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Review tests > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Dressler’s syndrom

A

post-MI syndrome (1-2wks)

pericarditis, fever, leukocytosis, and pericardial/pleural effusion

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2
Q

Cardiac markers in MI

A

Myoglobin: rises 1-4h peaks 6-7h normal 24h
Troponin-I: rises 3-12h peaks 24h normal 5-10d
Troponin T: rises 3-12h peaks12-48 norm5-14d
Total CK: rises 3-5h peaks 24h normal 48-72h
CK-MB: rises 3-12h peaks 24h normal 48-72h
LDH: rises 10h peaks 24-48h normal 10-14d

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3
Q

Drawing of cardiac markers in MI

A

Myoglobin 1-2h after onset
troponin - 12h after onset
Ck-MB three times; 12h apart
LDH once 24h + after onset

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4
Q

Congenital heart anomalies are classified as

A

cyanotic and non-cyanotic

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5
Q

Cyanotic congenital heart defects

A

Tetralogy of Fallot
Pulmonary atresia
Hypoplastic left heart syndrome
transposition of the great vessels

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6
Q

Non-cyanotic heart defects

A 
ASD
VSD
AV septal defect/canal
PDA
Coarctation of the aorta
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7
Q

Tetralogy of Fallot

A

subaortic septal defect, RV outflow obstruction, overriding aorta, RVH
cres-decres holosytolic murmur at LSB rad to back
cyanosis, clubbing, inc RV impulse at LLSB, loud S2
polycythemia present
TET spells (cyanosis, hyperpnea, agitation)

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8
Q

Pulmonary Atresia

A

Most often with an intact ventricular septum
Pulmonary valve closed; ASD and PDA present
May have TR
cyanosis/tachypnea at birth; single s1/s2; hyperdynamic apical impulse

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9
Q

Hypoplastic left heart syndrome

A

group of defects with a small L ventricle and normally placed great vessels
presentation varies
M>F; 1/4 of cardiac deaths before age 7

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10
Q

Transposition of the great vessels

A

complete transposition of the aorta and pulmonary arteries
systolic murmur if VSD; sys ejec mur if pul stenos
cyanosis in newborn MC
may have CHF symp, poor feeding, absent LE pulses

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11
Q

ASD- MC type

A

ostium secundum is the MC
Systolic ej murmur 2nd L ICS; early-mid sys rumble
FTT; fatigue; RV heave; wide FIXED SPLIT S2

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12
Q

VSD types

A

muscular, perimembranous, or outlet openings btw the ventricles
systolic murmur at LLSV
asymptomatic to signs of CHF

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13
Q

AV septal defect

A

Due to incomplete fusion between the endocardal cushions
*common in Downs syndrome (15-20% DS pts)
First dx may occur in adulthood
constellation of defects

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14
Q

Coarctation fo the aorta

A

narrowing in the proximal thoracic aortasystolic LUSB and left intersapular murmur; may be cont
Infants present w CHF
pathognomonic differences btw arterial pulses and BP in UE vs LE

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15
Q

PDA

A 
failure to close or a delay in closure of the channel bypasing lungs
12-15% cong dx; MC in premature infants
CONTINUOUS MACHINERY MURMUR
Wide pulse pressure 
hyperdynamic apical pulse
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16
Q

Machinery murmur

A

PDA

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17
Q

Holosystolic murmurs

A

MR
TR
VSD

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18
Q

Differences in UE and LE BP and arterial pulses is pathognomonic for

A

Coarctation

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19
Q

Widened pulse pressures

A

aortic regurg/insuff

20
Q

midsystolic murmur heard 2nd R ICS rad to neck and LSB. Loud and hash in quality. Inc with pt siting and leaning forward

A

AS

21
Q

Blowing, high-pitched diastolic decrescendo murmur. 2nd-4th L ICS rad to apex and RSB. Inc with pt sitting and leaning forward on full exhalation. May have soft systolic component. Pulses are large and bounding

A

AR

22
Q

Low-pitch, mid-dyastolic murmur heard at apex. No radiation. Heard best with patient in L lateral on full exhalation. S1 accentuated with opening snap following S2

A

MS

23
Q

Medium-high blowing holosystolic murmur heard best at apex; radiates to L axilla. S2 decreased with apical impulse prolonged

A

MR

24
Q

Holosystolic, blowing murmur heard best at LLSB with radiation to R sternum and xiphoid area. JVP elevated

A

TR

25
Q

Systolic, harsh murmur heard best at 2-3 L ICS. Midsystolic cres-decres with radiation to left should/neck.

A

PS

26
Q

ejection click

A

high pitched, early systolic sound associated with the opening of an abnormal valve, sometimes followed by a murmur
Aortic Stenosis - 2nd R ICS @ the SB
Pulmonic Stenosis- 2nd L ICS @ the SB

27
Q

Wide spliting

A

delay of the pulmonic valve closure -
Pulmonic Stenosis
Right Bundle Branch Block

28
Q

Fixed splitting

A

early closure of the aortic valve
Mitral Regurgitation
Atrial Septal Defect

29
Q

Paradoxical splitting

A

delay in the closure of the aortic valve
Left Bundle Branch Block-
S2 is usually a single sound in inspiration with LBBB

30
Q

Opening Snap

A

high-pitched diastolic sound associated with the opening of an abnormal valve, sometimes followed by a murmur
Tricuspid valve - @ the LLSB
Mitral valve - @ the apex

31
Q

S3

A

an early diastolic sound (blood passively entering the ventricle) associated with Heart Failure
heard at the LLSB or Apex with Left Heart Failure
heard over the lower sternum/ epigastric area with Right Heart Failure

may be normal in children

32
Q

S4

A

late diastolic sound associated with the active ejection of blood from the atria into the ventricles when the atria contract.

S4 may be normal with an enlarged healthy heart in an athletic, or abnormal with ventricular hypertrophy.

33
Q

Which cardiomyopathy? Sustained PMI or triple apical impulse, loud S4, variable sys murmur, bisferiens carotid pulse, JVP w prominent a wave

A

hypertrophic

34
Q

bisferiens carotid pulse

A

AR
AR + AS
hypertrophic cardiomyopathy

35
Q

Becks triad

A

cardiac tamponade

Hypotension, JVD, muffled heart sounds

36
Q

electrial alternans

A

pericardial effusion

37
Q

new murmur and fever

A

endocarditis

38
Q

painless dark lesions on palms/soles assoc w endocarditis

A

janeway lesions

39
Q

painful violaceous, raised lesions on fingers, toes, feet assoc w endocarditis

A

osler nodes

40
Q

exudative, flame-shaped hemorrhages seen on the retina in endocarditis

A

roth spots

41
Q

MCC of acute endocarditis

A

staph aureus

42
Q

MCC subacute endocarditis

A

strep viridens

43
Q

appropriate empiric tx for endocarditis

A

vanc and ceftriaxone

44
Q

kussmaul’s sign

A

JVD on inspiration (constrictive pericarditis, tamponade, restric cardiomyopathy)

45
Q

tx hypertrophic cardiomyopathy

A 
β blockers and CCBs
Giving these for their NEGATIVE INOTROPY
↓ myocardial O2 demand
↓ ectopy
↓ outflow obstruction  by ↑ LV filling
46
Q

drug of choice for endocarditis prophy

A

amoxicillin

Review tests (6 decks)

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