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CLINICAL CORRELATES IM PLAT > CARDIOLOGY > Flashcards

CARDIOLOGY Flashcards

1
Q

Triad of Rupture Aneurysm

A

Left flank pain
Hypotension
Pulsation mass

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2
Q

Diagnostic Triad of Wolf-Parkinson-White (WPW) 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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3
Q

Triad of Chronic Renal Failure in ECG

A

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

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4
Q

Three principal features of tamponade (BECK’s triad)

A

Hypotension

Soft / absent heart soundJugular venous distension with a prominent x-descent but an absent y-descent

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5
Q

Plaques that have caused fatal thrombosis tend to have

A

Thin fibrous caps
Relatively large lipid cores
High content of macrophages

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6
Q

Triad of Buerger disease

A

Claudication of the affected extremity
Raynaud phenomenon
Migratory superficial vein thrombophlebitis

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7
Q

Virchow triad

A

Stasis
Vascular/endothelial damage
Hypercoagulability

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8
Q

Clinical syndrome of hemochromatosis

A

Cirrhosis
Diabetes
Hypogonadism

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9
Q

Dressler’s triad (post MI pericarditis)

A

Fever
Pleuritic pain
Pericardial effusion

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10
Q

Phases of the cardiac action potential

A

Phase 0: Depolarization (due to rapid Na influx)
Phase 1: Partial Repolarization (Due to K efflux)
Phase 2: Plateau (K efflux balanced by Ca influx)
Phase 3: Complete Repolarization (due to K efflux)
Phase 4: Resting Membrane potential

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11
Q

Has prolongation of PR interval before dropped QRS complex

A

Mobitz type I

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12
Q

Has no prolongation of PR interval before dropped QRS complex

A

Mobitz II

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13
Q

Class of antiarrhythmic drug
Binds to activated Na channels & blocks flow of Na ions in to cardiac myocyte (prolongs action potential)
Used for A-fib, atrial flutter, v-tach

A

Class IA
Quinidine, Procainamide, Disopyramide
(MN: Quiapo Police Department)

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14
Q

Class of anti-arrhythmic drug
Bind to both activated and inactivated Na channels and blocks the flow of Na ions into the cardiac myocyte (shortens action potential)
Use: Post-ischemic arrhythmia, V-fib, V-tach

A

Class IB

Lidocaine, Mexiletine, Tocainide

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15
Q

Class of anti-arrhythmic drug
Binds to activated Na channels and blocks flow of Na ions into cardiac myocyte (no effect on action potential)
Use: treatment of severe refractory ventricular arrhythmia

A

Class IC

Flecainide, Encainid, Propafenone

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16
Q

Class of anti-arrhythmic drug

Blocks beta-adrenergic receptors

A

Class II

-olol group

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17
Q

Class of antiarrhythmic drug

Binds to K channels and blocks flow of K in myocyte (prolongs action potential)

A

Class III

Bretylium, Ibutilide, Amiodarone, Sotalol (BIAS)

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18
Q

Class of anti-arrhythmic drug
Blocks voltage-gated Ca channels thereby blocking the flow of Ca into the cell
Use: supraventricular tachycardia, rate reduction in patients with atrial fibrillation

A

Class IV

Verapamil, Diltiazem

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19
Q

Drugs for HF that increases contractility

A

Digoxin
Dobutamine
Milrinone

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20
Q

Drugs for HF that reduces preload

A

Diuretics
Vasodilator (e.g. nitrates, hydralazine)
Ace inhibitors/ ARBs

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21
Q

Drugs for HF that reduces afterload

A

Diuretics
Vasodilator
ACE inhibitors/ ARBS
Beta blockers

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22
Q

Most common cause of systolic dysfunction that lads to L-sided HF

A

Coronary artery disease (CAD)

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23
Q

Most common cause of diastolic dysfunction that leads to L-sided HF

A

Concentric LVH due to HPN

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24
Q

Most common cause of R-sided HF

A

L-sided HF

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25
Q

Earlier she cardinal symptom of L-side HF

A

Dyspnea

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26
Q

Earliest Cardinal sign of L-sided HF

A

L-sided S3

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27
Q

Most sensitive index of cardiac function

A

Ejection fraction

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28
Q

Single most important bedside measurement to estimate volume status

A

JVP (internal jugular vein is preferred)

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29
Q

Cardinal symptoms of HF

A

Fatigue

Shortness of breath

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30
Q

Most important mechanism f dyspnea in HF

A

Pulmonary congestion with accumulation of interstial or intra-alveolar fluid, which activates juxtacapillary J receptors

31
Q

Cornerstone of modern therapy for HF with depressed EF

A

ACE-I / ARBs and Beta blockers

32
Q

most common reason for rehospitalization in HF

A

Failure to meet criteria for discharge

33
Q

Gold standard for imaging valve morphology/motion, detection of pericardial effusion and tamponade, and assessment of LVcavity size, systolic function & wall thickness

A

2D echo

34
Q

Gold standard for assessing LV mass/volumes

A

Cardiac MRI

35
Q

Gold standar in assessing anatomy and physiology of the heart & associated vasculature

A

Cardiac catheterisation and coronary angiography

36
Q

Cornerstone in he diagnosis of acute and chronic ischemic heart disease

A

ECG

37
Q

Most common underlying cause of myocardial ischemia and injury

A

Obstruction of coronary arteries by atherosclerosisa

38
Q

Infection associated with accelerated atherosclerosis

A

Chlamydophila pneumoniae (pneumonia)

39
Q

Most common cause of anterior chest musculoskeletal pain

A

Costrochondral and chondrosternal syndromes

40
Q

Myocardial perfusion occurs during this time

A

Diastole

41
Q

represents the initial lesion of atherosclerosis

A

Fatty streak

42
Q

Major features of metabolic syndrome

A 
Central obesity
Hyperglycemia
Hypertriglyceridemia
Hypertension
Low HDL cholesterol
43
Q

Age when lipid screening should start (based on current ATP III guidelines)

A

All adults >20years (lipid profile : TC, TG LDL, HDL)

Q5y

44
Q

Key feature of metabolic syndrome

A

Central adiposity

45
Q

Most accepted and unifying hypothesis to describe Pathophysiology of metabolic syndrome

A

Insulin resistance

46
Q

Driving force behind the metabolic syndrome

A

Obesity

47
Q

Most common cause of myocardial ischemia

A

Atherosclerotic disease of pericardial coronary artery

48
Q

Most common major vessel involved in MI

A

Left anterior descending artery

49
Q

Sites of predilection for atherosclerotic plaques to develop due to increased turbulence

A

Branch points in epicardial arteries

50
Q

Time frame for reversible damage in myocardium

A

<20mins for total occlusion in the absence of collaterals

51
Q

Most widely used test for both the diagnosis of IHD and estimating the prognosis

A

Electrocardiographic stress testing

52
Q

Most common Pathophysiology cause of unstable angina

A

Plaque rupture or erosion with superimposed non-occlusive thrombus

53
Q

Only absolute contraindications to nitrate use

A

Hypotension

Sildenafil (or similar drug) in previous 24-48 hours

54
Q

Most common artery involved in Prinzmetal angina

A

Right coronary artery

55
Q

main agents for acute episodes of and to abolish recurrent episodes of prinzmetal’s angina

A

Nitrates and Ca channel blockers (nifedipine)

56
Q

Type of necrosis seen in MI

A

Coagulation necrosis (preserve architecture, faded details)

57
Q

Earliest detectable feature of myocyte necrosis

A

Sarcolemmal membrane disruption (which leads to leakage cardiac enzymes into circulation)

58
Q

Time frame where gross changes in MI occur

A

12 hours after the onset of symptoms

59
Q

Color changes in MI

A

Mottling: 4 hours
Bright yellow: 1 wk
Surrounding red granulation tissue : 2 weeks
Gray-white scar: 2 mos

60
Q

Fibrinous pericarditis (bread and butter pericarditis) post MI

A

Dressler syndrome

61
Q

Preferred biochemical markers for re-infarction

A

CK-MB

62
Q

Preferred biochemical markers ruptur in MI

A

Cardiac-Specific Troponin T and Cardiac-Specific Troponin I

63
Q

Level of coronary artery stenosis sufficient to produce ischemia (%)

A

70%

64
Q

Primary cause of out-of-hospital deaths.from STEMI

A

V-fib

65
Q

Primary cause of in-hospital deaths form STEMI

A

Pump failure

66
Q

Principal goal for fibrinolytic

A

Prompt restoration of full coronary arterial potency

67
Q

Extent of LV involvement that usually results in cardiogenic shock

A

Infarction > 40%

68
Q

Most common complication of angioplasty

A

Restenosis

69
Q

Most common thrombi found in NSTEMI (composed mainly of platelets)

A

White thrombi

70
Q

Most common thrombi found in STEMI (composed of cells and fibrin

A

Red thrombi

71
Q

Most common cause of sudden cardia death

A

Coronary artery disease

72
Q

Most common arrhythmia post-MI

A

Premature ventricular contraction

73
Q

Most common lethal arrhythmia post MI

A

V-fib

CLINICAL CORRELATES IM PLAT (3 decks)

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