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USMLE Step1 > CVS > Flashcards

CVS Flashcards

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USMLE® Step 1 flashcards
1
Q

Fixed splitting

A

ASD

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2
Q

Long QT interval predisposes to

A

Torsades de pointes

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3
Q

Congenital long QT syndrome associated with

A

Sensory neural deafness

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4
Q

PSVT rx

A

caroid massage, valslva, IV adenosine , beta blocker

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5
Q

Holiday heart

A

AF

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6
Q

TOF

A

PS ( important prognostic)
RVH
Overriding aorta
VSD

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7
Q

Rubella triad

A

Cataract sensory neural deafness PDA

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8
Q

Hyaline arteriosclerosis

A

Essential HT

DM

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9
Q

Hyperplastic arteriosclerosis

A

Malignant HT ( onion skinning)

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10
Q

Pericardial knock

A

Constrictive pericarditis

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11
Q

Wegners granulomatosis cf

A

Nasal ulcer
Necrotizing granuloma lung
RPGN

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12
Q

Nitrates AE

A

Reflex tachycardia

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13
Q

inferior wall of heart supplied by

A

right coronary artery by PDA

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14
Q

s3 and s4 nick names

A

s3 ventricular gallop (increased filling pressures MR)

s4 atrial kick

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15
Q

click in MVP is

A

mid-systolic (sudden tensing of chordae tendinae)

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16
Q

increased severity of MS

A

decreased distance between S2 and OS

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17
Q

progressive lengthening of PR interval and drop

A

2nd degree mobitz type I

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18
Q

BNP blood test for

A

heart failure

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19
Q

hypertensive urgency cut off

A

180/120

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20
Q

heart problem in infant of diabetic mother

A

TGV

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21
Q

cut of for antigina

A

75%

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22
Q

autoimmune fibrinous pericarditis: name and time

A

dressler syndrome (after 2 weeks to months)

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23
Q

post-infarction fibrinous pericarditis time

A

1-3 days

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24
Q

3 things in constrictive pericarditis

A

pulsus paradoxus (also in cardiac tamponade)
pericardial knock
kusmaul sign

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25
Q

arteritis: pulse less disease

A

takayasu arteritis

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26
Q

arteritis: jaw claudication

A

temporal/giant cell

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27
Q

arteritis: melena

A

PAN

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28
Q

arteritis: coronary aneursism

A

kawasaki disease

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29
Q

nimodipine indication

A

SAH

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30
Q

fenoldapam indication and MOA

A

D1 agonist, hypertensive emergency (enhances RBF)

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31
Q

hydralazine is the opposite of X

and both have same SE: what is that?

A

nitrates (nitrate more on vein)

but both cause reflex tachycardia

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32
Q

classify lipid lowering

A

statins, bile acid resins, ezetimibe, fibrates and niacin

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33
Q

special effects of statin, fibrates and niacin

A

statin LDL
fibrates TG
niacin increase HDL

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34
Q

PPARa activating lipid lowering drug

A

fibrates

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35
Q

anti-arrythmic Class I effect

A

reduce slope of depolarization

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36
Q

anti-arrythmic Class II effect

A

decrease slope of phase 4 and prolonged repolarization

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37
Q

anti-arrythmic Class III effect and code for names

A 
prolonged repolarization (AIDS)
amiodarone, ibutilde, dofetilide, sotalol
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38
Q

anti-arrythmic Class IV effect

A

slow rise of phase0 and prolonged repolarization

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39
Q

PFO ASD which is more common

A

PFO

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40
Q

valve of foramen ovale

A

septum primum

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41
Q

increased pulse pressure

A 
isolated SHT (aorta stiffening)
obstructive sleep apnea (increased sympatheic tone)
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42
Q

pulse pressure in AR and AS

A

AR increase AS decrease

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43
Q

digitalis is an INDIRECT blocker of

A

exhanger

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44
Q

metabolic conditions that reduce contractility

A

acidosis, hypoxia and hypercapnia

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45
Q

veno arterio botho dilators

A

veno nitrates, hydralazine arterioles

botho ACEI

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46
Q

DCM is - dysfunction

A

systolic (reduced contractility)

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47
Q

DHP sensitive

A

amlodipine

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48
Q

S3 pathologic conditions

A

MR, DCM, HF (increased ventricullar filling pressure during rapid filling) Problem if already full
Lt lateral position (same as S4)

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49
Q

S4 condition

A

HCM (stiff LV) Lt lateral position

sign of diastolic dysfuction

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50
Q

wide splitting (delay RV emptying)

A

PS, RBBB (note: paradoxial split occurs with AS and LBBB)

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51
Q

splitting and inspiration

A

increases

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52
Q

Lt sternal border murmers

A 
AR PR (diastolic)
HCM (systolic)
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53
Q

PDA murmer where

A

continous, left infra-claviular

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54
Q

triscuspid area extra murmers

A

VSD and ASD

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55
Q

inspiration and murmer

A

increases Rt sided

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56
Q

All procedures except hand grip affect

A

venour return (hand grip afterload)

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57
Q

hand grip and murmer

A

increase for all regurgiation murers
decreased in HCM and AS
HCM and MVP go together

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58
Q

all procedures other than hand grip, think about VR and increase pre-load

A

less HCM murmer and incrased AS

HCM and MVP go together

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59
Q

pulsus parvus et tardus

radiates to where

A

AS (week pulses with delayed peak)
SAD (syncope, angina and dyspnoea)
radiates to carotids

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60
Q

sever MR will have

MR murmer increases when

A

S3

inspiration

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61
Q

severe AR

A

long murmer (holo diastolic) and signs of hyperdynamic

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62
Q

QRS complex length

A

120msec

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63
Q

T wave inversion indicates

A

recent MI

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64
Q

U wave

A

hypokalemia bradycardia

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65
Q

torsades pointes electrolyte risk

A

low K and Mg

Rx with mg sulphate

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66
Q

ABCDE of torsades

A 
arrythmic (quiindine and sotalol) IA and III
Biotics (macrolides)
cychotic (haloperidol)
depressents (TCA)
Emetics (ondansetron)
antimalairiasl (quinine and cholorqine)
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67
Q

brugada syndrome

A

psudeo RBBB and ST elevation in V1 to V3
increased risk of ventri arrytmia and SCD
Rx ICD

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68
Q

WPW synrome

A

delta wave
less PR
wide QRS
Bundle of kent

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69
Q

saw tooth

A

flutter (saw tooth are regular p waves)

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70
Q

definitive treatment for flutter

A

cathetor ablation

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71
Q

no identifiable waves in

A

vent fibrillation

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72
Q

1st degree block

A

long PR

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73
Q

Mobi II drop

A

sudden drop (prolong and drop in I)

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74
Q

ANP and BNP MOA

A

opposite to aldosteroe

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75
Q

HF treatment with BNP drug name

A

nesiritide(BNP is diagnostic too)

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76
Q

PCWP increased in

A

MS

77
Q

cardiac chamber pressures

A

5 25/5 25/20

12 130/10 130/90

78
Q

aorta position in TGV

A

anterior

79
Q

formation and spiral absent

A

formation PTruncus A

spiral TGV

80
Q

frequeccncy of VSD

A

VSD ASD PDA

81
Q

common defect in VSD

A

osteum secondum

82
Q

coarcation of aorta two risk

A

dissection and berry

83
Q

differential cyanosis

A

late PDA

84
Q

fredrick ataxia heart defect

A

HCM

85
Q

heart defect alcohol

A

all left to right and TOF

86
Q

heart defect rubella

A

PDA and PS

87
Q

heart defect diabetes

A

TGV

88
Q

heart defect marfan

A

MVP THORACIC aneurism and dissection

89
Q

turner syndrom heart defect

A

coaration of aorta and biscupid aortic value

90
Q

williams syndome heart defect

A

supra valvular AS

91
Q

22q11 heart defect

A

persistent truncus and TOF

92
Q

tubercuous sclerois heart defect

A

rhabdomyoma

93
Q

HT emergency vs urgency

A

emergency for end organ damage (180/120)

94
Q

medial canfific sclerosis other name

A

monkeberg (calcification and pipestem)

95
Q

plane xanthoma

A

1o biliary cirrhoiss

96
Q

code for athero arteries

A

AbCo PoCa

97
Q

thoraric acotic aneurism

A 
non athero (marfan symphilis hypertension )
athero: abdominal
98
Q

aortic dissection RF

A

hypertenstion

99
Q

stanford A

A

ascending involved
B means ascenidng not involved
B for treatment with beta blocker

100
Q

rx for prinzmetal angina

A

CCB (note: sumatriptan and ergonovine drugs can ppt)

also tobacco and cocaine

101
Q

two drugs causing coronory steal syndrome

A

adenosine and dipyrdiamole

102
Q

LAD bypass

A

alone=left intrnal mammary

multiple: saphenous

103
Q

troponin I

A

4 hous last long (7-10 days) very speicific

104
Q

CKMB

A

6-12 hours, normal in 48 hours, not so specific but good for re-infrt

105
Q

peaked T wave in MI due to

A

localized hyperklemia

106
Q

ST for transmural and subendocardial

A

ST elevation and depreassion

107
Q

ECG localization

A 
anteroseptal-V1V2 (LAD)
Anteroapical_v3,v4 (LAD)
Anterolateral-v5,v6 (LAD/LCX)
lateral (LCX) I, aVL
Inferrion, II, III, aVF
108
Q

dyskineisa in doppler

A

true aneurism outward bulge during contraction

109
Q

STEMI best Rx

A

percutaenous coronory intervention

110
Q

HCM micro

A

myofiber disarray, interstitial fibrosis

111
Q

DCM causes

A 
A alcohol
B beri beri
C chaga
C coxB
C Cocaine
D Doxo
112
Q

HOCM which walve

A

mitral

113
Q

loffler syn

A

endomyocardial fibrosis with eosinophilic infiltrate

114
Q

a few causes of restrictive CardioM

A

amylo, sarco

post radiation endocardial fibroelastosis (endocardium of children)

115
Q

three causes of HCM

A

familal -beta myosin heavy chain
fredrick
c/c HT

116
Q

help CHF mortality

A

ACE beta, spironolactone (aldosterone antagonists)

117
Q

3 problems ith CHF compen

A

RAA and symahethic tone ,
both increase afterload
ADH

118
Q

primary insult in hge shock (pre, after and CO)

A

reduced preload (CVP low), CO less, after load more

119
Q

primary insult in cardiogenic shock(pre, after and CO)

A

less CO preload and after load more

120
Q

primary insult in obstructive shock(pre, after and CO)

A

less CO preload and after load more

121
Q

primary insult in distributiee shock(pre, after and CO)

A

less afte load (sepsis) (note: it is a high output failure) and preload will be less

122
Q

bacterial endocarditis 6 types and causes

A 
standard aureus
IV drug arues
suba/c, diseased value viridans
prostheic epidermidid
cutlure neg coxeilla
gallolyticsu colon ca
123
Q

three names in endocarditis

A

osler nodes
roth (retinal white)
janeway (remember picutre)

124
Q

what GN in endocarditis

A

DPGN (due to immune complexes)

125
Q

JONES

A 
joint
heart
node
erytema marginatum
ydenham chorea (basal ganglia mimicry)
126
Q

pericardial rub

A

pericarditis

127
Q

beck triad

A

hypotenstion, distended neck veins and distant heart soudns

also increase HR and pulsus pardoxus and electrical aternans

128
Q

distended neck veins two DD

A

cardiac tamponade and tension pneumothorax

129
Q

p. paradoxus and causes

A

no pulse in inpsiration
tamponade, const. pericarditis
asthma, cor pulomonale, obst. sleep apnoe, croup

130
Q

classify confusing pericardium

A

serious: tampanade and tension
not serious: pericaridits and constrictive pericarditis
rub and knock
p. paradoxus and kuss maul in construction

131
Q

cardiac tumors adult and children

A

myxoma (ball valve) mucopolysaccradie stroma

rbabdomyoma (t. sclresosis)

132
Q

kussmaul define

A

increase in JVP during inspiration instead of normal decrease

133
Q

lymphocytes infiltrate in mycordium

A

viral mycocarditis

134
Q

hepatic angeiosarcoma two causes

A

vinyl chorldide and arsenic

135
Q

tumor coming ater post mastectomry lymphedema

A

angeiosarcoma (firm violacious noduels)

also sun exposed and post radiation

136
Q

vascular tumor that cause ulceration and bleeing

A

pyogenic granuloma

137
Q

raynaud treatment

A

CCB (like prinzmetal)

138
Q

cystic hygroma is

A

cvenous hemangioma of the neck

139
Q

tocilizumab

A

IL-6 recepor (giant cell) CD4 T cell mediated

140
Q

bindess and polymmyalgia rheumatica

A

giant cell/temporal

141
Q

PAN vessels invllvement

A

viseral abd pain and melena
renal aneurism
skin purpura/livedo retinularis
(not pulmonary involvment)

142
Q

PAN hist and Rx

A

transmural inlammation with firboid nexrosis
HepB+
cyclocphosphamide and seroids

143
Q

wegners CF

A

URT, LRT and renal (RPGN/cresntic)

c-ANCA (PR3)

144
Q

microscopic polyngitis different from wegner

A

NO URT
p-anca (MPO)
pauciimmune GN
No granuloma (in the name)

145
Q

peripheral neurophaty which vasculitis

A 
churg strass
also pauci immune and pANCA
granuoma+
(necrotising vasculaits with granlom like wegners)
IgG and eosinophil
146
Q

triad of HSP

A

skin purpura, abd pain and bleeding and artharlia

147
Q

renal in HSP

A

IgA necphropathy (berger disease)

148
Q

first choice of drug in HT gneral population

A

diretics

149
Q

pregnancy hyper tension

A

hydra LMN

lbetalol, methdy dopa, nifedipine

150
Q

CCB for HT emergency

A

nicardipine and clevidipine

151
Q

nitroprusside and hydralazine nirates, ANP and BNP and NO MOA

A

cGMP

152
Q

reflex tachcardia with nitrate Rx

A 
beta blocker (this is a god combination) both reduces O demand
verapamil is equal to beta blockers in effect
153
Q

two patial beta agonists CI in angina

beta for emergency HT

A

pindolol and acebutlol

labetaol

154
Q

statin what else other than HMG CoA

A

increase LDL receptor on liver and increased uptake

155
Q

4 SE of statins

A

Hepato, myo and lactic

gall stones with fibrates and bile acid resins (they increase choleserol syntehsis)

156
Q

triglyerides in bile acrid resins

A

increase (only unexpected)

157
Q

ezetimibe only acts on

A

LDL decrease

158
Q

fibrates what after PPARgamma

A

upregulate LPL (increase TG clearance) and increase HDL

159
Q

niacin MOA

A

reduces hepatic VLDL syntheis

160
Q

fibrates SE

A

myopahty (stone with statin)

161
Q

niacin SE

A

flushing (NSAIDs), red face

hyper gly and uricmeia

162
Q

SE CCB

A

flushing, edema (AV block for cardic type)

remember verapamil is like beta blocker

163
Q

statin not metabolized by p450

A

parvastatin

164
Q

second action of digoxin

A

stiulate vagus

165
Q

SE digoxin

A

diagrrrhoe, yellow vision, hyperkaleia and AV block and arrytmia

166
Q

digoxin and hypokaleima

A

more drug binding

167
Q

digoxin and quinidne

A

less clearance and diplacement

168
Q

hypertryglyeridemia DOC

A

fibrates (otehrwise panreatitis)

169
Q

AF rx

A

regular beta 1 blockers

with CHF digoxin

170
Q

classsify anti-arrythmics

A

Na (Activted and inactivated) inresase QRS with increased HR
beta
K (reverse use dependence)
Ca

171
Q

1A, 1B AND 1C

A

disopyramide, quinidine, procainamide
lidocaine, tocainide, mexiletine
morizine, flecainide, propafenone

172
Q

remember class I

A 
A pisa gopuram tilt to right
b both shrunk
b: best post MI
c: stong slope, strong inding and strong dependence 
C: CONTRA in structural and IHD
call a CAB
173
Q

class II moa

A

decreased slope of 4 and prolged repol

174
Q

class II short acting

A

esmolol

175
Q

class II indi

A

SVT af, aflutter

176
Q

beta blockers are CI

A

phEROCHROMOCytomA, COCAIN (unoposed a1)

177
Q

SE quinindine

A

cinchonism

178
Q

SE procainamide

A

SLE (like isoniazid)

179
Q

class III names

A

AIDS

180
Q

amiodarone indication and SE

A

WPW syndrome
PFT (pul fibrosis), LFT and thyroid FT (iodine)
no torsades
hapten corneal and skin deposits

181
Q

class III moa

A

increase repol

182
Q

class 4 moa

A

slow depol and repol

183
Q

adenosine moa

A

k out and hyperpolarize

184
Q

interaction of adenosine

A

theophylline and caffiene

185
Q

adenosine se

A

flushing chest pain, bronchospasm

impending doom

186
Q

angiolathyrism

A

sweet pea lysil oxidase inhibitor

myxomatous degeneration

187
Q

ivabradine

A

only rate

188
Q

neprilysin

A

metalloprotease for anp and bnp

189
Q

neprilysin inhibitor

A

sacubitril

USMLE Step1 (19 decks)

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