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Pathology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

pulsus paradoxus

A

systolic BP decreases by 10 with inspiration

asthma
COPD
tamponade

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2
Q

Loeffler’s

A

causes restrictive cardiomyopathy

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3
Q

SVC from

A

right common cardinal v.

right anterior cardinal v.

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4
Q

bulbus cordis becomes

A

smooth LV, RV

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5
Q

coronary sinus from

A

left sinus venosus

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6
Q

rubella heart defects

A

PDA, PAS “Ruby”

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7
Q

wide split S2, TR

A

Ebstein anomaly, 80% have PFO

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8
Q

DiGeorge syndrome heart

A

TOF, TA “T”

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9
Q

Increased TPR

A

flatten venous return slide (DIT pg 145)

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10
Q

ejection fraction

A

SV/EDV

> 55%

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11
Q

pulmonary capillary wedge pressure

A

less than 12

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12
Q

NO LIP

A 
treat acute CHF:
nitrates
oxygen
loop diuretics
ionotropes - milranone, dobutamine
position up
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13
Q

only symptomatic relief from CHF

A

diuretics
digoxin
vasodilators

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14
Q

3rd aortic arch
4th aortic arch
6th aortic arch

A

CCA, proximal ICA
aortic arch, proximal right subclavian
proximal pulmonary, ductus arteriosis

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15
Q

treat cardiogenic shock

A

dobutamine

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16
Q

Swan-Ganz cath

A

right IJ > left SC artery

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17
Q

venous a wave

venous c wave

x descent

venous v wave

y descent

A

not in afib, at S4

Tricuspid close, ventricles contract against, after S1

not in TR, during systole

filling against closed tricuspid, at S3

RA into RV, diastole

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18
Q

wide S2
fixed S2
paradoxical S2

A

PS, RBBB
ASD
AS, LBBB

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19
Q

isovolumetric contraction

A

at QRS

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20
Q

heard best in LLD

A

MS, MR, S3, S4

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21
Q

Calcium electrophysiology

A

phase 2 in myocardium
phase 0 in pacemaker
+20

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22
Q

Na electrophysiology

A

phase 0 in mycocardium
phase 4 in pacemaker (funny current w/K)
+50

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23
Q

K electrophysiology

A

phase 3

-75 to -95

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24
Q

aVL

A

-30 degrees

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25
Q

left axis deviation

A

-30 to -90

inferior MI, LVH, LBBB, left anterior fasc. block

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26
Q

right axis deviation

A

+90 to +180

RVH, massive PE, RBBB, LP fascicular block

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27
Q

first degree AV block

A

> 200 from p

Lyme disease

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28
Q

Mobitz 1 (second degree)

A

dropped

=Wenckebach = “warning block”

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29
Q

Mobitz II (second degree)

A

no warning

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30
Q

jucntional escape

A

Q = R

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31
Q

cause torsades, prolong QT

A 
IA, III
macrolides**
chloroquine**
haloperidol
risperidone
methadone**
--navir protease inhibitors
ondansetron**
TCA**
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32
Q

vasocontrict via constitutive NOS in endothelium

A

bradykinin, ACh, alpha-2, histamine

serotonin, shear stress

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33
Q

vasocontrict via inducible NOS in smooth muscle

A

LPS

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34
Q

MLCK inhibition

A

DHP CCB block calmodulin-Ca

B2 epinephrine and PGE2 increase cAMP, which inhibits MLCK

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35
Q

treat:
aortic dissection
severe hypertension

A

B blocker

IV nitroprusside, IV labetalol

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36
Q

Stanford A aortic dissection

Stanford B

A

ascending, needs surgery

B-blockers then vasodilators

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37
Q

aliskiren

A

renin blocker

for HTN only
no CHF, MI

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38
Q

Black patient with HTN

A

give thiazide and CCB

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39
Q

minoxidil

A

opens K channels, hyperpolarize
relaxes smooth muscle
for severe HT, for hair loss

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40
Q

HTN + migraines

A

CCB or B-blocker

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41
Q

RCA

A

SA nodal branch
AV nodal branch
Posterior interventricular a.
Right main branch

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42
Q

LCA

A

Anterior interventricular a.

Circumflex branch

  • 20% PIVA
  • 20% SA nodal
  • 20% AV nodal
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43
Q

Prinzmetal angina

A

give nifedipine

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44
Q

AAA needing surgery

A
  1. 5 cm

0. 5 cm/6 mo

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45
Q

fibrates

A

decrease TAG

cause myalgias, cholesterol gallstones

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46
Q

resins

A

bind C dif toxin (cholestyramine)

cause gallstones

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47
Q

ezetimibe SE

A

increases LFT

diarrhea

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48
Q

MI ECG findings

A

ST elevated 1 mm in consec
T inversion
new LBBB
new Q waves (1 block wide or 1/3 QRS height)

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49
Q

3-14 days after MI

A 
ventricular aneurysm?
wall rupture?
papillary rupture?
yellow-tan softening
macrophage infiltrate
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50
Q

neutrophils after MI

A

12-24 hrs
wavy fibers too
reperfusion injury causes contraction bands

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51
Q

Dressler syndrome

A

> 2 wks after MI
pericarditis + fever
have a gray white collagen scar

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52
Q

days 1-2 after MI ECG

A

T wave inverts

Q wave deepens

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53
Q

Q wave

A

hours to weeks after MI

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54
Q

MI K and Na goals

A

K >4

Na >2

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55
Q

NSTEMI

A 
avoid fibrinolysis
do PCI (UF heparin needed)
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56
Q

Fe, cocaine, alcohol, ischemia

A

dilated cardiomyopathy

90% have S3

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57
Q

Ashcoff bodies

Antichow cells

A

rheumatic fever granuloma

giant cells

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58
Q

Minor Jones criteria

A

arthralgia, fever, ESR/CRP, long PR

2 major, 1 minor

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59
Q

pericarditis

A

ST elevation

PR decrease

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60
Q

Kussmauls sign

pulsus paradoxus

A

constrictive pericarditis - lupus

cardiac tamponade - asthma, croup, COPD

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61
Q

syphilis heart

A

AS
AR
aortic calcifications, treebark aorta**
blocked aortic vas vasorum - thoracic AA

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62
Q

not in lungs
yes in gut/renal
after Hep B or C

A

polyarteritis nodosa

ANCA negative

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63
Q

foot drop

A

Churg Strauss

pANCA

64
Q

saddle nose, perforate septum

A

Wegeners

cANCA

65
Q

leptomeningeal angioma

eye hemiplegia, seizure, glaucoma

A

Sturge-Weber

66
Q

Causes of Raynaud

A

MCTD
Beurgers (thromboangitis obliterans)
lupus
CREST

67
Q

treat Raynaud

A

warm

DHP CCB

68
Q

small red mole in older patient

A

cherry hemangioma

69
Q

primitive pulmonary vein

A

smooth left atrium

70
Q

dextrocardia from

A

left-right dynein defect

71
Q

valves come from

A

endocardial cushions

72
Q

Young Liver Synthesizes Blood

A 
fetal erythropoiesis:
Yolk sac 3-8 wks
Liver 6 wks to birth
Spleen 10-28 wks
Bone marrow 18 wks to adult
73
Q

ductus venosus

A

umbilical vein bypasses liver into IVC

74
Q

allantois becomes

A

urachus, then median umbilical ligament

75
Q

umbilical arteries become

A

medial umbilical ligaments

76
Q

umbilical vein becomes

A

ligamentum tere hepatis in falciform ligament

77
Q

posteriomedial papillary muscle blood

A

RCA PIVA

78
Q

pulse pressure and arterial compliance

A

inversely proportional

79
Q

pulse pressure factors

A

increased with hyperthyroid, AR, stiff aorta, sleep apnea, transiently with exercise

decrease with AS, cardiogenic shock, tamponade, HF

80
Q

decreases contractility

increases contractility

A

acidosis, high CO2, low O2, low cAMP

less extracellular Na (less Na/Ca exchanger)

81
Q

Law of LaPlace

A

Wall tension = PR / 2thickness

hypertrophy to decrease wall tension

82
Q

decrease both preload and afterload

A

ACEI and ARB

83
Q

Resistance

A

8viscositylength / pie*radius^4

84
Q

vessels in parallel

A

1/TR = 1/R1 + 1/R2

85
Q

organ removal fluid dynamics

A

increase TPR

decrease CO

86
Q

heart and narcotic overdose

A

decrease contractility

87
Q

heart and spinal anesthesia

A

decrease venous return

88
Q

heart and exercise

A

decrease TPR

89
Q

heart and sympathetic activity

A

increase venous return

90
Q

heart and AV shunt

A

decrease TPR

91
Q

TPR and mean systemic pressure

A

mean systemic pressure unchanged

CO changes at given preload

92
Q

left sternal border

A

AR, PR

93
Q

hand grip afterload

A

decreases hypertrophic cardiomyopathy murmur

later MVP

94
Q

Valsalva decreased preload

A

increases hypertrophic cardiomyopathy
murmur

earlier MVP

95
Q

rapid squat increase preload

A

increase AS murmur

decrease hypertrophic cardiomyopathy
later MVP

96
Q

rheumatic fever heart

A

MR early
TR, MVP, AR, Afib
MS late

mitral >aortic>tricuspid
Aschoff and Anitschkow, ASO

type II HS reaction

97
Q

S2 and OS

A

less time between is worse

98
Q

QT interval

A

ventricles depolarized

99
Q

U wave

A

hypokalemia, bradycardia

100
Q

speed of heart conduction order

A

Purkinje > atria > ventricles > AV node

101
Q

treat torsades

A

magnesium sulfate

102
Q

Congenital long QT

A

Romano Ward syndrome - AD, cardiac only

Jervell/Lange-Nielsen - AR, sensorineural

103
Q

Brugada syndrome

A

AD pseudo-RBBB with ST elevation in V1-V3
in Asian males
risk of V tach and sudden cardiac death

give ICD to treat

104
Q

IC antiarrhythmics to treat

A

Afib

105
Q

definitive treatment for atrial flutter

A

catherter ablation

106
Q

Vfib management

A

CPR and defibrillate!

107
Q

ANP

BNP

A

atrial myocytes after increased volume/P
cGMP vasodilate, lose Na at CT
dilate afferent, contrict efferent

ventricular myocytes after increased tension
longer half life,
HF diagnosis, nesiritide recombinant is Tx

108
Q

aortic arch chemo/baroreceptors

A

via vagus nerve to solitary nucleus of medulla for low and high BP

hypotension decreases afferent firing

aortic body chemoreceptor stimilated by O2

109
Q

carotid sinus baroreceptor

carotid body chemoreceptor

A

via CN9 to solitary nucleus of medulla

increased pressure/massage increases afferent firing, increases AV node refractory period –> slower HR

O2

110
Q

Cushing reaction

A

HT, bradycardia, respiratory depression

increased ICP increased CO2 and decreases pH –> symp –> HT

stretch –> peripheral baroreceptor –> slow HR

111
Q

central chemoreceptor

A

respond to CO2 and pH of brain ICF

no direct O2 effect

112
Q

skeletal muscle autoregulation

A

lactate, adenosine, K, H, CO2

113
Q

tricuspid atresia

A

needs ASD and VSD to live

has hypoplastic RV too

114
Q

tet spells

A

TOF cyanosis

squatting increases SVR, decreases R to L shunt

115
Q

left to right shunts

A

present later in childhood

116
Q

ASD

A

ostium secundum more common, isolated

ostium primum with other cardiac

not a patent foramen ovale

117
Q

PDA leads to

A

RVH, LVH, HF

late cyanosis on lower extremities

118
Q

Eisenmenger syndrome

A

late cyanosis, clubbing, polycythemia from PA hypertension/RVH flipping shunt

119
Q

location of coarctation of aorta

A

near ductus arteriosus = juxtaductal

120
Q

diabetic mother’s baby heart

A

transposition of great vessels

121
Q

Williams syndrome heart

A

supravalcular AS

122
Q

DiGeorge heart

A

truncus arteriosus

TOF

123
Q

Rubella heart

A

PDA, PAS, septal defect

124
Q

FAS heart

A

VSD, PDA, ASD, TOF

125
Q

fibromuscular dysplasia

A

10% of HT cause
RA has string of beads appearance
young women

126
Q

Monkeberg medial calcific sclerosis

A

calcified elastic lamina of medium sized arteries
stiff without obstruction of blood flow
pipestem x-ray
no intima involvement

127
Q

atherosclerosis locations

A

AA > CAD > popliteal > carotid

128
Q

unequal BP in arms

A

aortic dissection

129
Q

ST depression

A

stable angina
or unstable angina
or NSTEMI (subendocardial

130
Q

transient ST elevation

A

Prinzmetal/variant angina

trigger by tobacco, cocaine, triptans

give CCB, nitrates

131
Q

complication 1-3 days after MI

A

fibrinous pericarditis

-friction rub

132
Q

complication 3-14 days after MI

A 
wall rupture, causes MR or VAD
LV pseudoaneurysm (low CO, thrombus, arrhythmia)
133
Q

MI diagnosis

A
134
Q

complication 2 wks to months after MI

A

true ventricular aneurysm

-outward bulge when contract, fibrosis

135
Q

dilated cardiomyopathy has

A

S3
systolic regurgitant murmur
90% of cardiomyopathies

136
Q

hypertrophic cardiomyopathy occurrence

A

70% familial AD from B-myosin heavy chain
in Friedrich’s ataxia
ventricular arrhythmia death in young athlete
S4
systolic murmur
MR

137
Q

hypertrophic cardiomyopathy treatment

A

B-blocker or nonDHP CCB
ICD if needed
stop athletics

138
Q

spironolactone and HF

A

decreases mortality

139
Q

hemosiderin laden macrophages in lungs

A

left HF causing pulmonary edema via venous congestion

140
Q

SIRS

A 
>2 of:
fever/low T
HR - first sign!
RR
WBC up/down
141
Q

nonbacterial endocarditis

culture negative endocarditis

A

cancer, hypercoagulable, lupus

Coxiella, Bartonella, HACEK

142
Q

widespread ST elevation

PR depression

A

acute pericarditis

143
Q

cause acute pericarditis

A 
uremia
coxsackie
cancer
STEMI/Dressler
SLE, RA
radiation
144
Q

JVP increases with inspiration

A

constrictive pericarditis
restrictive cardiomyopathy
RA/RV tumor

“Kussmaul sign”

145
Q

Bacillary angiomatosis

A

neutrophilic infiltrate

in AIDS from Bartonella

146
Q

Kaposi sarcoma

A

lymphocytic infiltrate
skin, mouth, GI, respiratory
HHV8 and HIV

147
Q

chronic postmastectomy lymphedema causes

A

angiosarcoma

148
Q

hepatic angiosarcoma

A

vinyl chloride

arsenic

149
Q 
pulseless disease
night sweats
arthritis, myalgias
skin nodules
visual distubance
A

Takayasu arteritis -

narrowed aortic arch and great vessels

150
Q

vasculitis with Raynaud

A

thromboangitis obliterans

151
Q

pANCA

A

microscopic polyangiitis

Churg-Strauss

152
Q

renal microaneursyms
melena
neurological damage

A

polyarteritis nodosa

153
Q

AS leads to

A

microangiopathic hemolytic anemia
syncope with exercise
concentric LV hypertrophy

154
Q

louder with squatting and expiration

A

MR

155
Q

mets to heart

A

breast
lung
melanoma
lymphoma

get pericardium effusion

Pathology (8 decks)

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