Day 7.1 Cardio Flashcards
4 drugs used to treat tinea capitis or pubis
Pyrmethrin
Pyrethin
Lindane (but it’s neurotoxic)
Melathium
Organism in animal urine
Leptospira Hanta virus (rat/mouse urine)
Drug w best effect on:
HDL
LDL
TGs
Raises HDL: Niacin
Lowers LDL: Statins (HMG coA reductase inhib)
Lowers TGs: Fibrates (2nd- omega3 FA)
Murmur: mitral/tricuspid regurg (MR/TR)
Heard from S1 all the way to S2.
Holocystic, high-pitched “blowing murmur”
Mitral: loudest at apex, radiates to axilla
Enhanced by things that increase TPR (squatting, hand grip) or by increased LA return (expiration)
Tricuspid: loudest at tricuspid area, radiates to right sternal border
Enhanced by maneuvers that increase RA return (inspiration)
What are the causes of mitral and tricuspid regurg?
MR: ischemic heart dz mitral valve prolapse LV dilation rheumatic fever endocarditis
TR:
RV dilation
Endocarditis
Rheumatic fever
Murmur: Aortic stenosis
B/t ejection click and S2 (ejection click is shortly after S1)
Crescendo-decrescendo systolic ejection murmur after ejection click. (ED is d/t abrupt halting of valve leaflets)
LV prs»_space; aortic prs during systole
Radiates to carotids/apex
Heard in aortic area
“Pulsus parvus et tardus”- pulses are weak compared to heart sounds. Can lead to syncope.
Causes of aortic stenosis
Age-related calcific aortic stenosis
Bicuspid aortic valve
Murmur: VSD
Heard from S1 all the way to S2
Holocystolic, harsh sounding murmur
Loudest at tricuspid area
Murmur: mitral prolapse
From mid-systolic click to S2. (MC is halfway thru S1 and S2)
Late systolic crecendo murmur w midsystolic click. (MC is due to sudden tensing of chordae tendineae)
Most frequent valvular lesion
Loudest at S2 (bc crescendos up to it)
Usu benign
Can predispose to infective endocarditis (only if there is mitral regurg assoc w it. give abx before dental procedures)
Enhanced by maneuvers that increase TPR (squatting, hand grip)
What can cause mitral prolapse?
Myxomatous degeneration
Rheumatic fever
Chordae rupture
Murmur: Aortic regurg
Starts at S2
Immediate high-pitched “blowing” diastolic murmur
Wide pulse prs when chronic
Can px w bounding pulses and head throbbing
Cause of aortic regurg
Aortic root dilation (syphilis, Marfan’s)
Bicuspid aortic valve (but this is more characteristic of stenosis, not regurg)
Rheumatic fever
Murmur: mitral stenosis
After the Opening Snap (which is even after S2)
Follows opening snap (OS d/t tension of chordae tendineae)
Delayed rumbling late diastolic murmur
LA prs»_space; LV prs during diastole
Enhanced by maneuvers that increase LA return- expiration (vs split S2 sound, which is enhanced by INspiration)
What can cause mitral stenosis?
Often secondary to rheumatic fever
Chronic MS can result in LA dilation
Murmur: PDA
Continuous- from S1 to S2 and beyond, but most at S2
Continuous machinery-like murmur
Loudest at S2
What murmur can be heard best at the tricuspid area?
Pan-systolic:
Tricuspid regurg
VSD
Diastolic:
Tricuspid stenosis
ASD
What murmurs are enhanced when TPR is increased?
Mitral regurg
Mitral prolapse
What murmur is enhanced when LA return is increased?
Mitral regurg
Mitral stenosis
What murmurs can be d/t Rheumatic Fever?
Mitral regurg Mitral stenosis Aortic regurg Aortic stenosis Tricuspid regurg Mitral prolapse
What murmurs are loudest at S2?
Mitral prolapse
PDA
What are the diastolic murmurs? (After S2)
Aortic regurg
Mitral stenosis (late, after OS)
PDA is continuous, so can hear in both diastole and systole
What are the systolic murmurs? (B/t S1 and S2)
Mitral regurg Tricuspid regurg VSD PDA (continuous) Aortic stenosis (after EC) Mitral prolapse (late, after MC)
What sounds are d/t sudden tensing of chordae tendineae?
Midsystolic click (systole) Opening snap (diastole)
What do S1 and S2 heart sounds represent?
S1 = Mitral valve closure
S2 = Aortic valve closure
Between them is systole (contraction)