Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE Step 1 Quick Notes > Cardiology > Flashcards

Cardiology Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

What does bulbus cordis ake?

A

Smooth part of left and right ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does primitive pulmonary vein make?

A

Smooth part of left atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does left horn of sinus venosus make?

A

Coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does right horn of sinus venosus make?

A

Smooth part of right atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does acidosis do to contractility?

A

Decreases it because you want circulation to go slower so you have more time for gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why do you hear S4?

A

Because during the atrial kick, the atria must push blood into stiff left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the a wave of JVP?

A

Atrial contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the c wave of JVP?

A

RV contraction (closed tricuspid bulges into atrium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the x descent of JVP?

A

Atrial relaxation and downward displacement of closed tricuspid valve during ventricular contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In what situation would you see absent x descent of JVP?

A

Tricuspid regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the v wave of JVP?

A

Increased right atrial pressure due to filling against closed valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the y wave of JVP?

A

Passive blood flow from RA to RV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which murmur do you see radiation to carotids?

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which murmur do you see pulsus parvus et tardus (weak pulses and delayed)?

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which murmur specifically increases on handgrip?

A

VSD (low-pitch holosystolic murmur)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which murmur does MVP predispose?

A

Mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What decreases the intensity of aortic regurgitation murmur?

A

Vasodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the diagnosis? Thickened leaflets, fibrous bridging and calcifications.

A

Rheumatic Heart Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the diagnosis? Large vegetations, leaflet perforation.

A

Infective Endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the speed of conduction slowest at AV node?

A

To allow for ventircular filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Decrease in which ions predispose to torsades?

A

K, Mg (Treat with magnesium sulfate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the inheritance pattern of Romano Ward Syndrome?

A

AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the inheritance pattern of Jervell and Lange-Nielson Syndrome?

A

AR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the precipitating factors for atrial fibrillation?

A

Binge alcohol, cardiac sympathetic tone, pericardiits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which of the AV blocks are symptomatic?

A

Mobitz Type II and 3rd Degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which AV block does Lyme Disease cause?

A

3rd Degree AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the recombinant form of BNP?

A

Nesiritide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the Cushing triad?

A

Hypertension, bardycardia, and respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which organ has largest arteriovenous O2 difference?

A

Heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the major factor for determining autoregulation in skin?

A

Sympathetic stimulation - temperature control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which way does the heart shunt blood normally in septal defects?

A

Left to right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does adult type coarctation increase the risk for?

A

Ruptured intracranial aneurysms because of increased incidence of berry aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the risk factors for PDA?

A

Birth at high altitude (low O2 tension), mternal rubella infection, premature birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where is atherosclerosis most likely to develop?

A

Abdominal aorta then coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is corneal steal syndrome?

A

Giving vasodilators (adenosine, dipyradimole) sends blood to normal vessels that have now dilated rather than the poststenotic region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is Loefller Syndrome?

A

Endomyocardial fibrosis with a prominent eosinophilic infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are painless, small erythematous lesions on palms and soles?

A

Janeway lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are tender raised lesions on finger or toe pads?

A

Osler nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Who gets subacute infective endocardiis?

A

Previously diseased or congenitally abnormal valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What causes nonbacterial endocarditis?

A

Malignancy, hypercoagulable, or lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What do people with rheumatic heart disease die from?

A

Myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are granuloma with giant cells?

A

Aschoff bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are enlarged macrophages with ovoid, wavy, rod-like nucleus?

A

Anitschkow cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the triad for cardiac tamponade?

A

Hypotension, distended neck veins, and distant heart sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What do you see on EKG for cardiac tamponade?

A

Low voltage QRS and electrical alternans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What causes a “tree bark” appearance of the aorta?

A

Syphilitic heart disease?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What do you see pulsus paradoxus with?

A

Asthma, OSA, pericarditis, cardiac tamponade, croup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What looks like scattered cells within mucopolysaccharide stroma?

A

Myxoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is a glomus tumor?

A

Benign, painful, red-blue tumor under fingernails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What do glomus cells do?

A

Thermoregulate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Which tumor do women get post radical mastectomy?

A

Lymphangiosarcoma (lymphatic malignancy associated with persistent lymphedema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is a rare blood vessel malignancy see in head, neck, and breast areas usually in elderly on sun exposed areas?

A

Angiosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What cardiac drug causes hyperprolactinemia?

A

CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is Fenoldopam?

A

D1 agonist that causes vaodilation –> decreases BP and increases natriuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What decreases cholesterol absorption at small intestine brush border?

A

Ezetimibe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

How do fibrates work?

A

Upregulate LPL (Increased TG clearance); activate PPAR-alpha (increases HDL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How does digoxin slow HR?

A

Activates vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What drugs decreases digoxin clearance?

A

Verapamil, Amiodarone, and Quinidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What does digoxin do to the QT segment?

A

Decreases it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What causes increased toxicity for all class I drugs?

A

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Which of the Class I drugs is for ischemic or depolarized purkinje/ventricular tissue?

A

Class IB; used especially most MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Which Class I drug significantly increases refractory period?

A

Class IC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Which drug do you use for digitalis induced arrhythmias?

A

Class IB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What side effect does metoprolol cause?

A

Dyslipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What side effects do you see with beta blockers?

A

Impotence, COPD/asthma exacerbation, CV effects (AV block, bradycardia, decompensated CHF), CNS (sedation, sleep alterations), masks hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What do you use for atrial fibrillation?

A

CCB or beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the side effects of CCBs?

A

Hypotension, constipation, flushing, edema, AV block, sinus node depression, CJF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is 1st line for supraventricular tachycardia?

A

Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Which drugs prolong QRS to a greater extent at higher heart rates?

A

Class 1C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Why do you get janeway lesions in bacterial endocarditis?

A

Due to septic microemboli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are the side effects of statins?

A

Hepatotoxicity and myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

How would you improve forward flow: regurgitant flow ratio in mitral regurgitation?

A

Decrease afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is ergonivine?

A

Vasoconstrictors that activates alpha and serotonin receptors; worsens spasms/chest pain/ST elevation in patients with existing spasms (such as prinzmetal)

74
Q

What looks like a pedunculated mass with scattered cells with mucopolysaccharide stroma?

A

Myxoma

75
Q

What determines the severity of mitral stenosis?

A

A2-OS time interval (decreased interval means greater stenosis since left atrial pressure rises closer to aortic)

76
Q

What is the diagnosis? Renal fialure, toe gangrene, livedo reticularis after invasive vascular procedure.

A

Thromebolic disease (will see choelsterol crystals/emboli obstructing renal arteries)

77
Q

What are the major side effects of Verapamil?

A

AV block, constipation, flushing, edema, CHF, SA depression

78
Q

What is livedo reticularis?

A

Purple lace like discoloration due to obstruction

79
Q

What are the side effects of digoxin?

A

Bradycardia, hyperkalemia, decreased QT, increased PR, blurry yellow vision

80
Q

What do you use for isolated HTN?

A

Dihydropyridine CCB (amlodipine, nifedipine) and thiazides

81
Q

When do you hear an ASD murmur?

A

Diastolic

82
Q

When do you hear a VSD murmur?

A

Holosystolic

83
Q

What does it mean when you see increased left ventricular and atrial diastolic pressures in rheumatic heart disease?

A

Both aortic and mitral valves are affected

84
Q

What is posterior to the esophagus?

A

Descending aorta

85
Q

What activates arginine to NO conversion?

A

Bradykinin, Ach, substance P, serotonin, shear forces

86
Q

What is a normal right ventricular pressure?

A

25/5

87
Q

What is a normal pulmonary artery pressure?

A

25/10

88
Q

What is segmental thrombosing vasculitis associated with?

A

Buerger

89
Q

What are the symptoms of Buerger?

A

Rayandus, claudication, gangrene, autoamputation, phlebitis, hypersensitivty to intradermal tobacco injection

90
Q

What are the atrial pressures usually?

A

~10

91
Q

What is the embryological problem with tetralogy of fallot, persistent truncus arteriosus, TGA?

A

Abnormal neural crest migration to truncus and bulbus cordis

92
Q

What happens 10-14 days after MI

A

Granulation tissue made of type III collagen (eventually replaced by type 1)

93
Q

Which of the Class I drugs are for ischemic myocardium?

A

Lidocaine, Mexiletene

94
Q

What is hibernating myocardium?

A

It is when repetitive ischemia causes reversible but chronic loss of contraction (myocardial stunning is a less severe form)

95
Q

What is ischemic preconditioning?

A

It is resistance to infarction because of repetitive non lethal ischemia

96
Q

Why do you need nitrate free period?

A

To avoid tolerance developement

97
Q

What causes hereditary HCM?

A

Mutation in beta myosin heavy chain

98
Q

What lab value can you test for with large vessel vasculitises?

A

increased ESR

99
Q

How does nitroglycerin affect preload?

A

Decreases it because they increase venous capacitance . This reduces myocardial work and oxygen demand which is benficial in agina

100
Q

What are the complications of an MI for the lung?

A

Acute pulmonary edema, pulmonary venous HTN, transudate of plasma into lung interstitium and alveoli?

101
Q

What plays the biggest role with Valsalva?

A

Rectus abdominus: its like going to the bathroom

102
Q

What can varicose veins cause?

A

Skin ulcerations

103
Q

What percentage of the lumen must be narrowed to see symptoms of angina? What about if at rest?

A

> 75%: symptoms of angina

>95%: symptoms at rest

104
Q

What type of tissue do you se dystrophic calcification on?

A

Necrotic tissue

105
Q

When do you see dystrophic calcification of aortic valve?

A

With age (due to damage from hemodyanamic stress over time)

106
Q

How does age affect the aorta?

A

Causes it stiffen (increased isolated systolic BP)

107
Q

What is the physiology of pulsus paradoxus?

A

Inspiration –> increased pulmonary vessel capacitance –> more blood storage –> less return to left heart –> dec systolic BP (>10)

108
Q

Why do you see pulsus paradoxus in cardiac tamponade?

A

There is pressure around heart so septum bulges into left ventricle further decreasing systolic BP

109
Q

What is syphilitic aneurysm?

A

Obliteration of vaso vasorum, intimal wrinkling and dilation

110
Q

What is there a seropositivity for in polyarteritis nodosa?

A

HBV

111
Q

What do you use for HTN in pregnancy?

A

Methyldopa + hydralazine; also labetolol, nifedipine

112
Q

What is the MAP equation?

A

MAP = CO x TPR (if venous pressure severely increased then do MAP - RAP = CO x TPR)

113
Q

What deposits with Henoch Scohnlein

A

IgA immune complexes

114
Q

How do you tell lipofuscin from hemosiderin?

A

Prussian blue stain will show hemosiderin (iron deposits) –> hemochromatosis

115
Q

How does NO cause smooth muscle cell relaxation?

A

Decreases MLCK so causes dephosphorylation or increases MLCP which also dephosphorylates

116
Q

What is responsible for desynchronization of atria and ventricles?

A

AV node

117
Q

What helps improve cyanosis in tetralogy?

A

Squatting (increases afterload so more blood shunted from left to right into pulmonary artery)

118
Q

Where is the filter to prevent PE placed?

A

IVC

119
Q

What causes thoracic aortic aneurysm?

A

Cystic medial degeneration from HTN or marfan’s or tertiary syphilis (obliterates vaso vasorum)

120
Q

What causes abdominal aneurysm?

A

Atherosclerosis; seen MC in smoking males >50

121
Q

Where is the least O2 content in the body?

A

Coronary sinus because it has pure venous blood; pulmonary has mixed

122
Q

What is CAD related sudden cardiac death from?

A

Ventricular arrhythmias

123
Q

What is the intimal injury response due to?

A

Smooth muscle cells that migrate to media and intima

124
Q

What receptors does NE act on?

A

Alpha1, alpha2, beta1

125
Q

What would you see with acute MR vs chronic MR?

A

Acute MR: acute pulmonary edema since no time for LA compliance to increase
Chronic MR: at risk for atrial fibrillation, thromboemboism

126
Q

How does adenosine slow HR?

A

Affects phase 4 (it causes K+ efflux so hyperpolarizes which slows depolarization)

127
Q

What TTX from puffer fish inhibit?

A

Vna

128
Q

What does TEA inhibit?

A

Vk

129
Q

Why do you see pulmonary HTN in CHF?

A

Impaired NO and increased endothelin production leading to vasoconstriction

130
Q

What do you see deposition of in infective endocarditis?

A

Fibrin

131
Q

What happens do cardiac cells during ischemia?

A

They swell because of increased calcium

132
Q

What is myocyte efflux from cytoplasm caused by?

A

Na/Ca exchanger and Ca-ATPase (to get Ca into SR)

133
Q

What does lipofuscin look liek?

A

Brown perinuclear cytoplasmic inclusions

134
Q

What do you see with normal aging of the heart?

A

Sigmoid ventricular septum and decreased left ventricular chamber size, increased colalgen

135
Q

What happens if you use CCB and beta blockers together?

A

Decrease HR and hypotension due to slow SA conduction

136
Q

How do macrophages destabilize plaques?

A

Secreting metalloproteinases that break down collagen

137
Q

What can kawasaki kids develop?

A

Coronary artery aneurysms, thrombosing

138
Q

Which small vessel vasculitises have necrotizing granulomas?

A

Wegener’s, Churg-strauss

139
Q

What causes mitral valve prolapse?

A

Myoxmatous degeneration or inherited CT disorders (marfan, ehler’s)

140
Q

What is person with T2DM most likely to die from?

A

Coronary heart disease

141
Q

Where do left ventricular leads in biventricular packemakers go through?

A

Coronary sinus (in atrioventricular groove on posterior aspect of heart)

142
Q

How early can fatty streaks show up?

A

10 years old

143
Q

What can you give in a hypovolemic state?

A

Saline (increases SV and CO)

144
Q

What is a side effect of nitroprusside?

A

Cyanide toxicity

145
Q

What do you see with pulmonary infarction?

A

Hemorrhaging due to dual blood supply

146
Q

What can tricuspid endocarditis cause?

A

Septic emboli leading to pulmonary infarction

147
Q

What do cardinal give rise to?

A

SVC

148
Q

What does MVP predispose to?

A

Bacterial endocarditis

149
Q

What is nonbacterial thrombotic endocardiits from?

A

Hypercoagulable state (marantic from circulating products of cancer)

150
Q

Why do pregnant women get postural hypotension?

A

Baby compresses on IVC and decreases venous return

151
Q

What could early onset MI due to atherosclerosis be from?

A

Familial hypercholesterolemai (defective LDL receptor expression) - Type II

152
Q

How do valves look different between infective endocarditis and rheumatic heart disease?

A

Infective endocarditis: valves more friable and destructive

Rheumatic heart disease: fibrosed

153
Q

How does hyaline arteriosclerosis stain?

A

Pink on H&E

154
Q

What is hyaline arteriosclerosis seen with?

A

Essential HTN and DM; due to excessive ECM production by sMC and plasma stuff leakage across the endothelium

155
Q

Where is there damage if trauma to aorta?

A

Aortic isthmus because it is tethered by ligamentum arteriosum and is therefore fixed and immovable

156
Q

How to you treat beta blocker overdose?

A

Glucagon

157
Q

How does carcinoid present?

A

Hypotension, diarrhea, flushing

158
Q

Which of the nitrates has the greatest bioavailability?

A

Isosorbide dinitrate

159
Q

What is the MC ASD?

A

Ostium secundum

160
Q

What is the MC ASD in Down’s?

A

Ostium primum

161
Q

What drug improves long term survival of CHF patients?

A

Aldosterone antagonists, ACE-Inhibitors because it prevents aldosterone mediated heart remodeling

162
Q

Why are the side effects of hydralazine?

A

Tachycardia and fluid retention and sodium retention from reflexive B1 activation, lupus like syndrome

163
Q

Which of the class I drugs has greatest Na channel binding strength?

A

1C > 1A > 1B

164
Q

Which has greatest use dependence and what does that mean?

A

1C: it is slow to disassociate from Na channel so if heart starts beating faster than their effects intensify since there is less time in between AP to disassociate

165
Q

Which has reverse use dependence?

A

Class III blockers (as HR slows, they show greater effect)

166
Q

Which drugs cause increased risk for gallstones?

A

Bile acid resins and fibrates (increase cholesterol in bile)

167
Q

How does nitroprusside work?

A

Arterial AND venodilator (reduces afterload and preload)

168
Q

How does Digoxin slow HR?

A

Inhibits vagal tone (slows conduction through AV node and depression of SA node)

169
Q

Which drug has a slow disassociation from the VNa channels and what does this mean?

A

Class IC and this means use dependence. They are slow to disassociate and so when the channel is activated again from resting they exert their effect.

170
Q

Which drug quickly disassociates from Vna when it is in the resting state?

A

Class 1B

171
Q

What do hepatocytes increase in response to statins?

A

LDL receptor density to increase uptake of circulating LDL to make more cholesterol

172
Q

What is the problem that leads to development of Transposition of great vessels?

A

Failure to septate

173
Q

What is constrictive pericarditis?

A

Chronic process that takes months-years to create tamponade.

174
Q

How is digoxin cleared?

A

By the kidneys

175
Q

What are the side effects of nitrates?

A

Hypotension, flushing, headache, reflex tachycardia

176
Q

What are people with OSA at risk for?

A

Pulmonary HTN and resulting Right HF

177
Q

To what do you want to prevent irreversible damage to when you fix an ASD?

A

Pulmonary vessels because they get damaged from HTN

178
Q

What murmur is heard best in the lateral decubitus position?

A

Mitral stenosis

179
Q

What causes syncope during coughing?

A

Syncope is due to transient decrease in BF to the brain. Coughing diminishes venous return which can reduce BF to the heart.

180
Q

What antiarrhythmic/antihypertensive drug would cause bilateral interstitial infiltrate?

A

Amiodarone (remember it causes pulmonary fibrosis)

USMLE Step 1 Quick Notes (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions