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USMLE Step 1 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

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USMLE® Step 1 flashcards
1
Q

Embryonic origin of the left atrium

A

Trabeculated left atrium –> primitive atria Smooth part of left atrium –> smooth part of left atrium

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2
Q

Embryonic origin of the right atrium

A

Trabeculated right atrium –> primitive atria Smooth part of right atrium –> right horn of sinus venosus

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3
Q

Which embryonic aortic arch forms the adult aortic arch?

A

Left fourth

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4
Q

Which embryonic aortic arch forms the adult left pulmonary artery and ligamentum arteriosum?

A

Left sixth

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5
Q

Which embryonic aortic arch forms the adult right pulmonary artery?

A

Right sixth

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6
Q

Which embryonic aortic arch forms the adult right subclavian artery?

A

Right fourth

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7
Q

Describe the course of the recurrent laryngeal nerves?

A

The left recurrent laryngeal nerve loops under the aortic arch near the ligamentum arteriosum. The right recurrent laryngeal nerve loops under the right subclavian artery.

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8
Q

Which embryonic aortic arches forms the common carotid arteries and proximal internal carotid arteries?

A

Left and right third

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9
Q

Leads I and aVL

A

Lateral MI –> left circumflex

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10
Q

Leads V1-V4

A

Anterior MI –> left anterior descending

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11
Q

Leads V1-V4, V5-V6, I, aVL

A

Anterolateral MI –> left main

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12
Q

Leads II, III, aVF

A

Inferior MI –> posterior descending (85% branches from right coronary)

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13
Q

What increases the heart’s contractility?

A

Catecholamines –> ↑ inward Ca2+ current during phase 2 –> ↑ intracellular Ca2+ ↑ HR –> ↑ intracellular Ca2+ ↓ extracellular Na+ (↓ activity of Na+/Ca2+ pump) Digitalis –> inhibits Na+/K+ ATPase –> intracellular Na+ ↑ –> diminished gradient for Na+/Ca2+ pump –> ↑ intracellular Ca2+

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14
Q

What increases stroke volume?

A

↑ contractility ↑ preload ↓ afterload Anxiety, exercise (early), pregnancy

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15
Q

What decreases the heart’s contractility?

A

β1-blockade Heart failure with systolic dysfunction Acidosis Hypoxia/hypercapnea Non-dihydropyridine CCB Parasympathetic stimulation –> ↓ inward Ca2+ current –> ↓ intracellular Ca2+

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16
Q

What does S1 correspond to?

A

Closure of mitral and tricuspid valves

17
Q

What does S2 correspond to?

A

Closure of aortic and pulmonary valves

18
Q

What does S3 correspond to?

A

Rapid ventricular filling during early diastole a/w increased filling pressures –> mitral regurgitation, CHF, pregnancy

19
Q

What does S4 correspond to?

A

Atrial kick in late diastole a/w high atrial pressures –> ventricular hypertrophy

20
Q

What can cause prolonged QT interval?

A

Hypokalemia Hypomagnesemia Drugs (sotalol, risperidone, macrolides, chloroquine, protease inhibitors, quinidine, thiazides)

21
Q

What decreases myocardial oxygen consumption?

A

↓ preload/end-diastolic volume ↓ BP (↓ afterload) ↓ HR ↓ contractility Nitrate + β-blocker greatly reduces myocardial oxygen consumption and is used to treat angina

22
Q

Which congenital heart diseases results in early cyanosis (blue babies) and requires urgent surgical correction and/or maintenance of a PDA?

A

5 T’s: Truncus arteriosus Transposition of the great vessels Tricuspid atresia Tetrology of Fallot TAPVR (totally anomalous pulmonary venous return)

23
Q

Congenital heart defect associated with DiGeorge syndrome (22q11 syndrome)?

A

Truncus arteriosus Tetralogy of Fallot

24
Q

Congenital heart defect associated with Down Syndrome?

A

ASD VSD AV septal defect (endocardial cushion defect)

25
Q

Congenital heart defect associated with congenital rubella?

A

Septal defects PDA Pulmonary artery stenosis

26
Q

Congenital heart defect associated with Turner Syndrome?

A

Bicuspid aortic valve Coarctation of the aorta (preductal)

27
Q

Congenital heart defect associated with Marfan Syndrome?

A

MVP Thoracic aortic aneurysm and dissection Aortic regurgitation

28
Q

Congenital heart defect associated with infants with diabetic mothers?

A

Transposition of the great vessels

29
Q

Causes of dilated cardiomyopathy?

A

Alcohol abuse Wet beriberi Coxsackie A and B virus myocarditis Chronic cocaine use Chagas disease Doxorubicin toxicity Hemochromatosis Peripartum cardiomyopathy

30
Q

Unilateral headaches, jaw claudication, blindness (if untreated)

A

Temporal (giant cell) arteritis Labs: elevated ESR and CRP Dx: temporal artery biopsy shows granulomas, intimal thickening, elastic lamina fragmentation, multinucleated giant cells Tx: corticosteroids Cx: polymyalgia rheumatica, IL-6 related to severity of disease

31
Q

Weak upper extremity pulses, arrowing of aortic arch and proximal great vessels

A

Takayasu arteritis Tx: corticosteroids

32
Q

Hepatitis B, hypertension, transmural inflammatory and fibrinoid necrosis of arterial wall, “string of pearls” on arteriogram

A

Polyarteritis nodosa Tx: cyclophosphamide, corticosteroids

33
Q

Fevers, conjunctivitis, cervical lymphadenopathy, strawberry tongue, rash on palms and soles

A

Kawasaki disease Tx: aspirin, IV immunoglobulins Complications: coronary artery aneurysm

34
Q

Smoking, claudication,gangrene, autoamputation, Raynauds

A

Buerger disease (thromboangiitis obliterans) Tx: smoking cessation

35
Q

c-ANCA (PR3-ANCA), involvement of nasopharynx, lungs, kidneys

A

Granulomatosis with polyangiitis (Wegners) Tx: cyclophosphamide, corticosteroids

36
Q

p-ANCA (MPO-ANCA), invovlement of lungs, kidneys

A

Microscopic polyarteritis No nasopharyngeal involvement and no granulomas distinguishes from Wegners

37
Q

p-ANCA (MPO-ANCA), asthma, palpable purpura, GI complaints, increased IgE

A

Churg Strauss (eosinophilic granulomatosis with polyagiitis) Granulomas with eosinophils

38
Q

Dystrophic vs. metastatic calcification

A

Dystrophic calcification = calcification of necrotic tissue + normocalcemia Metaststic calcification = calcification of normal tissue + hypercalcemia

39
Q

Lipofuscin vs. hemosiderin

A

Lipofuscin = “wear and tear” yellow-brown, finely granular perinuclear pigment composed of lipid polymers and protein-complexed phospholipids forms as a result of free radical injury and lipid peroxidation often seen in the heart and liver of aging, cachectic/malnourished patients Hemosiderin = iron-containing brown pigmented granules

USMLE Step 1 (20 decks)

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