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CVS Flashcards

1
Q

Young Liver Synthesizes Blood

A

Yolk sac (3-8wks)

Liver (6wks-birth)

Spleen (10-28wks)

Bone marrow (18wks-adult)

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2
Q

SA and AV node supplied by what blood vessel

A

RCA

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3
Q

CO=

A

SV x HR

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4
Q

Fick principle

CO=

A

Rate of O2 consumption / (arterial O2 content - venous O2 content)

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5
Q

MAP=

A

CO x TPR

2/3 DP + 1/3 SP

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6
Q

SV=

A

EDV-ESV

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7
Q

SV affected by CAP

A
  • Contractility
  • Afterload
  • Preload
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8
Q

Contractility (and SV) increased with (4)

A
  1. Catecholamines: increasing Ca pump activity
  2. Increase intracellular Ca
  3. Decrease extracellular Na
  4. Digitalis
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9
Q

Contractility (and SV) decreased with (5)

A
  1. β-blockers
  2. HF and systolic dysfunction
  3. Acidosis
  4. Hypoxia/hypercapnea
  5. Ca channel blockers
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10
Q

What decreases preload

A

Venodilators (Nitroglycerin)

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11
Q

What decreases afterload

A

Vasodilators (Hydralazine)

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12
Q

Ejection Fraction (EF)=

A

SV/EDV

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13
Q

Aortic area systolic murmur is due to

A

Aortic stenosis

Flow murmur

Aortic Valve sclerosis

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14
Q

Pulmonic area systolic ejection murmur heard in

A

Pulmonic stenosis

Flow murmur

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15
Q

Tricuspid area pansystolic murmur heard in

A

Tricuspid regurgitation

Ventricular spetal defect

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16
Q

Tricuspid area diastolic murmur heard in

A

Tricuspid stenosis

ASD

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17
Q

Hand grip (increased vascular resistance) increases intensity of all murmurs excpet

A

ASD

Hypertrophic cardiomyopathy

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18
Q

P wave represents

A

Atrial depolarization

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19
Q

PR interval represents

A

Conduction delay through AV node

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20
Q

QRS complex represents

A

Ventricular depolarization

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21
Q

QT interval represents

A

Mechanical contraction of the ventricles

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22
Q

T wave represents

A

Ventricular repolarizatioin

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23
Q

ST segment represents

A

Isoelectric, ventricles depolarized

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24
Q

U wave represents

A

Caused by hypokalemia and bradycardia

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25
Q

Some Risky Meds Can Prolong QT

A
  1. Sotalol
  2. Risperdone
  3. Macrolides
  4. Chloroquine
  5. Protease inhibitors (-navir)
  6. Quinidine
  7. Thiazides
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26
Q

Romano-Ward syndrome is

A

AD congenital long QT syndrome

Pure cardiac

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27
Q

Jervell and Lange-Nielsen syndrome

A

AR congenital long QT syndrome

Sensorineural deafness

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28
Q

What causes 3rd degree (complete) heart block

A

Lyme disease

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29
Q

Vagus N in aortic arch responds to

A

Only increase BP

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30
Q

Glossopharyngeal N in Carotid sinus responds to

A

Increase and decease in BP

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31
Q

Hypotension sequence on Baroreceptors

A
  • Decrease in arterial P causes decrease in stretch leading to decrease afferent baroreceptor firing
  • Leads to increase efferent sympathetic firing and decrease efferent parasympathetic stimulation
  • Leads to:
  1. Vasoconstriction
  2. Increase HR
  3. Increase contractility
  4. Increase BP
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32
Q

Carotid massage affecet on Baroreceptor

A
  • Increase P on carotid sinus causes increase stretch leading to increase baroreceptor firing
  • Increases AV node refractory period and decrease HR
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33
Q

Transposition of great vessels seen in

A

Infants of Diabetic mothers

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34
Q

Tetralogy of Fallot PROVe

A
  1. Pulmonary infundibular stenosis
  2. RVH
  3. Overriding aorta
  4. VSD
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35
Q

Infantile type Coarctation of the aorta associated with

A

Turner syndrome

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36
Q

MC locations of Atherosclerosis

A
  1. Abdominal aorta
  2. Coronary A.
  3. Popliteal A
  4. Carotid A
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37
Q

Thoracic aortic aneurysm associated with

A

HT

Marfan

3o syphilis

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38
Q

Leads V1-V4 with Q wave means infarct in

A

Anterior wall (LAD)

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39
Q

Leads V1-V2 with Q wave means Infarct in

A

Anteroseptal (LAD)

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40
Q

Leads V4-V6 with Q wave means infarct in

A

Anterolateral (LAD or LCX)

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41
Q

Leads I and aVL with Q waves means infarct in

A

Lateral wall (LCX)

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42
Q

Leads 2, 3 and avF with Q wave means infarct in

A

Inferior wall (RCA)

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43
Q

ABCCCD of Dilated Cardiomyopathy

A
  1. Alcohol abuse
  2. Beriberi
  3. Coxsackie B
  4. Cocaine
  5. Chagas
  6. Doxorubicin
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44
Q

Endocardial fibroelastosis is

A

Restrictive cardiomyopathy with thick fibroelastic tissue in young children

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45
Q

Löffler syndrome is

A

Restrictive cardiomyopathy with prominent eosinophilic infiltrate

46
Q

What cardiomyopathy causes decrease EF

A

Systolic dysfunction

Dilated cardiomyopathy

47
Q

Roth spots are

A

Round white spots on retina surrounded by hemorrhage seen in Bacterial endocarditis

48
Q

Osler nodes are

A

Tender raised lesions on finger or toe pads seen in Bacterial endocarditis

49
Q

Janeway lesioins are

A

Small painless, erythematous lesions on palm and sole seen in Bacterial endocarditis

50
Q

Negative-culture bacterial endocarditis caused by

A

Coxiella burnetii

Bartonella

51
Q

Bacterial endocarditis FROM JANE

A
  • Fever
  • Roth spots
  • Osler nodes
  • Murmur
  • Janeway lesion
  • Anemia
  • Nail-bed hemorrhages
  • Emboli
52
Q

Findings in Cardiac tamponade

A
  1. Beck triad
  2. Increase HR
  3. Pulsus paradoxus
  4. Kussmaul sign
53
Q

Beck triad is

A
  1. Hypotension
  2. Distended neck V
  3. Distant heart sound
54
Q

Kussmaul sign is

A

Increase in JVP on inspiration instead of normal decrease

55
Q

Kussmaul seen in

A
  1. Constrictive pericarditis
  2. Restrictive cardiomyopathies
  3. Right atrial or ventricular tumore
56
Q

Pyogenic granuloma is

A

Polypoid capillary hemangioma that can ulcerate and bleed

57
Q

Pyogenic granuloma associated with

A

Trauma and pregnancy

58
Q

Cystic hygroma is

A

Cavernous lymphangioma of the neck

59
Q

Cystic hygroma seen in

60
Q

Temporal arteritis associated with

A

Polymyalgia rheumatica

61
Q

Churg-Strauss syndrome is

A

Vasculitis with:

  1. Asthma
  2. Sinusitis
  3. Palpable purpura
  4. Peripheral neuropathy (wrist/foot drop)
62
Q

Churg-Strauss path

A

Granulomatous necrotizing vasculitis with eosinophilia

63
Q

Henoch-Schönlein purpura path

A

Vasculitis 2o to IgA complex deposition

Associated with IgA nephropathy

64
Q

Henoch-Schönlein purpura classic triad

A
  1. Skin: palpable purpura on buttocks/legs
  2. Arthraligias
  3. GI lesions
65
Q

Henoch-Schönlein purpura often follows

66
Q

How do you treat Primary (essential) HT (4)

A
  1. Diuretics
  2. ACEi
  3. ARBs
  4. Ca channel blockers
67
Q

How do you treat HT with CHF (4)

A
  1. Diuretics
  2. ACEi/ARBs
  3. β-blockers
  4. Aldosterone antagonist
68
Q

How do you treat HT with DM (5)

A
  1. ACEi/ARBs
  2. Ca channel blockers
  3. Diuretics
  4. β-blocker
  5. α-blocker
69
Q

Mechanism of Ca channel blockers (-dipine + Diltiazem, Verapamil)

A

Block voltage-dependent L-type Ca channels reducing muscle contractility

70
Q

What Ca channel blocker given for subarchnoid hemoorhage

A

Nimodipine

71
Q

Ca channel blocker toxicity (6)

A
  1. AV block
  2. Edema
  3. Flushing
  4. Dizziness
  5. Hyperprolactinemia
  6. Constipation
72
Q

Hydralazine mechanism of action

A

Increase cGMP causing smooth muscle relation

Vasodilates arterioles > veins

Afterload reduction

73
Q

What is the first line therapy for HT in pregnancy

A

Hydralazine and methyldopa

74
Q

Hydralazine toxicity

A

Lupus-like

75
Q

What is the goal of antianginal therapy

A

Reduction of myocardial O2 consumption

76
Q

Affect of Nitrates on EDV

77
Q

Affect of nitrates on BP

78
Q

Affect of Nitrates on contractility

A

Increase due to Reflex response

79
Q

Affect of Nitrates on HR

A

Increase due to reflex response

80
Q

Affect of Nitrates on Ejection time

81
Q

Affect of β-Blocker on EDV

82
Q

Affect of β-Blocker on BP

83
Q

Affect of β-Blocker on Contractility

84
Q

Affect of β-Blocker on HR

85
Q

Affect of β-Blocker on Ejection time

86
Q

Affect of β-Blocker + Nitrate on EDV

A

No effect or a slight decrease

87
Q

Affect of β-Blocker + Nitrate on BP

88
Q

Affect of β-Blocker + Nitrate on contractility

A

Little to no effect

89
Q

Affect of β-Blocker + Nitrate on HR

90
Q

Affect of β-Blocker + Nitrate on Ejection time

A

Little to no effect

91
Q

What β-Blocker contraindicated in Angina and why

A

Pindolol and Acebutolol because they are Partial agonists

92
Q

-Statins are

A

HMG-CoA reductase inhibitors

93
Q

-Statin affect on lipds

A

Greatly decrease LDL

Slight increase in HDL

Slight decrease in TG

94
Q

-Statin toxicity

A

Hepatotoxicity

Rhabdomyolysis

95
Q

Niacin mechanism of action

A

Inhibit lipolysis in adipose tissue reducing hepatic VLDL synthesis

96
Q

Niacin affec on lipids

A

Moderate decrease in LDL

Moderate increase in HDL

Slight decrease in TG

97
Q

Niacin toxicity

A

Hyperglycemia (acanthosis nigricans)

Hyperuricemia (exacerbates gout)

98
Q

Ezetimibe mechanism of action

A

Prevents cholesterol absorption at small intestine brush border

99
Q

Ezetimibe affect on lipids

A

Moderate decrease in LDL

100
Q

Gemfibrozil + -Fibrate mechanism of action

A

Upregulate LPL leading to Increase TG clearance

Activates PPAR-α to induce HDL synthesis

101
Q

Gemfibrozil + -Fibrate affect on lipids

A

Slight decrease in LDL

Slight increase in HDL

Great decrease in TG

102
Q

Digoxin toxicity (6)

A
  1. Blurry yellow vision
  2. Increase PR
  3. Decrease QT
  4. T-wave inversiton
  5. Arrhythmia
  6. AV block
103
Q

What decreases Dioxin clearance

A
  1. Verapamil
  2. Amiodarone
  3. Quinidine
104
Q

Toxicity of Class 1A antiarrhytmics (5)

A
  1. Cinchonism
  2. SLE-like
  3. HF
  4. Thrombocytopenia
  5. Torades due to Increase QT
105
Q

Class 1A antiarrhythmics are

A

Na channel blcokers

  1. Quinidine
  2. Procainamide
  3. Diopyramide
106
Q

Class 1A antiarrhythmics MOA

A

Increase AP duration

Increase effective refractory period

Increase QT interval

107
Q

Class 1B antiarrhythmics MOA

A

Decrease AP duration

108
Q

Class 2 Antiarrhythmics are

A

β-Blockers

109
Q

Class 2 antiarrhythmics toxicity

A

Impotence

COPD/asthma exacerbated

May mask signs of hypoglycemia

110
Q

Class 3 Antiarrhythmics are

AIDS

A

K channel blockers

  • Amiodarone
  • Ibutilide
  • Dofetilide
  • Sotalol (also β-Blocker)
111
Q

Class 4 antiarrhythmics are

A

Ca channel blockers

  1. Verapamil
  2. Diltiazem

First Aid (16 decks)

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