Cardiology Flashcards
1
Q
First pharyngeal arch
A
CN V, maxillary artery
2
Q
Second pharyngeal arch
A
CN VII, stapedial artery (regresses)
3
Q
Third pharyngeal arch
A
CN IX, common carotid, prox internal carotid artery
4
Q
Fourth pharyngeal arch
A
CN X, true aortic arch, subclavian arteries
5
Q
5th pharyngeal arch
A
Oblitered!
6
Q
6th pharyngeal arch
A
CN X (recurrent laryngeal), pulmonary arteries, ductus arteriosus
7
Q
Down syndrome
A
endocardial cushion defects (ostium primum) ASD, regurgitant AV valves
8
Q
DiGeorge
A
TOF, interrupted AA
9
Q
Friedreich ataxia
A
Hypertrophic cardiomyopathy
10
Q
Marfan
A
Cystic medial necrosis (dissection, aneurysm), MV prolapse. Cardiovascular dz most likely cause of death (esp aortic dissection)
11
Q
Tuberous schlerosis
A
cardiac rhabdomyomas -> valvular obstruction
12
Q
Turner
A
Aortic coarction, bicuspid valve
13
Q
Vancomycin MOA, SE
A
blocks glycoprotein polymerization by binding to D-ala, D-ala; redman syndrome, nephrotoxicity
14
Q
Daptomycin MOA, SE
A
Depolarization of bacterial (cannot penetrate GN bacteria outer cell membrane, is inactivated by lung surfactant); myopathy & CK elevation
15
Q
Linezolid MOA, SE
A
Inhibit protein synthesis by binding to 50s subunit; thrombocytopenia, optic neuritis, serotonin syndrome
16
Q
Post-MI: 0-4 hours
A
Minimal change
17
Q
Post MI: 4-12 hours
A
Early coag necrosis: edema, hemorrhage, wave fibers
18
Q
Post MI: 12-24 hours
A
Coag necrosis, marginal contraction band necrosis
19
Q
Post MI: 1-5 days
A
Coag necrosis, PMN infiltrate
20
Q
Post MI: 5-10 days
A
MO phagocytosis of dead cells
21
Q
Post MI: 11-14 days
A
Granulation tissue, neovascularization
22
Q
Post MI: 2 weeks - 2 months
A
Collagen deposition, scar formation
23
Q
Local amyloid production: cardiac, thyroid, pancreatic islets, cerebrum/cerebral blood vessels, pituitary gland
A
atrial naturietic protein, calcitonin, islet amylin protein (TIID), beta-amyloid protein, prolactin
24
Q
Systemic amyloid protein
A
IG light chain, esp gamma light chains; associated with MM
25
Malignancy re: exposure to arsenic, thorotrast, polyvinyl chloride; cells express CD-31 (PECAM-1)
Hepatic angiosarcoma from vascular endothelial cells
26
Familial chylomicronemia syndrome (Type I)
Lipoprotein lipase/ApoC-II (cofactor) defect; elevated chylomicrons; pw acute pancreatitis, eruptive skin xanthelomas, HSM, lepemia retinalis
27
Familial hypercholesterolemia (Type II A)
LDL receptor/ApoB-100 defect; elevated LDL; pw premature CAD, corneal acrus, tendon xanthomas, xanthelesmas
28
Familial dysbetalipoproteinemia
ApoE; chylomicrons/LDL; pw premature CAD/PVD, palmar xanthelomas
29
Familial hypertriglyceridemia
ApoA-V; VLDL; pancreatitis, obesity/insulin resistance
30
Atrial myxoma
preference for LA; mid-diastolic rumble; histo: scattered cells w/ mucopolysaccharide stroma; VEGF & IL6
31
Sx of wide pulse pressure
head pounding, head bobbing
32
m/c cause of AR
aortic root dilatation, bicuspid aortic valve
33
CABG: LAD alone, multile arteries
Left internal mammary; great saphenous vein
34
IVDU endocarditis
R-side, TR, Staph A, early systolic murmur accentuated by inspiration
35
MI healing require what kind of collagen, when?
Type I; 2 weeks post-MI
36
Type II collagen
Cartilage, vitreous humor, nucleus pulposus
37
Type III collagen
skin, lung, GI, blood vessels, lympatic, granulomatous tissue
38
Type IV collagen
Basement membrane (Alport)
39
Niacin SE, mediated by, rx
Flushing, prostaglandin, aspirin
40
Vanc SE, mediated by
Redman syndrome, histamine
41
Capsaicin MoA
Decrease pain by decreasing substance P
42
Digoxin toxicity induced by; rx
hypokalemia, hypovolemia, renal failure; anti-digoxin antibody fragments
43
Heart sound: Loud P2
Pulmonary HTN
44
Post-MI complication days 3-7
Rupture LV free wall
45
TOF/truncus arteriosus/TGV embryology
NC cells migrate into truncus arteriosus and bulbar ridges to induce aorticopulmonary septation
46
Nitroglycerin MoA
venodilator of large veins, reduces pre-load and oxygen demand to rx angina pectoris
47
Arterial baroreceptors: where? nerves?
Carotid, glossopharyngeal; aortic arch, vagus nerve
48
atrial myoxoma pw, histo, cytokines
large pedunculated mass on LA with mid diastolic rumble @ apex, SOB w/ sitting up, fever; scattered cells with mucopolysaccharide stroma, abnormal blood vessels, hemorrhage; VEGF (angiogenesis), IL-6 (weight loss, fever)
49
AR pw, etiology
Early diastolic murmur (if severe, holodiastolic) with palpitations, head pounding, head bobbing; aortic root dilatation, bicuspid aortic valve
50
CABG: vessel source if LAD alone, multiple arteries
left internal mammary; great saphenous vein (surgeons access the vein inside femoral triangle)
51
R-side tricuspid regurgitation moa, pw
IV drug use, staph endocarditis; early systolic, accentuated by inspiration
52
Vertebral levels at which IVC branches into renal veins, common iliac veins
L1/L2, L4
53
MI healing culminates in what type of collagen? how long does deposition last?
type I collagen, 1 week - 2 months
54
niacin-induced flushing mediated by what molecule? rx with what drug?
prostaglandin; aspirin
55
Digoxin toxicity induced by what situations?
hypokalemia, hypoveolemia, renal failure
56
Digoxin toxicity pw, rx
nonspecific GI (anorexia, N/V), neuro (confusion, fatigue, weakness, color vision change), arrhythmia (most dangerous); rx with anti-digoxin antibody fragments
57
constrictive pericarditis moa, pw
thick, fibrous tissue in percardial space that restricts ventricular filling during diastole, reduces CO, and causes RHF (kussmaul sign: JVP increases with inspiration); pw pulsus paradoxicus, pericardial knock, increased JVP
58
constrictive pericarditis etiologies
idiopathic, viral, cardiac surgery/radiation, tuberculosis
59
heart sounds: loud P2
pulmonary HTN
60
heart sounds: S3
dilated ventriclesdecreased ventricular wall compliance (intrinsic in restrictive cardiomyopathy, extrinsic in constrictive cardiomyopathy)
61
pulsus paradoxicus moa
during inspiration, increased systemic venous return; but if pericardium cannot expand (2/2 tamponade, constrictive/restrictive pericarditis, severe obstructive lung dz), then RV pushes into LV and CO/BP decreases
62
Post-MI rupture of LV free wall moa
days 3-7 after coagulative necrosis, PMN infiltration, and enzymatic lysis of connective tissue reduces stability
63
Asthma: beta-agonist, steroid moa
Stimulated beta-2 adrenergic receptor on lungs, stimulation of Gs receptor leads to increased activation of AC and increased cAMP; steroids impair eosinophilic degranulation
64
Recent respiratory illness may lead to what heart condition?
serous viral pericarditis, significant acute pericardial effusion, and tamponade
65
rheumatic heart dz most commonly affects what valve?
MV (but can affect both MV and AV in a quarter of cases)
66
tetrology of fallot pw and development
most common cause of cyanotic congenital heart disease (may not present in neonate if pulmonary stenosis is mild); in beginning, VSD allows L to R shut, thus infrequent cyanotic episodes; however, over time pulmonary HTN develops and R to L shunt leads to frequent cyanotic episodes
67
ToF, truncus arteriosis, TGV developmental misfortune
aorticopulmonary septation requires NC cells to migrate into truncal (truncus arteriosis) and bulbar ridges (bulbus cordis) in order to grow into the aorta and pulmonary artery; failure of this process
68
main myocardial energy source:
FA oxidation (60%), but FA oxidation requires more O2, produces more ATP, thus shift of FA to glucose oxidation can improve stable angina
69
longer QT means highe rrisk of torsades; which anti-arrhythmic, thought it increases QT interval, does not increase risk of torsades?
amiodarone
70
adenosine moa
binds to A1 receptors on cardiac cells and activates K+ channels and increases K+ clearance; results in transient conduction delay through AV and briefly treats SVT
71
nitrate limitation on use
around-the-clock administration results in tolerance; thus give nitrate-free interval at night
72
statins 2 moa, main se
1. lower cholesterol, 2. stabilize atheromatous plaque (decrease chance of second MIA); risk of myositis (increased CK), myalgias (normal CK)
73
statin risk of myositis increases with which drugs?
niacin, fibrates
74
persistent lymphadema increases risk of what disease?
lymphangiosarcoma, rare malignancy of the endothelial lining of lymph system
75
cavernous hemangioma
benigh neoplasm of small blood endothelial cells
76
carvernous lympangioma
network of endothelium lined lymph spaces below epidermis
77
cystic hygroma
cavernous lympangioma + absence of luminla blood cells, common in H&N, turner's syndrome
78
pyogenic granuloma
capillary form of cappilary hemangioma, exophitic red nodules attached by stalk to oral mucucosa and skin;
79
MS-related enlargement impinges on what nerve and causes what symptom?
L recurrent laryngeal nerve, hoarseness
80
PDA associated with what congenital dz?
rubella
81
ventricular septal defect associated with what pregnancy condition?
fetal alcohol syndrome
82
MVP increases or decreases with squatting?
decreases. squatting increases preload and PVR; thus it increases LV volume. this returns leaves to normal arrangement (in MVP, mitral redundancy occurs 2/2 elongation, overlap of leaflets).
83
native valve bacterial endocarditis (NVBE): most common etiology
MVP among 15-60 yo americans; upon which plt and fibrin deposit and is colonized by bacteria
84
nitroglycerin moa
converts to NO at vascular SM cell membrane; NO converts GTP to cGMP; increased cGMP decreases Ca in cytosol, which decreases activity of myosin LC kinase, myosin LC dephosphorylase; muscle relaxation
85
congenital QT prolongation: responsible mutation
K+ channel protein
86
After contraction, how does myocyte achieve Ca efflux?
Ca-ATPase (SR) and Na/Ca exchange mechanism (plasma membrane)
87
cystic medial degeneration moa, histology
myxomatous changes in the media of large arteries; fragmentation of elastic tissue ("basket weave"), separation of elastic/fibromuscular componenets that produce small cleft-like spots with amorphous ECM filling
88
lysyl oxidase fxn, required cofactor
cross-link collagen fibers, elastin; copper (Menkes)
89
organ susceptibility to infarction
CNS (5 min), myocardium (20-30 min), kidney (30 min), spleen, liver (less likely 2/2 dual blood supply, unless transplanted)
90
Class I anti-arrhythmic: binding strength to Na channel
1C>1A>1B
91
Anti-arrhythmic medication for ischemia-induced ventricular arrhythmias
1B (lidocaine, mexiletine, tocainide) as dissociation is rapid with minimal cumulative effective
92
ANP fxn
1. kidney (increase diuresis); 2. adrenal gland (increase naturesis by inhibiting aldosterone secretion); 3. blood vessels (vasodilation)
93
Veramapil fxn, SE, c/i
rate control for A-fib with RVR; negative ionotrope (helpful for angina, HTN); bradycardia, AV block, constipation; CHF pt (2/2 negative ionotropic effect)
94
Which statin is not metabolized by P-450 system?
pravastatin
95
P-450 inducers
phenytoin, phenobarbitol, rifampin, griseofulvin, carbamazapine
96
P-450 inhibitors
macrolides (erythromycin/clarithromycin) , ketoconazole, isoniazid, cipro, grapefruit
97
turner's syndrome: unusual findings
cystic hygroma (located in neck, cystic spaces rich in lymphoid tissue); aortic co-arction
98
atherosclerotic plaques, likely locations
aorta > coronary arteries > popliteal > internal carotid > circle of willis
99
muscular/elastic arteries
coronary, poplitleal/ aorta, carotid, iliac
100
hypertrophic cardiomyopathy mutation
AD mutations of sarcomere protein leads to deficiency in force generation
101
what is unique about staph a in infectious endocarditis?
sports a surface adhesion molecule that can invade intact valvular endothelium; thus, can affect pts without pre-existing valvular dz
102
embryology: vein development (vitilline, umbilical, cardinal)
vitilline - portal veins; umbilitcal veins - degenerate; and cardinal - systemic veins
103
furosemide moa, effect on K, Ca
at ascending limb, loop diuretic that blocks Na/K/2Cl symporter; decreases K, Ca
104
thiazide moa, effect on K, Ca
at distal tubule, blocks Na/Cl symporter; decreases K, increases Ca
105
amiloride moa, effect on K
block ENaC, at apical membrane of principal cells K sparing
106
primary pulmonary HTN
medial hypertrophy of arteries/arterioles, concentric laminar intimal fibrosis that reduces lumina
107
most common cause of cor pulmonale
COPD-related obliteration of segments of pulmonary vasculature
108
intimal injury 2/2 athersclerosis: key cytokines in reactive intimal hyperplasia
PDGH: encourage SMC migration, proliferation; VCAM: adherence of monocytes/lymphocytes
109
syndenham chorea moa
anti-strep antibodies cross-react w basal ganglia
110
TGA: moa, aorta position relative to pulmonary artery
failure of aorticopulmonary septum to spiral normally; aorta lying anterior to (normally posterior)
111
Gq pathway
activates phospholipase C, degrades membrane lipids into DAG (activate protein kinase C) or IP3 (release Ca from SR)
112
nitroprusside SE, rx
cyanide poisoning (altered mental status, lactic acidosis); rx with Na thiosulfate, which adds sulfate to liver rhodonase to help with metabolism
113
ebstein's anomaly: what is it, what causes it
apical displacement of tricuspid valve, decreased RV volume, atrialization of RV; lithium
114
nitroglycerin + sildenafil
hypotension
115
milrinone moa
phosphodiesterase isoenzyme 3 inhibitor, increases conductance of Ca channels on SR at the heart; at the periphery, can lead to vasodilation so don't use in hypotensive patient
116
ACE-I and bilateral renal artery stenosis
do not use ACE-I - can limit efferent arteriole constriction to maintain renal artery perfusion
117
aortic coarctation adults vs children
adults: stenosis is post-PDA; children: pre-PDA
118
pritzmetal angina: dx
ergonavine (ergot alkaloid that acts via alpha-adrenergic receptor to induce vascular smooth muscle constriction )
119
carcinoid heart dz: moa, why limited to R side?
fibrous intinal thickening and endocardial plaques; limited to R-heart because serotonin and bradykinin inactivated by pulmonary vascular endothelial monoamine oxidase
120
hemosiderin-laden MO in alveoli: histo, how to differentiate with lipofuschin (age-related byproducts of lipid oxidation)
golden-yellow/brownish cytoplasmic capsule; prussian blue stain (blue=hemosiderin)
121
normal aging and effect on heart macro/micro appearance
macro: decreased LV size 2/2 ventricular septum becoming sigmoidal; micro: increased interstitial CT with concomitant amyloid deposition (w/i myocites, progressive accumulation of lipofuscin)
122
PDA more likely with
prematurity, rubella
123
functional heart murmur
2/2 acute hemodynamic change
124
VSD: heart sound, pulse ox finding
loud, holosystolic murmur over LLSB with Sp02 difference between RA and RV
125
class III anti-arrhythmics
amiodarone, ibutilide, dofetilide, sotalol
126
dopamine low, medium, high dose effect
low: kidney (increased GFR, Na excretion); med: cardiac (increased contractility, SBP, pulse pressure via beta-1); high: vasculature (increased SVP, decreased CO 2/2 alpha-1 )
127
epi/phenylephrine difference
phenyl: pure alpha-1 (vasoconstriction, decreased HR); epi: added beta effect (increased SBP, decreased DBP, increased HR, increased contractility)
128
likelihood of plaque rupture is associated with
mechanical strength of overlying fibrous cap
129
cellular sign of irreversible cardiac injury
mitochondrial vacuolization: myofibril relaxation, polysome disaggregation, TG droplet accumulation
130
niacin SE
vasodilation (decrease HTN meds), insulin resistance (increase DM meds), increase uric acid (careful in gout)
131
digoxin deadly SE
AV block, ventricular tachyarrhythmias
132
digoxin electrolyte SE that reflects serum toxicity
hyperkalemia
133
class III antiarrhythmic with beta-adrenergic blocking abilityes and QT prolongation
sotalol
134
verapamil vs diltiazam
more cardioselective
135
TGF-beta
arrest of cell cycle, angiogenesis, stimulation of fibroblasts to lay down ECM
136
hypertrophic cardiomyopathy histo findings
myocyte hypertrophy, haphazard arranged myocyte and myocyte bundles and fibrosis in interstitial spaces
137
thiamine deficiency leads to what cardiac outcome
wet beriberi leads to DCM
138
acute rheumatic fever pw
pericarditis: weak heart sound, increased HR, pericardial friction rub, arrhythmias; myocarditis: dilatoin, MR and acute heart failure; chronic ARF: MS
139
aortic rupture occurs most often at what location?
isthmus, tethered by ligamentum arteriosum, relatively fixed/immobile place
140
BB overdose rx
glucagon (increased cAMP, Ca, independent of adrenergic receptors)
141
PE prefers what lobes?
lower lobes
142
isoprotenolol
nonselective beta agonst (beta 1: increased contractility, beta 2: vasodilation)
143
labetolol moa
combined alpha, beta blocker (beta 1 blocker: decreased contraction; beta2 blocker/alpha1 blocker: decreased SVR)
144
fenoldopam moa, function
rx for HTN emergencies, esp in pt with renal insufficiency; selective DA-1 agonist: at periphery, decreases blood pressure and at kidney, increases renal blood flow)
145
NE in peripheral vein causes what, and how to you reverse
extravation can cause vasoconstriction, induration/pallor of tissue; prevent with alpha-1 antagonist like phentolamine
146
congenital QT prolongation: two kinds
jervell and lange-nelson (AR) with neurosensory deficiency; romano-ward (AD) no deafness
147
congenital DCM moa
cardiac cell cytoskeleton (problem with force transfer) and mitchondrial enzymes of oxidative phosphorylation (problem of force generation)
148
spontaneous intracranial hemorrhage: m/c etiology
AVM, ruptured aneurysm, cocaine
149
What's the basis of association between cerebral aneurysm and coarction of aorta?
HTN means more likely to rupture
150
hallmarks of lightning strike
lichtenburg figures (fern-leaf pattern erythema) + second degree burns; most common reason for death is arrhythmias, respiratory failure
151
acute pericarditis most common causes
MI, rheumatic fever, uremia, viral
152
embryo: truncus arteriosus
ascending aorta, pulmonary trunk
153
embryo: bulbus cordis
smooth part of L/R ventricles
154
embryo: primitive atrium
trabeculated part of L/R atria
155
embryo: primitive ventricle:
trabeculted part of L/R ventricles
156
embryo: primitive pulmonary vein
smooth part of left atrium
157
embryo: right horn of sinus venosus
smooth part of right eatrium
158
embryo: left horm of sinus venosus
coronary sinus
159
embryo: right common cardinal vein and right anterior cardinal vein
SVC
160
Defect in L/R dynein (Kartagener's) affects what organ and what time in development?
looping of the primary heart tube at week 4
161
PFO moa
failure of septum primum and septum secundum to fuse
162
VSD moa
membranous septum
163
sequence of fetal erythropoiesis organs
yolk sac, liver, spleen, bone marrow
164
allantois/urachus
median umbilical ligament
165
foramen ovale
fossa ovalis
166
notocord
nucleus pulposus
167
umbilical arteries
medial umbilical ligaments
168
umbilical vein
ligamentum teres hepatis (in falciform ligament)
169
coronary blood flow peaks during
early diastole
170
arterioles provide most of; veins provide most of
TPR, blood storage capacity
171
organ remove has what effect on TPR and CO?
increase TPR and decrease CO
172
speed of conduction
purkinje > atria > ventricles > AV node
173
pacemaker pace
SA > AV > bundle of his/purkinje/ventricles
174
ABCDE of drugs that induce long QT
anti Arrhythmics (IA, III), antiBiotics (macrolides), anti Cychotics (e.g. haloperidol); anti-Depressants (TCA); antiEmetics (ondansetron)
175
rx for torsades
give magnesium sulfate
176
brugada syndrome
AD d/o of asian males, ECG shows pseudo-RBB with ST elevation in V1-V3; increased risk of ventricular tachyarrhythmias and SCD; preven with implantable cardioverter-defibrillator
177
WPW anatomic cause, pw, complication
abnormal fast accessory conduction pathway (bundle of Kent); delta wave, widened QRS, shortened PR; supraventricular tachycardia
178
lyme dz heart problemz
3rd degree heart block
179
BNP and ANP difference
BNP has longer half life
180
hypoxia: pulmonary vs systemic reaction
vasoconstriction (to move blood to well-perfused areas), vasodilation
181
ApoB-48
mediates chylomicron secretion (chylomicron)
182
ApoB-100
binds LDL receptor (VLDL, IDL, LDL)
183
ApoC-II
lipoprotein lipase cofactor (VLDL, chylomicron)
184
ApoA-I
activates LCAT (HDL, chylomicron)
185
ApoE
mediates remnant uptake (all but LDL)
186
dystrophic calfcification
hallmark of cell injury and necrosis; m/c in age/damaged cardiac valve or atheromatous plaques; pw fine, gritty white clumps with dark purple, sharp-edged granules on H&E
187
dofetelide moa
class 3 (K+ blocking in cardiac myocytes in phase 3)
188
ARF: aschoff bodies
interstitial granulomas in cardiac cells
189
ARF: anotschkov cells
macrophages with abundant cytoplasm and central nucleus that become aschoff giant cells
190
prostacycline synthesized by, role, disease
synthesized in capillary endothelium by prostacyclin synthase; maintain capillary patency by promoting vasodilation and inhibiting platelet adhesion; damaged endothelial cells can't synthesized PG so increased risk of thrombus formation
191
beta-1 antagonist moa
receptors on cardiac and renal tissue (JG cells) that blocks catecholamine-induced renin release and inhibits RAS
192
digoxin moa
1. slow depolarization and increase diastolic filling time; 2. reduced Na influx slows Ca efflux, thus allowing more Ca inside
193
Class 1C and Class III different effect on QT duration
1C prolong QRS more with high HR ("use dependence"); III prlonged more with low HR ("reverse use dependence")
194
phentolamine moa
reversible, competitive non-specific alpha-antagonist used in catacholamine induced HTN crisis (pheo, MAOI crisis, cocaine)
195
phenoxybenzamine moa
irreversible non-specific alpha antagonist, used in pheo
196
very important difference between epi and NE
epi has more beta-2 effect than NE
197
hydralazine/minoxidal moa, SE
direct arterial vasodliators; tachycardia and edema
198
ulcertaed atherosclerotic plaque with partially obstructive thrombus leads to what conditions
UA, subendocardial MI, and sudden death
199
ruptured plaque with fully obstructed thrombus
transmural MI
200
Post-catheterization atheroembolic dz presents with
renal failure, toe gangrene, livedo reticularis; light microscopy showing cholesterol emboli obstructing renal arterioles
201
cilostazol 2 moa
decreased plt phosphodiesterase, increase cAMP, reduce plt aggregation; direct arterial vasodilator
202
churg-strauss moa
antibodies against PMN myeloperoxidase (p-ANCA); pw adult-onset asthma, eosinophilia, atopia, neuropathy
203
plt dysfunction
increased bleeding time, mucocutaneous bleeding
204
intrinsic/extrinsic coagulation pathway measured by
aPTT; PT
205
during exercise, what changes occur? what does not change? why?
increased CO, venous constriction, arterial constriction (all but muscles); MAP does not change; decreased SVR 2/2 vasodilation of muscle arterioles
206
myocardial "hibernation"
reduced metabolism 2/2 persistant hypoperfusion or reptitive ischemia
207
ventricular tachycardia: preferred treatment
amiodarone
208
drug-inced SLE
hyralazine, procainimide, isoniazide; positive ANA, anti-smith; negative dsDNA
209
HCM: obstruction etiology
abnormal systolic anterior motion of the anterior leaflet of MV toward hypertrophied interventricular septum
210
CXR findings of CHF
cardiomegaly, pleural effusion, kerley B lines (edema of intralobular septa)
211
NBTE etiology, pw
hypercoagulable state (2/2 pro-coagulant mucin of mucinous adenoma of pancreas/lungs); small, sterile, nondestructive fibrinous vegetations along the closure lines of cusps (bland thrombus without inflammation or valvular damage); if cancer-related, called "morantic"
212
Silly reason to get secondary pulmonary HTN
extended consumption of appetite suppresants like fenfluramine, phentemine
213
most common cause of death in MI patient pre-hospital, in-hospital
cardiac arrhythmia, ventricular failure
214
coagulase-negative staphlococcal infection of prosthetic valve is most likely what bacteria, and what is the rx?
S. epidermidis (polysaccharide slime); vanc with rifamin or gent
215
digeorge syndrome
maldevelopment of third/fourth branchial pouches 2/2 deletion on chromosome 22
216
precapillary spincters sensitive to
epi, NE; histamine, low Ox
217
AV block: origin of conduction
AV node
218
nitroprusside effect
balanced venous/arterial vasodilator
219
AVM effect on preload and afterload
increase preload, decrease afterload
220
eruptive skin xanthomas
hypertriglyceridemia
221
tendon xanthomas/xanthelasmas
hypercholesterolemia
222
thromboangiitis obliterans (buerger's dz)
vasulitis of medium/smal arteries (tibial, radial); acute/chronic inflammation of arterial walls, thrombosis of lumen with recanalization; segmental, and fibrosis extends into contiguous veins and nerves
223
polyarteritis nodosa
transmural inflammatoin of the arterial wall
224
noncyanotic congenital heart defect
ASD, VSD, PDA, coarctation
225
within 60 seconds of the onset of total ischemia
loss of cardiomycocyte contractility
226
NO mechanism
stimulate GC, increase cGMP, decrease Ca, decrease myosin LC kinase, myosin LC dephosphorylation and smooth muscle relaxation
227
constrictive pericarditis: chronic or acute
chronic process
