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FA Rapid Review > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Fixed splitting

A

ASD (L to R shunt and increased flow thru pulmonic valve such that, regardless of breath, pulmonic closure is greatly delayed)

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2
Q

Wide splitting

A

Conditions that delay RV emptying (pulmonic stenosis, RBBB)

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3
Q

Paradoxical splitting

A

Conditions that delay LV emptying (AS, LBBB)

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4
Q

Mitral/tricuspid regurgitation

A

Holosystolic, high pitched “blowing murmur”

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5
Q

Aortic stenosis

A

Crescendo-descrescendo systolic ejection murmur following ejection click (abrupt halting of valve leaflets)

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6
Q

VSD

A

Holosystolic, harsh-sounding murmur

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7
Q

Mitral prolapse

A

Late systolic crescendo murmur with midsystolic click (sudden tensing of chordae tendinae)

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8
Q

Aortic regurgitation

A

Immediate high-pitched “blowing” diastolic murmur

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9
Q

Mitral stenosis

A

Delayed rumbling late diastolic murmur, follows opening snap (abrupt halt in leaflet motion)

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10
Q

Patent ductus arteriosus

A

Continuous machine-like murmur

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11
Q

Anything that prolongs the QT interval can predispose to…

A

torsades de pointes (Vtach)

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12
Q

Congenital heart disease (5)

A 
Truncus arteriosus
Transposition of great vessels
Tricuspid atresia
Tetralogy of Fallot
Total anomalous pulmonary venous return (TAPVR)
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13
Q

L to R shunts

A

VSD > ASD > PDA

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14
Q

Tetralogy of Fallot parts

A

PROVe

  1. Pulmonary stenosis
  2. RVH
  3. Overriding aorta (overrides VSD)
  4. VSD
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15
Q

Transposition of great vessels due to…

A

failure of the aorticopulmonary septum to spiral

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16
Q

Transposition of great vessels associated with…

A

maternal diabetes

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17
Q

Infantile coarctation of aorta associated with…

A

Turner syndrome

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18
Q

Adult type coarctation of the aorta (postductal) associated with…(3)

A

notching of ribs, HTN in UE, weak pulses in LE

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19
Q

For PDA, close with #1, keep open with #2

A 
#1 indomethacin
#2 PGE
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20
Q

Causes of renal artery stenosis

A 
Atherosclerosis (elderly male)
Fibromuscular dysplasia (young female)
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21
Q

“Pipestem” arteries

A

Monckeberg pattern of arteriosclerosis (calcification in media of arteries)

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22
Q

AAA epidemiology

A

Male smokers > 50y/o

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23
Q

Thoracic aortic aneurysm appearance

A

“tree bark” appearance

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24
Q

Aortic aneurysm triad of sx

A

Hypotension
Pulsatile abdominal mass
Flank pain

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25
Q

Aortic dissection associated with…

A

HTN

Cystic medial necrosis (Marfan’s syndrome)

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26
Q

Most common cause of death from aortic dissection

A

pericardial tamponade

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27
Q

ST depression represents…

A

subendocardial ischemia

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28
Q

ST elevation represents…

A

transmural infarct

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29
Q

Tx for MI

A 
ASA/heparin to limit thrombosis
Supp O2 to minimize ischemia
Nitrates to vasodilate, dec preload
BB to slow HR, dec demand for O2
ACEI to dec LV dilation by volume, dec afterload
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30
Q

Evolution of MI

A

Coag necrosis – 1d – Acute inflammation – 1wk – granulation tissue – 1mo – scar

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31
Q

Dressler syndrome

A

autoimmune pericarditis 6-8wks after MI

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32
Q

Risk in early period after MI

A

arrhythmia

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33
Q

Risks at 5-10d post-MI

A

free wall rupture, tamponade, papillary muscle rupture, interventricular septal rupture

34
Q

Risk at 7wks post-MI

A

Ventricular aneurysm

35
Q

Complication 3-5d post-MI

A

Fibrinous pericarditis

36
Q

Causes of dilated CM

A 
ABCCCD
Alcohol abuse
wet Beriberi
Coxsackie B virus myocarditis
chronic Cocaine use
Chagas' disease
Doxorubicin toxicity
hemochromatosis
peripartum CM
37
Q

Causes of restrictive CM

A 
sarcoidosis
amyloidosis
postradiation fibrosis
endocardial fibroelastosis
Loffler's syndrome
hemochromatosis
38
Q

Main reasons for CHF symptoms

A

Decreased LV contractility leading to 1. Pulm venous congestion (pulm edema) 2. Dec cardiac output (activation of RAAS)

39
Q

Bacterial endocarditis sx

A 
Bacteria FROM JANE
Fever
Roth's spots
Osler's nodes
Murmur
Janeway lesion
Anemia of chronic dz
Nail-bed hemorrhage
Emboli (septic)
40
Q

Tricuspid valve endocarditis due to…

A

IV drug abuse

S. aureus, Pseudomonas, Candida

41
Q

Subacute bacterial endocarditis

A

viridans streptococci

sequela of dental procedures

42
Q

Endocarditis with negative BCx

A

HACEK

Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella

43
Q

Bacterial endocarditis and colon cancer

A

S. bovis

44
Q

Bacterial endocarditis and prosthetic valves

A

S. epidermidis

45
Q

Nonbacterial endocarditis 2/2…

A

malignancy, hypercoagulable state, lupus (Libman Sacks)

46
Q

Rheumatic fever sx

A 
FEVERSS
Fever
Erythema marginatum
Valvular damage
ESR increased
Red-hot joints (migratory polyarthritis)
Subcutaneous nodules
St. Vitus' dance (chorea)
47
Q

Rheumatic fever consequence of….

A

pharyngeal infection with group A beta-hemolytic strep (Strep pyogenes)

48
Q

Rheumatic fever affecting heart valves

A

Mitral > aortic&raquo_space; tricuspid

49
Q

Cardiac tamponade findings

A

hypoTN, increased JVD, distant heart sounds, increased HR, pulsus paradoxus

50
Q

Most common primary cardiac tumor in adults

A

myxomas

51
Q

Most common primary cardiac tumor in children

A

Rhabdomyomas

52
Q

Raynaud’s disease

A

Decreased BF to skin 2/2 arteriolar vasospasm in response to cold temp or emotional stress

53
Q

Raynaud’s phenomenon

A

2/2 mixed connective tissue disease, SLE, CREST syndrome

54
Q

Large vessel vasculitis (2)

A

Temporal (giant cell) arteritis

Takayasu’s arteritis

55
Q

Medium vessel vasculitis (3)

A

Polyarteritis nodosa
Kawasaki disease
Buerger’s disease (thromboangiitis obliterans)

56
Q

Small vessel vasculitis (4)

A

Wegener granulomatosis
Microscopic polyangiitis
Churg-Strauss syndrome
Henoch Schonlein purpura

57
Q

Most common form of vasculitis in older adults > 50y/o

A

Temporal (giant cell) arteritis

58
Q

Temporal (giant cell) arteritis sx

A

U/l ha, jaw claudication

May progress to irreversible blindness (ophthalmic a. occlusion)

59
Q

Takayasu’s arteritis affects…

A

Asian females <40y/o

60
Q

String of pearls appearance on imaging

A

Polyarteritis nodosa (multiple aneurysms/constrictions on arteriogram, late complication)

61
Q

Polyarteritis nodosa associated with…

A

Hep B seropositivity in 30% of patients

62
Q

Kawasaki disease sx

A

CRASH & BURN (fever)

Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hands/feet erythema

63
Q

Kawasaki disease affects…

A

Asian children < 4y/o

64
Q

Buerger’s disease affects…

A

heavy smokers, males <40 y/o

65
Q

How to remember Wegener granulomatosis

A

“C” distribution (nasopharynx, lungs, kidneys)
c-ANCA positive
tx with cyclophosphasmide, corticosteroids

66
Q

Triad of Wegener granulomatosis

A
  1. Focal necrotizing vasculitis
  2. necrotizing granulomas in lung and upper airway
  3. necrotizing glomerulonephritis
67
Q

Churg-Strauss syndrome

A

granulomatous vasculitis with EOSINOPHILIA (p-ANCA positive)

68
Q

Most common form of childhood systemic vasculitis

A

Henoch-Schonlein purpura

69
Q

Henoch-Schonlein purpura

A

Palpable purpura on buttocks/legs
Arthalgia
Abd pain
Hematuria (IgA nephropathy)

70
Q

Sturge-Weber disease manifests as…

A
  1. port-wine stain on face
  2. i/l leptomeningeal angiomatosis (intracerebral AVM)
  3. seizures
    4, early-onset glaucoma
71
Q

PVC exposure

A

Angiosarcoma

72
Q

Purple patches, plaques, nodules on skin

A

Kaposi’s sarcoma

73
Q

1st line tx for HTN in pregnancy

A

hydralazine, methyldopa

74
Q

Mechanism of antiarrhythmics

A

Slow or block conduction
Decrease slope of phase 0 depolarization
Increase threshold for firing in abnormal pacemaker cells

75
Q

Class IA antiarrythmics

A

Quinidine
Procainamide
Disopyramide
“the Queen Proclaims Diso’s pyramid”

76
Q

Class IB antiarrhythmics

A 
Lidocaine
Mexiletine
Tocainide
"I'd Buy Lidy's Mexican Tacos"
"IB is Best post-MI"
77
Q

Class IC antiarrhythmics

A

Flecainide
Propafenone
“IC is Contraindicated post-MI)

78
Q

Causes increased toxicity for all class I drugs

A

Hyperkalemia

79
Q

Class III antiarrhythmics (K channel blockers)

A 
Ibutilide
Sotalol
Bretylium
Amiodarone
Dofetilide
"K IS BAD"
80
Q

Class IV antiarrhythmics (Ca channel blockers)

A

Verapamil

Diltiazem

81
Q

Drug of choice in dx/abolishing SVT

A

Adenosine

82
Q

Effective in torsades de pointes and digoxin toxicity

A

Mg2+

FA Rapid Review (11 decks)

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