Cardiology Flashcards
1
Q
What organs have resistance in series?
A
Liver and Kidneys
2
Q
What organs have resistance in parallel?
A
All the rest of the organs (except liver and kidneys)
3
Q
What organ has the highest AVO2 Difference at rest?
A
heart
4
Q
What organ has the highest AVO2 difference after excercise?
A
Muscle
5
Q
What organ has the highest AVO2 difference after a meal?
A
GI tract
6
Q
What organ has the highest AVO2 difference during a test?
A
Brain
7
Q
What organ has the lower AVO2 difference?
A
Kidney
8
Q
Where does a Type A thoracic aortic dissection occur?
A
Ascending Aorta, (occurs in Cystic medial necrosis and Syphilis)
9
Q
Where does a Type B thoracic aortic dissection occur?
A
Descending Aorta, (occurs in trauma and Atherosclerosis)
10
Q
In what layers does a true aortic aneurysm occur?
A
Intima, media, and adventitia
11
Q
In what layers does a pseudo aortic aneurysm occur?
A
Intima and media layers
12
Q
What is pulse pressure?
A
Systolic minus diastolic pressure
13
Q
What vessel has the thickest layer of smooth muscle?
A
Aorta
14
Q
What vesels have the most smooth muscle?
A
Arterioles
15
Q
What vessels have the largest cross-sectional area?
A
Capillaries
16
Q
What vessel has the highest compliance?
A
Veins
17
Q
What vessels have the highest capacitance?
A
Veins and Venules
18
Q
What is your maximum heart rate?
A
220 minus the person’s age
19
Q
What is stable angina?
A
Pain with exertion that is relieved with rest (Athersclerosis MCC)
20
Q
What unstable angina?
A
Pain at rest (transient clots MCC)
21
Q
What is Prinzmetal’s angina?
A
Coronary Artery Spasm
22
Q
What is Amyloidosis and what stain is used?
A
Amyloid deposits that stain Congo red: Apple-Green Birefringence (AA-chronic disease)
23
Q
What is hemochromatosis?
A
Iron deposits in organs
leads to hyperpigmentation, bronze diabetes, and arthritis
24
Q
What is cardiac tamponade?
A
Pressure equalized in all 4 chambers, quiet Precordium, no pulse or BP, Kussmaul’s Sign, Pulsus Pardoxus (Decrease in BP greater than 10 mm Hg with inspiration)
25
What is transudate?
An effusion with mostly water
If too much water: Heart or Renal failure....
Or not enough protein: Cirrhosis (can't make protein), and Nephritic Syndrome (spilling out protein in urine)
26
What is exudate?
```
Effusion of mostly protein
Too much protein: Will have ---
Purulent (from Bacteria),
Hemorrhagic (from trauma, CA, PE)
Fibrinous (from collagen vascular disease), Granulomatous (non-bacterial)
```
27
What is systole?
Ejection of blood from the heart, Decreased blood flow to Coronary arteries, more extraction of Oxygen Phase 1 Korotkoff
28
What is diastole?
Heart ventricles filling
increased blood to Coronary arteries
less extraction of oxygen
Phase 4 and 5 Korotkoff
29
What are the only arteries with deoxygenated blood?
Pulmonary and umbilical arteries
30
What murmur has a water hammer pulse?
Aortic regurgitation
31
What murmur has Pulsus Tardus?
Aortic stenosis
32
What cardiomyopathy has Pulsus Alternans?
Dilated cardiomyopathy
33
What disease has pulsus bisferiens?
IHSS- Idiopathic Hypertrophic Subaortic Stenosis
34
What murmur has an irregular-irregular pulse?
A fib (no P waves)
35
What murmur has a regular-irregular pulse?
PVC
36
What sound radiates to the neck?
Aortic stenosis
37
What sound radiates to the axilla?
Mitral regurgitation
38
What sound radiates to the back?
Pulmonic stenosis
39
Boot-shape on x-ray?
RVH
40
Banana-shape on x-ray?
IHSS
41
Egg-shape on x-ray?
Transposition of the great arteries
42
Snowman-shape on x-ray?
Total anomalous pulmonary venous return
43
What disease has a "3" shape on x-ray?
Coarctation of the aorta
44
What is the Osler-Weber-Rendu?
AVM (Atrial-Venous Malformation)
in lung, GI, CNS
the AVM sequesters platelets and causes acquired Telangiectasia's
45
What is VHL?
Predisposes individuals to bnign and malignant tumors, AVM in the head, and retina (AD inheritance in Chromosome 3)
46
What CA risk does VHL have?
RCC
47
When do valves make noise under normal physiology?
When the valves close
48
What valves make noise at the end of diastole?
Mitral and Tricuspid
49
What murmurs occur during systole?
Holosystolic or pansystolic
50
What are the Holosystolic murmurs?
Tricuspid Regurg
Mitral Regurg
VSD
51
What are the Systolic Ejection Murmurs?
Aortic Stenosis, Pulmonic Stenosis, Hypertrophic Cardiomyopathy
52
What valves make noise at the end of systole?
Aortic and Pulmonic
53
What are the sounds made from diastolic murmurs?
Blowing and rumbling
54
What are the Diastolic Blowing murmurs?
Aortic regurgitation, pulmonic regurgitation
55
What are the diastolic rumbling murmurs?
Tricuspid Stenosis
| Mitral Stenosis
56
What are the continuous Murmurs?
PDA or AVM's
57
What has a friction rub while breathing?
Pleuritic
58
What has a friction rub while holding breath?
Pericarditis
59
What does a mid-systolic click tell you?
MVP- Mitral valve prolapse
60
What does an ejection click tell you?
Aortic or Pulmonic Stenosis
61
What does an opening snap tell you?
Mitral or Tricuspid Stenosis
62
What does S-2 splitting tell you?
Normal on inspiration
| Pulmonic valve closing later
63
What does a wide S-2 split tell you?
Increases Oxygen
Increased right ventricular volume
Delayed pulmonic vlave opening
64
What does fixed wide S-2 splitting tell you?
ASD
65
What does a paradoxical S-2 split tell you?
Aortic Stenosis or LBBB
66
What is cor-pulmonale?
Pulmonary HTN leads to Right ventricular failure
67
What is Eisenmenger's Syndrome?
Physiological shunt from left to right now changes right to left
68
What is transposition of the great arteries?
Aorticopulmonary septum did not spiral, most common congenital cyanotic heart disease in the first month of life (Neural crest cell migration problem)
69
What is Tetralogy of Fallot?
Overriding aorta: Aorta sits on intraventricular Septum giving rise to a VSD, this in turn causes Pulmonary Stenosis and ultimately right heart failure (boot shape x-ray)
70
What is Total Anomalous Pulmonary return?
All pulmonary veins enter into the right atrium (Snowman x-ray)
71
What is Truncus arteriosus?
Spiral membrane did not develop, there is one Aortic Pulmonary trunk, mixed blood, needs PDA
72
What is Epstein's anomaly?
Small right ventricle and very large right atrium (in fetus due to mom taking Lithium during pregnancy)
73
What Kidney complications can Lithium cause to the person taking the drug?
Destroy the collecting ducts V2 aquaporin receptors, causing Nephrogenic DI
74
What are theh Renin-angio system effectors?
ACE inhibitors and ARBs
75
What are the ACE inhibitors?
Captopril, Enalapril, Fosinopril, Lisinopril
76
What is the MOA of ACE inhibitors?
Inhibits conversion of Ang I to Ang II, decreases Ang II
77
What are the Indications for ACE inhibitors?
HTN, CHF, post MI and vasodilation
78
What are the adverse effects of ACE inhibitors?
Hyperkalemia, cough, angioedema
| contraindicated in pregnancy (fetal renal malformations)
79
What is the MOA of ARBS?
Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II
80
What are the indications for Losartan?
HTN
81
What are the adverse effects of Losartan?
Fetal renal toxicity
| Hyperkalemia
82
What are the sympathoplegics?
Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine
83
What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?
Selective B1-Blockers
84
What is the MOA of Propranolol, Timolol?
B1 and B2 Blockers
85
What is the MOA of Carvedilol?
Alpha and B-Blocker
86
What are the indications for B-blockers
HTN, Angina, MI, Antiarrhythmic
87
What are the adverse effects of B-blockers?
Impotence, asthma, bradycardia, AV block, heart failure, sedation, sleep alterations
88
What is the MOA of Prazosin?
Alpha 1-Blocker, vasodilation, decreases TPR
89
What are the indications for Prazosin?
Pheochromocytoma, HTN
90
What are the adverse effects of Prazosin?
Orthostatic Hypotension
91
What is the MOA of Clonidine?
Alpha 2 agonist = decreases peripheral resistance
92
What are the indications for Clonidine?
HTN
Smoking
Cocaine
Heroin withdraw
93
What are the adverse effects of Clonidine?
Drowsiness, dry mouth, and rebound HTN after abrupt withdraw
94
What is the MOA of Methyldopa?
Alpha 2 agonist = decreases peripheral resistance
95
What are the indications for Methyldopa?
HTN
96
What are the adverse of Methyldopa?
Sedation and Hemolytic Anemia
| (+) Coombs test
97
What is the MOA of Hexamethonium?
Nicotinic Ganglionic blocker
98
What are the adverse effects of Hexamethonium?
Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
99
What is the MOA of Reserpine?
Prevents the storage of monoamines in synaptic vesicle
100
What are the indications for Reserpine?
HTN
101
What are the adverse effects of Reserpine?
Mental depression
102
What is the MOA of Guanethidine?
Interferes with norepinephrine release
103
Whata re the indications for Guanethidine?
Severe HTN
104
What are the adverse effects of Guanethidine?
Contraindicated in patients taking TCA's
105
What are the Vasodilators?
Hydralazine, Minoxidil, Nifedipine, Verapamil, Nitroprusside, Diazoxide
106
What is the MOA of Hydralazine?
increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction
107
What are the indications for Hydralazine?
Severe HTN, 1st line treatment for HTN in pregnancy
108
What are the adverse effects of Hydralazine?
Compensatory tachycardia, fluid retention, Lupus like syndrome, contraindicated in Angina/CAD because of compensatory tachy
109
What is the MOA of Minoxidil?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
110
What are the adverse effects of Minoxidil?
Hypertrichosis and Pericardial Effusion
111
What is the MOA of Nifedipine and verapamil?
Ca+ channel antagonists
112
What are the indications for Nifedipine and verapamil?
HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud's
113
What is the MOA of Nitroprusside?
Direct release of NO, increases cGMP, vasodilator
114
What are the indications for Nitroprusside?
Hypertensive emergency, CHF, Angina
115
What are the adverse effects of Nitroprusside?
Cyanide Toxicity, hypotension, short acting
116
What is the MOA of Diazoxide?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
117
What are the indications for Diazoxide?
HTN
118
What are the adverse effects of Diazoxide?
Hypoglycemia (reduces insulin release) and hypotension
119
What are the HMG-CoA reductase inhibitors?
Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin
120
What are the indications for HMG-CoA reductase inhibitors?
Strong decrease LDL
Decrease Triglycerides
Increase HDL
121
What are the adverse effects of HMG-CoA reductase inhibitors?
Hepatotoxicity (increase LFT's)
| Rhabdo
122
What is the MOA of Niacin?
Inhibits lipolysis in adipose tissue
| reduces hepatic VLDL secretion into circulation
123
What are the indications for Niacin?
Decrease LDL and Triglycerides
| Strong increase HDL
124
What are the adverse effects of Niacin?
Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia
125
What are the Bile acid resins?
Cholestyramine
Colestipol
Colesevelam
126
What is the MOA of Bile Acid resins?
Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more
127
What are the indications for Bile Acid Resins?
Slightly increase HDL and triglycerides
| Decrease LDL
128
What are the adverse effects of Acid Resins?
Tastes bad and causes GI discomfort
bile decreases absorption of fat soluble vitamins
cholesterol gallstones
129
What are the cholesterol Absorption blockers?
Ezetimibe
130
What is the MOA of Ezetimibe?
Prevents cholesterol reabsorption at small intestine brush border
131
What are the indications for Ezetimibe?
Decrease LDL
132
What are the adverse effects of Ezetimibe?
Rare increase LFT's
133
What are the Fibrates?
Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate
134
What is the MOA of FIbrates?
Upregulate LPL, increase triglyceride clearance
135
What are the indications for fibrates?
Strong decrease of triglycerides
slight decrease of LDL
slight increase in HDL
136
What are the adverse effects of fibrates?
Myositis, hepatotoxicity (increase LFT's) cholesterol gallstones
137
What is the MOA of Digoxin?
Direct inhibition of Na+/K= ATPase leads to indirect inhibition of Na+/Ca2+ exchanger, positive inotrope, stimulates vagus nerve
138
What are the indications for digoxin?
CHF (increase contractility)
A fib (decrease conduction at the AV node)
depression of the SA node
139
What are the adverse effects of Digoxin?
Cholinergic, ECG: icnrease PR, decrease QT worsened by renal failure
Quinidine displaces Digoxin from tissue binding sites
140
What is the MOA of Nesiritide?
Recombinant BNP, increase in cGMP and vasodilation
141
What are the indications for Nesiritide?
Acute decompensated heart failure
142
What are the adverse effects of Nesiritide?
Hypotension
143
What are the Class IA antiarrhythmic?
Quinidine, Procainamide, Disopyramide
144
What is the MOA of Class IA antiarrhythmic?
Na+ channel blocker
145
What are the indications for the Class IA antiarrhythmic?
Increase AP duration, icnrease effective refractory period (ERP) QT interval, affect reentrant and ectopic SVT and ventricular tachy
146
What are the adverse effects of the Class IA antiarrhythmic?
Quinidine: Cinchonism
Procainamide: Torsades de Pointes
147
What are the Class IB antiarrhythmic?
Lidocaine, Mexiletine, Tocainide
148
What is the MOA of Class IB antiarrhythmic?
Na+ channel blocker
149
What are the indications for the Class IB antiarrhythmic?
Decrease AP duration, acute ventricular Arrhythmias, local anesthesia
150
What are the adverse effects of the Class IB antiarrhythmic?
CNS stimulation and depression
Cardiovascular depression
Hyperkalemia increases toxicity
151
What are the Class IC antiarrhythmic?
Flecainide, Encainide, Propafenone
152
What is the MOA of Class IC antiarrhythmic?
Na+ channel blocker
153
What are the indications for Class IC antiarrhythmic?
Ventricular tachy progressing to V. fib, last resort
154
What are the adverse effects of Class IC antiarrhythmic?
Prolongs refractory period in AV node Hyperkalelmia increases toxicity
155
What are the K+ channel blockers?
Sotalol, Ibutilide, Bretylium, Amiodarone
156
What is the MOA of the K+ channel blockers?
Increase AP duration, increase effective refractory period (ERP), increase QT interval
157
What are the indications for the channel blockers?
WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism
158
What are the Ca2+ channel blockers?
Verapamil, Diltiazem
159
What is the MOA of the Ca2+ blockers?
Decreases conduction velocity of the AV node, increases ERP and PR interval
160
What are the indications for the Ca2+ channel blockers?
SVT/ prevent nodal arrhythmias
161
What are the adverse effects of the Ca2+ channel blockers?
Flushing, edema, constipation, CHF, AV block
162
What is the MOA of adenosine?
Increase K+ efflux, hyperpolarizes the cell
163
What are the indications for adenosine?
Dx. and tx. of AV nodal arrhythmias
164
What are the adverse effects of adenosine?
flushing, hypotension, and chest pain
| very short acting
165
What is the MOA of Potassium on the heart?
Depresses ectopic pacemaker in hypokalemia
166
What are the indications for administering Potassium?
Digoxin toxicity, activated charcoal: binds digoxin in the intestine
Digibind: binds to digoxin in the bloodstream
167
What are the indications from Magnesium?
Effective in Torsades and Dig toxicity
