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high yield concepts > cardiology > Flashcards

cardiology Flashcards

1
Q

Most efficient extractor of oxygen

A

heart

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2
Q

Intracellular junctions responsible for the cardiac syncytium

A

Gap junctions

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3
Q

Substance that dilates upstream blood vessels

A

Endothelium-derived Relaxing factor (EDRF) aka Nitric Oxide (NO)

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4
Q

Most potent vasoconstrictor

A

ADH (can incrase levels of endothelin 1)

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5
Q

An increase in Venous return will increase the stroke voluume, Basisl Stretching of cardiac sarcomeres will increase contraction

A

Frank-Starling Mechanism

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6
Q

Hypertension, irregular respiration and bradycardia due to activation of the CNS ischemic response and baroreceptor reflex in increased intracranial pressure

A

Cushing Reflex

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7
Q

Formula for BP based on Ohm’s Law

A 
BP = CO x TPR
TPR= (HR x SV) x TPR

TPR is synonymous with systemic Vascular resistance and increases when arterioles vasoconstricted

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8
Q

Normal pressure at various parts of the adult circulation

A 
Large Arteries = <120/80 mmHg
Systemic Capillaries: 17 mmHg
Vena Cava : 0 mmHg
Pulmonary Artery: 25/8 mmHg
Pulmonary Capillaries: 7 mmHg
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9
Q

Abdominojugular Reflux

A

At least 10 second pressure over the RUQ

(+) = sustained rise of >3 cm in JVP for at least 10-15 seconds after release of the hand

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10
Q

Pansystolic murmur of tricuspid regurgitation

Louder during inspiration and diminishes during forced expiration

A

Carvallo’s sign

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11
Q

High pitched, diastolic, decresendo blowing murur along the left sternal border due to dilation of the pulmonary valve ringl occurs in mitral valve disease and severe pulmonary hypertension

A

Graham Steell Murmur

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12
Q

Condition where the murmur of AS may be transmitted downward and to the apex and may be confused with the systolic murmur of mitral regurgitation

A

Gallavardin effect

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13
Q

Apical pulse is reduced and may retract in systole in constrictve pericarditis

A

Broadbent’s sign

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14
Q

A rapidly rising “water-hammer: pulse that collapses suddenly as arterial pressure falls rapidly during late systole and diastole, Seen in AR

A

Corrigan’s pulse

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15
Q

Capillary pulsation manifests as alternate flushing and paling of the skin while pressure is applied to the tip of the nail, seen in AR

A

Quincke’s pulse

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16
Q

A booming “pistol-shot” sound heard over the femoral arteries, seen in AR

A

Traube’s sign

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17
Q

To- and -fro murmur audible if the femoral artery is lightly compressed with a stethoscope, seen in AR

A

Duroziez Sign

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18
Q

Major noninvasive marker of increased CV morbidity/Mortality risk

A

LVH

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19
Q

Cornerstone in the diagnosis of acute and chronic ischemic Heart disease

A

ECG

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20
Q

ideal imaging modality for cardiac emergencies

A

2D echo

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21
Q

Gold standard for assessing LV mass and volumes

A

MRI

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22
Q

Triad of ruptured aneurysm

A

Left Flanked pain
hypotension
Pulsatile mass

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23
Q

Dx triad of Wolff-parkinson-white ECG pattern

A

wide QRS complex
Relatively short PR interval
Slurring of the initial part of the QRS complex (delta wave)

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24
Q

Triad of Chronic renal failure in ECG

A

Peaked T waves (hyperkalemia)
Long QT due to ST segment lengthening (hypocalcemia)
LVH (systemic hypertension)

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25
Q

3 principal features of tamponade (BECK’s TRIAD)

A

Hypotension
Soft/Absent heart sound
Jugular venous distension with a prominent x-descent but an absent y-descent

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26
Q

Plaques that have caused fatal thromboses tend to have……

A

Thin fibrous caps
Relatively large lipid cores
High content of macrophages

27
Q

Major determinants of myocardial O2 demand

A

Heart rate
Myocardial contractility
Myocardial wall tension (stress)

28
Q

triad of Buerger’s disease

A

Claudication of the affected extreminity
Raynaud’s phenomenon
Migratory superficial vein thrombophlebitis

29
Q

Virchow’s triad

A

Stasis
Vascular/Endothelial damage
Hypercoaguability

30
Q

Dressler’s triad (post-MI pericarditis)

A

fever
pleuritic pain
pericardial effusion

31
Q

Drugs that increasses contractility

A

Digoxin
Dobutamine
Mlrinone

32
Q

Drugs that reduces Preload

A

Diuretics
Vasodilators
ACE inhibitors, ARBS

33
Q

Drugs that reduces afterload

A

Diuretics
Vasodilators
Ace inhibitors, ARBS
Beta Blockers

34
Q

Class IA drug

A

MOA: Binds to activated sodium channels and blocks the flow of sodium ions into the cardiac myocyte (PROLONGS AP)

Clinical Use: Afib, Aflutter, VTach

Examples: Quinidine, Procainamide, Disopyramide

35
Q

Class IB drug

A

MOA: Binds to both activated and inactivated sodium channels and blocks the flow of sodium ions in the cardiac myocyte (SHORTENS AP)

Clinical Use: Post ischemic arrythmia, V.Fib,V-tach

Examples: Lidocaine, Tocainamide, Mexiletene

36
Q

Class IC drug

A

MOA: Binds to activated sodium channels and blocks the flow of sodium ions into the cardiac myocyte (NO EFFECT on AP)

Clinical use: Treatment of severe refractory Ventricular arrythia

Examples: Flecainide, Encainide, Propafenone

37
Q

Class II drugs

A

MOA: Blocks beta-adrenergic receptors

Clinical use: Numerous

Examples: Propanolol, metoprolol

38
Q

Class III drugs

A

MOA: Binds potassium channels and blocks the flow of K in the myocyte (PROLONGS AP)

Clinical use: Atrial and ventricular arrythmias

Examples: Sotalol, Ibutilide, Bretylium, Amiodarone

39
Q

Class IV drugs

A

MOA: Blocks voltage-gated calcium channels therbey blocking the flow of calcium into the cells

Clnical use: Supraventricular tachycardia rate reduction in patients with Afib

40
Q

[Antihypertensive Drug] that causes Na excretion and reduction in blood volume

A

diuretics

41
Q

[Antihypertensive Drug] Calcium channel blocker that exerts more effect on the vessels than the heart

A

dihydropyridines

nifedipine, felodipine, amlodipine

42
Q

[Antihypertensive Drug] Calcium channel blocker that exerts more effect on heart than the vessels

A

Nondihydropyridines

verapamil, Diltiaem

43
Q

[Antihypertensive Drug] Decreases the work load of the hear

A

Beta blockers

44
Q

[Antihypertensive Drug] Blocks the AT1 receptor of angiotensin II

A

ARBs

45
Q

[Antihypertensive Drug] Notorious for drug-induced cough by increasing bradykinins

A

ACE inhibitors

46
Q

[Antihypertensive Drug] Blocks aldosterone action in the collecting tubules

A

Spironolactone, Eplerenone

47
Q

[Antihypertensive Drug] Hypertension with benign prostatic hyperplasia

A

alpha-1 anatagonists (Prasozin)

48
Q

[Antihypertensive Drug] Maintenance medication for pre eclampsia

A

methyldopa

49
Q

Physiologic basis for normal ECG tracing

A

P wave: atrial depolarization
QRS complex: ventricular depolarization
T wave: ventricular repolarization

50
Q

Master pacemaker of the heart

A

SA node

51
Q

Causes of depolarization of the SA node

A

Calcium influx (sodium influx will merely bring potential closer to threshold; however sodium is still the determinant of heart rate)

52
Q

Chronotropic Incompetence

A

Failure to increase heart rate during exercise, alternatively defined as:

1) Unable to achieve 85% of predicted maximal heart rate
2) Unable to achieve a heart rate >100 bpm with exercise

Maximal HR with exercise <2 SD below that of the age -matched control population

53
Q

The only electrical connection between the atria and ventricles

A

AV node

54
Q

Most common arrythmia mechanism

A

Reentry

55
Q

Only reliable therapy for symptomatic bradycardia in the absence of extrinsic and reversible etiologies

A

Permanent pacemaking

56
Q

Most rapid conduction in the heart

A

His bundle and bundle branchers

57
Q

Most expeditious technique in the manangement of AV conduction block

A

transcutaneous pacing

58
Q

Most common arrythmia identified during extended ECG monitoring

A

Atrial premature complexes

59
Q

Most common sustained arrythmia

A

Atrial fibrillation

60
Q

Has prolongation of PR befored dropped QRS complex

A

Mobitz type I

61
Q

Has no prolangation of PR interval befored dropped QRS complex

A

Mobitz type II

62
Q

Duration that distinguishes sustained from nonsustained ventricular tachycardia

A

> 30 seconds

63
Q

Most common arrythmia post-MI

A

Premature Ventricular Contraction

64
Q

Most common lethal arrythmia post MI

A

Ventricular Fibrillation

high yield concepts (21 decks)

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