CVS Flashcards
1
Q
Fixed splitting
A
ASD
2
Q
Long QT interval predisposes to
A
Torsades de pointes
3
Q
Congenital long QT syndrome associated with
A
Sensory neural deafness
4
Q
PSVT rx
A
caroid massage, valslva, IV adenosine , beta blocker
5
Q
Holiday heart
A
AF
6
Q
TOF
A
PS ( important prognostic)
RVH
Overriding aorta
VSD
7
Q
Rubella triad
A
Cataract sensory neural deafness PDA
8
Q
Hyaline arteriosclerosis
A
Essential HT
DM
9
Q
Hyperplastic arteriosclerosis
A
Malignant HT ( onion skinning)
10
Q
Pericardial knock
A
Constrictive pericarditis
11
Q
Wegners granulomatosis cf
A
Nasal ulcer
Necrotizing granuloma lung
RPGN
12
Q
Nitrates AE
A
Reflex tachycardia
13
Q
inferior wall of heart supplied by
A
right coronary artery by PDA
14
Q
s3 and s4 nick names
A
s3 ventricular gallop (increased filling pressures MR)
s4 atrial kick
15
Q
click in MVP is
A
mid-systolic (sudden tensing of chordae tendinae)
16
Q
increased severity of MS
A
decreased distance between S2 and OS
17
Q
progressive lengthening of PR interval and drop
A
2nd degree mobitz type I
18
Q
BNP blood test for
A
heart failure
19
Q
hypertensive urgency cut off
A
180/120
20
Q
heart problem in infant of diabetic mother
A
TGV
21
Q
cut of for antigina
A
75%
22
Q
autoimmune fibrinous pericarditis: name and time
A
dressler syndrome (after 2 weeks to months)
23
Q
post-infarction fibrinous pericarditis time
A
1-3 days
24
Q
3 things in constrictive pericarditis
A
pulsus paradoxus (also in cardiac tamponade)
pericardial knock
kusmaul sign
25
arteritis: pulse less disease
takayasu arteritis
26
arteritis: jaw claudication
temporal/giant cell
27
arteritis: melena
PAN
28
arteritis: coronary aneursism
kawasaki disease
29
nimodipine indication
SAH
30
fenoldapam indication and MOA
D1 agonist, hypertensive emergency (enhances RBF)
31
hydralazine is the opposite of X
| and both have same SE: what is that?
nitrates (nitrate more on vein)
| but both cause reflex tachycardia
32
classify lipid lowering
statins, bile acid resins, ezetimibe, fibrates and niacin
33
special effects of statin, fibrates and niacin
statin LDL
fibrates TG
niacin increase HDL
34
PPARa activating lipid lowering drug
fibrates
35
anti-arrythmic Class I effect
reduce slope of depolarization
36
anti-arrythmic Class II effect
decrease slope of phase 4 and prolonged repolarization
37
anti-arrythmic Class III effect and code for names
```
prolonged repolarization (AIDS)
amiodarone, ibutilde, dofetilide, sotalol
```
38
anti-arrythmic Class IV effect
slow rise of phase0 and prolonged repolarization
39
PFO ASD which is more common
PFO
40
valve of foramen ovale
septum primum
41
increased pulse pressure
```
isolated SHT (aorta stiffening)
obstructive sleep apnea (increased sympatheic tone)
```
42
pulse pressure in AR and AS
AR increase AS decrease
43
digitalis is an INDIRECT blocker of
exhanger
44
metabolic conditions that reduce contractility
acidosis, hypoxia and hypercapnia
45
veno arterio botho dilators
veno nitrates, hydralazine arterioles
| botho ACEI
46
DCM is - dysfunction
systolic (reduced contractility)
47
DHP sensitive
amlodipine
48
S3 pathologic conditions
MR, DCM, HF (increased ventricullar filling pressure during rapid filling) Problem if already full
Lt lateral position (same as S4)
49
S4 condition
HCM (stiff LV) Lt lateral position
| sign of diastolic dysfuction
50
wide splitting (delay RV emptying)
PS, RBBB (note: paradoxial split occurs with AS and LBBB)
51
splitting and inspiration
increases
52
Lt sternal border murmers
```
AR PR (diastolic)
HCM (systolic)
```
53
PDA murmer where
continous, left infra-claviular
54
triscuspid area extra murmers
VSD and ASD
55
inspiration and murmer
increases Rt sided
56
All procedures except hand grip affect
venour return (hand grip afterload)
57
hand grip and murmer
increase for all regurgiation murers
decreased in HCM and AS
HCM and MVP go together
58
all procedures other than hand grip, think about VR and increase pre-load
less HCM murmer and incrased AS
| HCM and MVP go together
59
pulsus parvus et tardus
| radiates to where
AS (week pulses with delayed peak)
SAD (syncope, angina and dyspnoea)
radiates to carotids
60
sever MR will have
| MR murmer increases when
S3
| inspiration
61
severe AR
long murmer (holo diastolic) and signs of hyperdynamic
62
QRS complex length
120msec
63
T wave inversion indicates
recent MI
64
U wave
hypokalemia bradycardia
65
torsades pointes electrolyte risk
low K and Mg
| Rx with mg sulphate
66
ABCDE of torsades
```
arrythmic (quiindine and sotalol) IA and III
Biotics (macrolides)
cychotic (haloperidol)
depressents (TCA)
Emetics (ondansetron)
antimalairiasl (quinine and cholorqine)
```
67
brugada syndrome
psudeo RBBB and ST elevation in V1 to V3
increased risk of ventri arrytmia and SCD
Rx ICD
68
WPW synrome
delta wave
less PR
wide QRS
Bundle of kent
69
saw tooth
flutter (saw tooth are regular p waves)
70
definitive treatment for flutter
cathetor ablation
71
no identifiable waves in
vent fibrillation
72
1st degree block
long PR
73
Mobi II drop
sudden drop (prolong and drop in I)
74
ANP and BNP MOA
opposite to aldosteroe
75
HF treatment with BNP drug name
nesiritide(BNP is diagnostic too)
76
PCWP increased in
MS
77
cardiac chamber pressures
5 25/5 25/20
| 12 130/10 130/90
78
aorta position in TGV
anterior
79
formation and spiral absent
formation PTruncus A
| spiral TGV
80
frequeccncy of VSD
VSD ASD PDA
81
common defect in VSD
osteum secondum
82
coarcation of aorta two risk
dissection and berry
83
differential cyanosis
late PDA
84
fredrick ataxia heart defect
HCM
85
heart defect alcohol
all left to right and TOF
86
heart defect rubella
PDA and PS
87
heart defect diabetes
TGV
88
heart defect marfan
MVP THORACIC aneurism and dissection
89
turner syndrom heart defect
coaration of aorta and biscupid aortic value
90
williams syndome heart defect
supra valvular AS
91
22q11 heart defect
persistent truncus and TOF
92
tubercuous sclerois heart defect
rhabdomyoma
93
HT emergency vs urgency
emergency for end organ damage (180/120)
94
medial canfific sclerosis other name
monkeberg (calcification and pipestem)
95
plane xanthoma
1o biliary cirrhoiss
96
code for athero arteries
AbCo PoCa
97
thoraric acotic aneurism
```
non athero (marfan symphilis hypertension )
athero: abdominal
```
98
aortic dissection RF
hypertenstion
99
stanford A
ascending involved
B means ascenidng not involved
B for treatment with beta blocker
100
rx for prinzmetal angina
CCB (note: sumatriptan and ergonovine drugs can ppt)
| also tobacco and cocaine
101
two drugs causing coronory steal syndrome
adenosine and dipyrdiamole
102
LAD bypass
alone=left intrnal mammary
| multiple: saphenous
103
troponin I
4 hous last long (7-10 days) very speicific
104
CKMB
6-12 hours, normal in 48 hours, not so specific but good for re-infrt
105
peaked T wave in MI due to
localized hyperklemia
106
ST for transmural and subendocardial
ST elevation and depreassion
107
ECG localization
```
anteroseptal-V1V2 (LAD)
Anteroapical_v3,v4 (LAD)
Anterolateral-v5,v6 (LAD/LCX)
lateral (LCX) I, aVL
Inferrion, II, III, aVF
```
108
dyskineisa in doppler
true aneurism outward bulge during contraction
109
STEMI best Rx
percutaenous coronory intervention
110
HCM micro
myofiber disarray, interstitial fibrosis
111
DCM causes
```
A alcohol
B beri beri
C chaga
C coxB
C Cocaine
D Doxo
```
112
HOCM which walve
mitral
113
loffler syn
endomyocardial fibrosis with eosinophilic infiltrate
114
a few causes of restrictive CardioM
amylo, sarco
| post radiation endocardial fibroelastosis (endocardium of children)
115
three causes of HCM
familal -beta myosin heavy chain
fredrick
c/c HT
116
help CHF mortality
ACE beta, spironolactone (aldosterone antagonists)
117
3 problems ith CHF compen
RAA and symahethic tone ,
both increase afterload
ADH
118
primary insult in hge shock (pre, after and CO)
reduced preload (CVP low), CO less, after load more
119
primary insult in cardiogenic shock(pre, after and CO)
less CO preload and after load more
120
primary insult in obstructive shock(pre, after and CO)
less CO preload and after load more
121
primary insult in distributiee shock(pre, after and CO)
less afte load (sepsis) (note: it is a high output failure) and preload will be less
122
bacterial endocarditis 6 types and causes
```
standard aureus
IV drug arues
suba/c, diseased value viridans
prostheic epidermidid
cutlure neg coxeilla
gallolyticsu colon ca
```
123
three names in endocarditis
osler nodes
roth (retinal white)
janeway (remember picutre)
124
what GN in endocarditis
DPGN (due to immune complexes)
125
JONES
```
joint
heart
node
erytema marginatum
ydenham chorea (basal ganglia mimicry)
```
126
pericardial rub
pericarditis
127
beck triad
hypotenstion, distended neck veins and distant heart soudns
| also increase HR and pulsus pardoxus and electrical aternans
128
distended neck veins two DD
cardiac tamponade and tension pneumothorax
129
p. paradoxus and causes
no pulse in inpsiration
tamponade, const. pericarditis
asthma, cor pulomonale, obst. sleep apnoe, croup
130
classify confusing pericardium
serious: tampanade and tension
not serious: pericaridits and constrictive pericarditis
rub and knock
p. paradoxus and kuss maul in construction
131
cardiac tumors adult and children
myxoma (ball valve) mucopolysaccradie stroma
| rbabdomyoma (t. sclresosis)
132
kussmaul define
increase in JVP during inspiration instead of normal decrease
133
lymphocytes infiltrate in mycordium
viral mycocarditis
134
hepatic angeiosarcoma two causes
vinyl chorldide and arsenic
135
tumor coming ater post mastectomry lymphedema
angeiosarcoma (firm violacious noduels)
| also sun exposed and post radiation
136
vascular tumor that cause ulceration and bleeing
pyogenic granuloma
137
raynaud treatment
CCB (like prinzmetal)
138
cystic hygroma is
cvenous hemangioma of the neck
139
tocilizumab
IL-6 recepor (giant cell) CD4 T cell mediated
140
bindess and polymmyalgia rheumatica
giant cell/temporal
141
PAN vessels invllvement
viseral abd pain and melena
renal aneurism
skin purpura/livedo retinularis
(not pulmonary involvment)
142
PAN hist and Rx
transmural inlammation with firboid nexrosis
HepB+
cyclocphosphamide and seroids
143
wegners CF
URT, LRT and renal (RPGN/cresntic)
| c-ANCA (PR3)
144
microscopic polyngitis different from wegner
NO URT
p-anca (MPO)
pauciimmune GN
No granuloma (in the name)
145
peripheral neurophaty which vasculitis
```
churg strass
also pauci immune and pANCA
granuoma+
(necrotising vasculaits with granlom like wegners)
IgG and eosinophil
```
146
triad of HSP
skin purpura, abd pain and bleeding and artharlia
147
renal in HSP
IgA necphropathy (berger disease)
148
first choice of drug in HT gneral population
diretics
149
pregnancy hyper tension
hydra LMN
| lbetalol, methdy dopa, nifedipine
150
CCB for HT emergency
nicardipine and clevidipine
151
nitroprusside and hydralazine nirates, ANP and BNP and NO MOA
cGMP
152
reflex tachcardia with nitrate Rx
```
beta blocker (this is a god combination) both reduces O demand
verapamil is equal to beta blockers in effect
```
153
two patial beta agonists CI in angina
| beta for emergency HT
pindolol and acebutlol
| labetaol
154
statin what else other than HMG CoA
increase LDL receptor on liver and increased uptake
155
4 SE of statins
Hepato, myo and lactic
| gall stones with fibrates and bile acid resins (they increase choleserol syntehsis)
156
triglyerides in bile acrid resins
increase (only unexpected)
157
ezetimibe only acts on
LDL decrease
158
fibrates what after PPARgamma
upregulate LPL (increase TG clearance) and increase HDL
159
niacin MOA
reduces hepatic VLDL syntheis
160
fibrates SE
myopahty (stone with statin)
161
niacin SE
flushing (NSAIDs), red face
| hyper gly and uricmeia
162
SE CCB
flushing, edema (AV block for cardic type)
| remember verapamil is like beta blocker
163
statin not metabolized by p450
parvastatin
164
second action of digoxin
stiulate vagus
165
SE digoxin
diagrrrhoe, yellow vision, hyperkaleia and AV block and arrytmia
166
digoxin and hypokaleima
more drug binding
167
digoxin and quinidne
less clearance and diplacement
168
hypertryglyeridemia DOC
fibrates (otehrwise panreatitis)
169
AF rx
regular beta 1 blockers
| with CHF digoxin
170
classsify anti-arrythmics
Na (Activted and inactivated) inresase QRS with increased HR
beta
K (reverse use dependence)
Ca
171
1A, 1B AND 1C
disopyramide, quinidine, procainamide
lidocaine, tocainide, mexiletine
morizine, flecainide, propafenone
172
remember class I
```
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
class II moa
decreased slope of 4 and prolged repol
174
class II short acting
esmolol
175
class II indi
SVT af, aflutter
176
beta blockers are CI
phEROCHROMOCytomA, COCAIN (unoposed a1)
177
SE quinindine
cinchonism
178
SE procainamide
SLE (like isoniazid)
179
class III names
AIDS
180
amiodarone indication and SE
WPW syndrome
PFT (pul fibrosis), LFT and thyroid FT (iodine)
no torsades
hapten corneal and skin deposits
181
class III moa
increase repol
182
class 4 moa
slow depol and repol
183
adenosine moa
k out and hyperpolarize
184
interaction of adenosine
theophylline and caffiene
185
adenosine se
flushing chest pain, bronchospasm
| impending doom
186
angiolathyrism
sweet pea lysil oxidase inhibitor
| myxomatous degeneration
187
ivabradine
only rate
188
neprilysin
metalloprotease for anp and bnp
189
neprilysin inhibitor
sacubitril
