelong

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73
Q

when is UFH usefull to give a patient?(11)

A
DVT 
PE 
ACS 
artificial valve thrombosis 
only drug safe for pregnancy 
ECMO 
PCI
TAVI 
PVI 
ASD
Afib
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74
Q

what must be monitored when giving UFH?

A

aPTT 25-39s

this is the intrinsic pathway bleeding time

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75
Q

what is PT time?

A

measure extrinsic pathway time - 12 sec

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76
Q

what are NOAC and DOAC?

A
they mean the same 
Non-vit K oral anticoagulants 
Direct oral anticoagulants 
they inhibit F10 and F2 
also calles Noval oral anti coagulants
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77
Q

What is ischemic heart disease?

A

It’s the term given to heart problems caused by narrowed heart arteries.

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78
Q

drug used in pharmacological stress test?

A

Dobutamin

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79
Q

Holter montoring?

A

A continuous, ambulatory, battery-operated ECG recorder worn for 24–48 hours

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80
Q

extracardiac provoking factors of angina?

A
anemia 
hyperthyroidism 
HT 
fever
hypoxemia
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81
Q

cardiac provoking factors for angina?

A

tachycardia
bradycardia
HOCM
aortic valve disease

82
Q

stable angina treatment?

A
ABCDE 
Aspirin / clapidogrel / Nitro 
B-blockers 
Cigarette stop 
Diet 
Education and exercise
83
Q

what causes stable angina?

A

plaque blocking more then 75% of CA

84
Q

what causes unstable angina?

what are the consequence?

A

plaque rupture - thrombus formation blockage
ischemic damage to heart
if papillary muscle is involved then valvular disease
conduction abnormalities

85
Q

what can you do when AS plaque rupture in coronary artery?

A

stent implantation

CABG (coronary artery bypass graft)

86
Q

what to do in prinzmetal angina?

A

immediate coronary angiography

87
Q

what can cause NSTE-ACS?

A

-Plaque rupture 95%
- Coronary spasms (prinzmental)
- Coronary embolisms
- Stable coronary stenosi sees in heavy exercise

88
Q

current complaints in NSTE-ACS?

A

pain retrosternal, interscapula, epigastric radiating to shoulder, chest and arm

89
Q

ECG in a NSTE-ACS?
(acute coronary syndrom)

A

ST depression

deep T waves in V2-V4!!!

90
Q

what can be the result of a NSTE-ACS?

A

Unstable angina

NSTEMI

91
Q

what is a normal troponin level?

A

< 14 ng/ml

92
Q

what is the “wash-out”phenomenon?

A

increase in cardiac biomarkers after re perfusion, indicate success

93
Q

ST segment elevation ACS is the same as STEMI

what is the treatment pre-hospital?

A

If chestpain and ECG ST elevation that enough to diagnose MI!!!

  1. Morphine
  2. Oxygen if SpO2<90
  3. Nitrates
  4. Aspirin 250mg + clapidogrel 600mg
94
Q

when in a STEMI should Nitrates NOT be given?

A

if RV infarct due to hypotention

95
Q

STEMI add on treatment at hospital after the pre-MONA treatment

A
BASC
B-blockers 
ACEI 
Statins 
Clopidogrel
PCI within 120 min!!!
96
Q

absolutt contraindications for fibrinolysis?

A

aortic dissection
previous hemmorhagic stroke
active internal bleeding

97
Q

fibrinolysis trearment?

A

streptokinase
alteplase
reteplase

98
Q

heart cathetirization inlet points?

A

radial
brachial
femoral

99
Q

steps of inserting cathether into vessle

A
  1. find vessle
  2. insert needle
  3. insert guide wire
  4. take out needle
  5. insert catheter sheet tube
  6. insert catheter over guiding wire
100
Q

Is a artery or vein used in Right sided heart catheterization?

A

Femoral vein to reach the right side of the heart!

101
Q

why do we doe heart cathetirization?

A
PCI (stenting)  
Coronary angiography 
Atherectomy (plaque removal) 
Cardiac biopsy 
pericardiocentesis (fluis drainage) 
valvuloplasty
pressure measurments
102
Q

is heart cathetirization a dual form of usage?

A

Yes, it is both diagnostic and therapeutic

103
Q

complication of Heart cathetirization?

A
pericardial temponade 
angina 
hemorrhage 
contrast reaction 
arrhythmias 
loss of peripheral pulse
104
Q

calculate MAP

A

MAP = DP + 1/3(SP – DP)

105
Q

how do you do a hemodynamic evaluation?

A
  1. feel puls around the body
  2. BP measurment
  3. MAP calculation
  4. dopler flow measurment
  5. Arterial pulse pressure
  6. CO and SV
106
Q

type of stents?

A

Bare metal stent (BMS): bare-surfaced, metallic stent that provides a mechanical framework to keep the artery open.
Drug-eluting stent (DES): coated with antiproliferative substances (immunosuppressant drugs, cytostatic drugs) that prevent excessive intimal hyperplasia

107
Q

what is CABG

A

Coronary artery bypass graft surgery

108
Q
  1. anticoagulant therapy in NSTEMI?
  2. anticoagulant therapy in PCI?
A
  1. Clopidogrel + Abciximab
  2. Clopigdogrel+ Aspirine
109
Q

life threatening causes of chest pain?

A

MI
PE
perforated ulcer
Aortic dissection

110
Q

cardiopulmonary causes of chest pain?(9)

A
ACS 
Angina pectoris 
Aortic dissection 
aneurysm 
PE 
Pneumonia 
Myocarditis, Pericarditis 
Arrhythmias
111
Q

PE source?

A

illiac, femoral or popliteal vein

112
Q

PE and Pulmonary infarction difference?

A

people have a lot of micro PE that resolve on its own, when the emboli is big enough it causes PI wich is leathal

113
Q

Diagnose PE

A
CT pulmonary angiogram 
V/Q lung scan 
D-dimer 
DVT US 
ECG to exclude
114
Q

treatmrnt of PE

A

O2 + IV saline + vassopressor + anticoagulant + morphine

immediatly give 5000 IU heparin + 1000-2000 IU LMWH nd warfaris as long term anticoagulant

115
Q

when do you use the CHADS VAS SCORE?

A

to determine risk factor and if the patient should be getting anticoagulants in afib state

116
Q

when to do a valvular replacement of aorta?

A
  1. Positive stress test
  2. EF < 50%
  3. symptomes
117
Q

can we treat Aortic stenosis with drugs?

A

NO DRUGS HELP

118
Q

what are the two methods used in aortic valve replacement?

A
  1. balloon aortic valvuloplasty

2. transcatheter aortic valve replacement (TAVI)

119
Q

why is ballon aortic valvuloplasty not a good option?

A

50% restenosis within 6 months

120
Q

should we do Balloon aortic valvuloplasty if regurgitation?

A

No, bec. it makes it worse when there is a backflow

121
Q

organic and functional mitral regurgitation causes?

A

organic is anatomical abnormalities

functional is when the leaflets are normal but damaged

122
Q

causes of acute mitral regurgitation?

A

AMI - ischemia causing chorda or papillari rupture

Endocarditis

123
Q

concequence of acute mitral regurgitation?

A

no time for adaption - cardiogenic shock

acute pulmonary edema

124
Q

indication of intervention in mitral reg.

A

Pulmonary hypertension
Afib
EF < 50%

125
Q

percutaneous mitral valve interventions?

A

Clip - double orifice
Perc. mitral valve implantation with catheter
Perc. mitral ring implantation

126
Q

aortic regurgitation signs?

A

Di musset’s sign: bobbing of the head

Muller’s sign: uvula budding

127
Q

Endocarditis prophylaxis in high risk AB used?

A

amoxicillin
Ampicillin
Clindamycin

128
Q

what to use when we want to look at a prostetic valve?

A

TEE ecco

129
Q

types of vascular grafts?

A

autograft
allograft
xenogenicgraft

130
Q

symptomes of acute lower extrimity ischemia?

A
6 P 
pain 
pallor
pulselessness 
paralysis 
parenthisia 
poikilothermia
131
Q

aortic dissection classification?

A

De-bakey

IA: originates in acending aorta extends to at least the arch but often longer
IIA: confined to acending
IIIB: originates in decending and extends peripherally

132
Q

in regards to the De-bakey classification of aortic disecction when to we need surgery?

A

if class A then surgery ASAP

133
Q

aortic dissection symptomes?

A
sudden chest pain 
different BP in different locations 
nausea 
syncope
dyspnea 
weakness 
chronic HF, MI 
acute limb ischemia 
anuria
134
Q

imaging for aortic dissection?

A

MRI angiography

TTE

135
Q

indication of a CABG?

A
  1. high grade > 50% LM stenosis
  2. LAD + 2 or 3 small vessel diseased
  3. symptomatic 2-3 vessel
  4. non response to PCI
136
Q

how do we stop the heart in open heart surgry?

A

Cardioplagia with K+ solution

137
Q

heart failure mechanical suppport?

A

Aortic balloon pump
ECMO
CentriMag RVAD
Heartmate3 LVAD

138
Q

Large aretry vasculitis

A

Giant cell arteritis

Takyashu arteritis

139
Q

medium sized vessle vasculitis

A

PAD
burgers
Kawasaki

140
Q

small vessle arteritis

A

Granulomatosis Polyangitis

141
Q

what is used to screen for vasculitis in aorta?

A

MRI
CT angiography
US

142
Q

treatment of kawasaki vasculitis?

A

Ig and aspirin

143
Q

Buergers typically?

A

smoking males

causes ischemia and autoamputation of toes and fingers

144
Q

polyarteritis nodusa treatment?

A

corticosteroids and cyclophosphamide

145
Q

churg-strauss syndrom

A

eosinophilic granulmatosis polyangitis

asthma, sinusitis, skin nodules, purpura

146
Q

arterial disease risk factors

A

Major risk factors for PAD include older age, diabetes mellitus, current smoking, high blood pressure, high cholesterol level, obesity, and physical inactivity.

147
Q

screening for peripheral arterial disease

A

AB index

148
Q

imaging for peripheral arteri disease

A

Doppler ultrasound if ABI is abnormal

angiography through common illiac artery with contrast

Magnetic resonance angiopraphy

149
Q

messenteric artery disease presents as?

A

postpradial pain
weightloss
bloody stool

150
Q

treatment for PAD?

Peripheral artery disease

A

angioplasty
artherectomy
stenting

151
Q

what is defined as peripheral arteri?

A

not supplying the heart or brain

152
Q

symptomes of PAD

A
claudication 
fatigue, numbness aching 
cold 
thick nails 
shiny skin ( athropy) 
hairloss at area 
poor wond healing
153
Q

what is a normal antebrachial index?

A

1-1.3

154
Q

Classification for lower limb PAD

A

Rutherford classification based on level of claudification by cathegory 0-6 where 0 is asymptomatic and 6 is major tissue loss

155
Q

surgical treatment of PVD

A
embolectomy 
open endartectomy
eversion endartectomy 
end to end anastomosis
vessel reconstruction (bypass or interposition) 
stent
156
Q

define chronic venous insufficiency

A

blood pools in veins causing venous hypertension resulting in swelling and ulcers

157
Q

symptomes of CVI

A
varicose veins 
chronic swelling
pruritis
hyperpigmentation 
lymphedema 
venous ulceration
158
Q

diagnosing chronic venous insufficiency?

A

US

reflex filling time with photophletysmography

159
Q

classification of CVI?

A
CEAP criteria 
clinical ethiology anatomy pathophyiology 
c0. no symptomes 
c1.. telenangiectasia 
c2. varicous veins 
c3. edema 
c4. pigmentation skin changes 
c5. healed ulcers and skin changes 
c6. skin changes with active ulcers
160
Q

signs of DVT (names)

A

Homan sign: calf pain on dorsiflextion
MEyer sign: compression of calf is painfull
Payr sign: pain when pressure to medial sole

161
Q

scoring system used in DVT to diagnose?

A

Wells score

  1. medical history
  2. immobilization
  3. clinical symptomes

<2 unlikely
>2 likely

162
Q

DVT treatment

A
  1. UFH heparin 4-5 days
  2. warfarin 3 months or rivaroxiban for 3 months
  3. thrombolysis
163
Q

most common site of supra-aortic stenosis?

A

carotid biforcation

and can cause thromboembolism or TIA

164
Q

carotid stenosis treatment?

A

endarterectomy

165
Q

Mitral stenosis treatment

A

Percutaneous balloon mitral commissurotomy (PMBC) is recommended as the first choice of treatment

166
Q

what is subclavian steal syndrom?

A

stenosis prevertebral a. on one side. upon usage of that arm the vertebral a. blood on the opposite side will redirect blood to the occluded side causing less perfusion to the brain. syncope, dizziness and ischemic symptoms of the arm as well (the arm “steals” blood from brain)

167
Q

What is the difference between vascular and endovascular surgery?

A

Vascular surgery and endovascular surgery are both modalities to treat vascular disease. Endovascular describes a minimally invasive approach commonly done through needle puncture and a sheath. Traditional vascular surgery is more invasive and involves incisions, which is more surgical in nature

168
Q

treatment for aortic aneurysm, when do we operate?

A

when the aneurysm is > 5.5 in males and 5.0cm i diameter in females

  1. endovascular repair
  2. open surgical repair (either valvesparing or also changing valve)
169
Q

when do we choose the open surgery in treatment for AAA?

A

Mycotic aneurysm or infected graft
Persistent endoleak and aneurysm sac growth following EVAR
Anatomical contraindications for EVAR

endovascular repair of abdominal aneurysm

170
Q

most common site of peripheral aneurysms?

A

popliteal artery

171
Q

most common visceral aneurysm sites?

A

spleenic
hepatic
renal

172
Q

types of aneurysms?

A

saccular
fusiform
psaudosaccular

173
Q

acute aortic syndromes?

A

aortic dissection
intramural hematoma (IMH)
perforated aortic ulcer

174
Q

vascular imaging methods?

A

duplex US
MRA
CTA

175
Q

what does a pulmonary AVM show on US, MRI, CT

A

US: enlarged arteries/dilated veins, high flow

MRI, CT: Large arteries, draining veins, rapid AV shunt

176
Q

what is a hemangioma?

A

it is a AVM benign tumor of the vessles. The most common form is infantile hemangioma, known as a “strawberry mark”, most commonly seen on the skin at birth or in the first weeks of life. A hemangioma can occur anywhere on the body, but most commonly appears on the face, scalp, chest or back.

177
Q

AV fistulas why? most common?

A

we do this to make the wall of a vein stronger to withstand multiple punctures due to hemodialysis. most common is the radial artery to the cephalic vein. after 4-6w the wall of the vein becomes thicker due to increased pressure.

178
Q

VA ECMO sites?

A

femoral vein to femoral artery

179
Q

VV ECMO sites?

A

Right femoral vein to the right IJV and advanced through the SVC into the RA

180
Q

ECMO complications

A

coagulation disorders and bleeding
hemolysis
thrombocytopenia
infections, sepsis

181
Q

what is the difference between the cannula sites of CPBM and ECMO?

A

ECMO is peripherally not in the heart

182
Q

what is important with extracorporal circulation in regards to temperature?

A

the patient needs to be thermoregulated down to 28-32C to slow the bodies BMR decreasing oxygen demand

183
Q

when to do a endovascular vs open surgeru in aortic dissection?

A

Type A: immediate open surgery with graft inplant

Type B: endovascular with stent

184
Q

causes of acute aortic regurgitation?

A

endocarditis and aortic dissection

185
Q

when do we need to do acute heart surgery?

A

acending aorta aneurysm
AMI CABG
acute aortic regurgitation
acute mitral regurgitation with no adaption
cardiac temponade
abdominal aneurysm larger then 8cm in diameter.

186
Q

when do we operate the valves in endocarditis?

A
  1. significant stenosis or regurgitation
  2. elevated end diastolic volum
  3. increased LV atrial pressure and PH
  4. recurrent septic emboli
  5. vegitations > 10mm
  6. persistent bloodculture despite AB
  7. relapsing infections
  8. abscess formation
187
Q

drug in cardioversion?

A

amiodoran

188
Q

when can we not do a cardioversion?

A

throbus in the heart

189
Q

drugs inhibiting remodeling of heart in HF?

A

ACEI
ARB
B-blockers
spironolacton

190
Q

hypertension mediated organ damage HMOD

A
brain 
eyes
heart 
kidney 
arteries
191
Q

if you see ST elevation and chestpain after a intervention what can it be?

A

stent thrombosis

192
Q

abnormal ventricular wall motion?

A

Akinesis: lack of wall motion

Dyskinesia: outward movement of a wall segment during systole (transmural infarct)

hypokinesis: movements with decreased amplitude

193
Q

contrastagent in MRI heart?

A

Gadolinium

194
Q

pericarditis on ECG?

A

depressed PR intervall

195
Q

tripple rule out

A

Triple-rule-out (TRO) CT angiography is a recent technique for evaluation of:
Coronary arteries
Aorta
Pulmonary arteries
Adjacent intrathoracic structures

Done simultaneously for patients with acute chest pain.

196
Q

what do you have to give if patient is on aspirin?

A

PPI due to gastric ulcers

197
Q

why do we have to do syncronized cardioversion in supraventricular arrhythmias?

A

if you give shock at the wrong time you can start Vfib

198
Q

why is it better to use thoracic artery then saphenous vein in CABG?

A

veins collapse after about 10 years, arteries dont

199
Q

why is radial artery the 3rd choice in CABG?

A

bec. tends to get spasms faster

200
Q

in ECMO what is the time difference between VV and AV

A

AV week

VV months