Cardiovascular

Question 1

Cystic hygromas are ______ caused by ______ and are commonly found in _____ (area of the body). If seen in a neonate, it is suggestive of ______ (disease).

Answer 1

Fluid filled sacs below the skin; lymphatic malformation resulting in blocked lymphatic drainage; on the neck; Turner’s Syndrome. Causes the webbed neck feature

Question 2

Cardiac conditions associated with Turner’s Syndrome and findings

Answer 2

Coarctation of the aorta (reduced lower extremity pulses); bicuspid aortic valve stenosis

Question 3

Turner’s syndrome is associated with ______ (pre or post ductal) aortic coarctation with patent PDA. This results in ______

Answer 3

pre-ductal; pressures are lower in the aorta after the coarctation, so with patent PDA, blood from the venous system will flow into the aorta leading to lower-body cyanosis.

Question 4

Broad-shield chest (widely spaced nipples); gonadal dysgenesis; high arched palate and short stature are associated with ______

Answer 4

Turner’s Syndrome

Question 5

Rib notching seen on ______ is associated with ______ (disease) and caused by ______

Answer 5

X-ray; Turner’s Syndrome; collaterals due to aortic coarctation

Question 6

Hyaline arteriosclerosis vs hyperplastic arteriosclerosis (appearance, associated conditions)

Answer 6

Hyaline is smooth protein deposits and occurs in essential hypertension and diabetes; hyperplastic is associated with malignant hypertension >220/120 and has “onion skinning” due to concentric laminated thickening and proliferation of SM

Question 7

Mockenberg arteriosclerosis is caused by ______ and patients typically present ______. X-ray shows ______ appearance.

Answer 7

calcification of lamina and media; asymptomatically because it does not cause occlusion. “Pipestem”

Question 8

What should be considered as hypertensive medication in those suffering from asthma or other lung problems?

Answer 8

Choose a B1 selective antagonist. B2 allows for smooth muscle relaxation so antagonizing it can constrict bronchial tone.

Question 9

Which drugs are B1 selective vs B2 selective? What are exceptions?

Answer 9

Generally, -olol starting with A-M are B1 selective and N-Z are B2 selective. Labetolol is an exception as it is non-selective to beta receptors and is an alpha-1 antagonist

Question 10

______ is when the LV bulges out during systole and in during diastole. It is indicative of ______

Answer 10

Paradoxical movement; ischemic damage (MI)

Question 11

The anteroseptal heart is supplied by ______ and EKG would show elevation in ______

Answer 11

Left anterior descending; V1, V2

Question 12

The anteroapical heart is supplied by ______ and EKG would show elevation in ______

Answer 12

Distal left anterior descending; V3-V4

Question 13

The lateral heart is supplied by ______ and EKG would show elevation in ______

Answer 13

LAD or left circumflex; V5-V6, AVL, LI

Question 14

The inferior heart is supplied by ______ and EKG would show an elevation in ______

Answer 14

Right Coronary artery; II, III, AVF

Question 15

The posterior heart is supplied by ______ and EKG would show ______

Answer 15

posterior descending artery; ST depression in V1-V3 and Tall R waves

Question 16

The ______ nerve carries afferent information from the carotid sinus to the _____ (part of brain). It is activated under ______. The result is ______.

Answer 16

Glossopharyngeal; medulla; increases in pressure; increased parasympathetic activity (slowing of the heart).

Question 17

The ______ nerve carries afferent information from the aortic arch baroreceptors to the ______ (part of brain).

Answer 17

vagus nerve; medulla

Question 18

Focal small areas of subendocardial fibrosis is a result of

Answer 18

stable angine pectoris; subendocardium is deepest layer and most likely to suffer from ischemia. In angina, there are short episodes of decreased blood flow to the heart.

Question 19

Circumferential, diffuse subendocardial infarction results from ______

Answer 19

long standing hypotension that affects inner layer of heart (contrast with angina which would be focal areas of subendocardial fibrosis)

Question 20

There would be an increase in ______ concentration in an arteriovenous fistula. This can result in ______ surrounding tissue because ______

Answer 20

Oxygen; necrosis; oxygenated blood is entering venous system without passing through capillaries.

Question 21

Atypical presentation of ischemic heart disease in women

Answer 21

Elevated AST (found in heart and liver) without elevations in ALT or other liver markers. Epigastric pain.

Question 22

Congestive heart failure results in ______ liver appearance which is caused by _____

Answer 22

nutmeg, venous congestion

Question 23

Endocarditis due to drug use typically results from ______ (bacteria) and infects ______ (valve)

Answer 23

S. aureus; tricuspid

Question 24

Libman-Sachs endocarditis is associated with ______(disease) and it has unique vegetations in that ______

Answer 24

SLE; occur on both sides of valves

Question 25

Calculating resistance in a parallel vs series

Answer 25

Parallel (1/R+1/R = 1/Rt) vs series (R1+R2=Rt)

Question 26

What are fatty streaks?

Answer 26

Lipid-laden macrophages (foam cells) lining the arteries

Question 27

How can atherosclerosis lead to MI

Answer 27

Fatty streak –> fibrous clot –> rupture of clot –> thromboembolus –> occlusion

Question 28

In parallel circuit, loss of one parallel circuit leads to _____ total peripheral resistance

Answer 28

increase

Question 29

Endocardial cushions are derived from ______

Answer 29

Neural crest cells

Question 30

Failure of ______ results in ASD

Answer 30

endocardial cushion fusions

Question 31

______ typically presents 4-6 weeks after MI. This is a ______ condition that results in ______.

Answer 31

Dressler’s syndrome; autoimmune mediated pericarditis; fibrinous pericarditis

Question 32

Fever, positional chest pain ______ (time) after MI typically indicates ______ (syndrome)

Answer 32

4-6 weeks; Dressler’s

Question 33

______ shock can be secondary to acute MI. What is true of HR, SV, EF, and SVR?

Answer 33

Cardiogenic; increased HR (from baroreceptors sensing hypotension), low SV and EF due to pump failure (and less filling time), and increased SVR from baroreceptor response.

Question 34

Sudden cardiac death following MI is most likely caused by ______

Answer 34

Arrhythmia

Question 35

Pericarditis can be a complication post-MI at two different times. When and what are the causes?

Answer 35

1-3 days after MI - inflammation due to ischemia

4-6 weeks after MI - Dressler’s Syndrome autoimmune response

Question 36

Friction rub is caused by _____ and signifies ______

Answer 36

Rubbing together and visceral and parietal peritoneum due to inflammation; pericarditis

Question 37

Sepsis can lead to pulmonary edema by causing ______

Answer 37

increase in microvascular permeability. Due to bacterial release of exotoxins

Question 38

Accumulation of fluid in the ______ results in cardiac tamponade. This is the space between ______ (layers). Also name layers of the heart

Answer 38

pericardial space. visceral pericardium and parietal paricardium. The heart itself if endocardium, myocardium and epicardium (visceral pericardium). Then it is the pericardial space. The outer border of the space is parietal pericardium which is attached to the outermost fibrous pericardium (no space).

Question 39

Cholesterol levels of 600 indicate (heterozygous/homozygous) hypercholesterolemia. If this individual has a child with someone with no history of hypercholesterolemia, what happens to children?

Answer 39

Homozygous; the individual is AD (AA) and has child with partner (aa). 100% of his children will be heterozygotes and have the condition (Aa). They won’t be as severe (300-400 LDL level).