DIT Cardiology part 2

Question 1

What causes smooth muscle relaxation?

Answer 1

activated myosin phosphatase (removes phosphate from myosin, so opposite of myosin light chain kinase)

That is activated by cGMP! which is done by NO activating gunylyl cyclase from arginine and nitrates)

Question 2

Type A dissection vs type B? Mnemonic alert.

Tx for each

Answer 2

Type A invovles Ascending Aorta

Type B is Beyond the Branches

A is emergency surgery
B is medical treatment

GIVE BETA BLOCKERS to decrease slope of increase of BP so each beat pounds it, and this decreases intensity of rise of BP

Question 3

aliskiren?

Answer 3

renin inhibitor

Question 4

What drugs are for HTN in preggers? mnemonic alert

Answer 4

Hypertensive Moms Love Nifedipine

Hydralazine
Methyldopa
Labetalol
Nifedipine

Question 5

Minoxidil mechanism?

Answer 5

Opens potassium channel and hyper polarizes smooth muscle to cause relaxation of smooth muscle.

Severe HTN

Question 6

Patient has no ST elevation but chest pain and a new LBBB. What is it?

Answer 6

NSTEMI. Would still have cardiac markers.

Question 7

What does a Q wave mean?

Answer 7

Evolving or previous infarct

Question 8

What can cause dilated cardiomyopathy? Mnemonic

Answer 8

ABCCCCD

Alcohol abuse
Ber1 Ber1 (wet, thyamine)
Chronic cocaine and booze
Chronic myocardial ischemia
Coxsackie B
Chagas (everything big with chagas)
Doxorubicin
Hemachromatosis

Question 9

Hypertrophic cardiomyopathy clinical findings?

Histology?

Answer 9

Autosomal dominant

Lateral highest impulse
S4
Aortic stenosis b/c hypertrophied septum interferes withouflow MURMUR WORSE WITH VALSALVA (only time that happens)

Histo: disarrayed fibers

Question 10

If you hear Loffler, what do you think?

Answer 10

eosinophils. In this case, can cause restrictive cardiomyopathy

Question 11

What are causes of restrictive cardiomyopathy? Mnemonic alert:

Answer 11

LEASH to restrict your heart

Loffler
Endocardial fibroelastosis (congen)
Amyloidosis
Sarcoidosis
Hemochromatosis

Question 12

What is libman sacks endocarditis?

Answer 12

SLE causes LSE

Sterile vegitations on both sides of valve (unlike infective which is normally just one side of the valve)

Question 13

What are aschoff bodies?

Anitschkow bodies?

Answer 13

granuloma with giant cell in the heart with Rheumatic heart disease

Macrophage with ovoid wavy rod like nucleus

Question 14

What causes kussmaul sign?

Answer 14

JVD with inspiration is from CHRONIC CONSTRICTIVE PERICARDITIS (usually lupus)

b/c decreased capacity of RV

Question 15

Tumor in heart in adults?

In kids? (association)?

Answer 15

Left atrial myxoma

Rhabdomyoma: TUBEROUS SCLEROSIS (the R in Hamartomas mnemonic). Along with astrocytoma and angiomyolipoma.

Mets are lymphoma and melanoma

Question 16

Vasculitis in asthmatic?

Answer 16

Churg Strauss

Question 17

Arthralgia, plapable purpura on butt and legs with GI pain? Followed URI?

Answer 17

Henoch Schonlein

IgA complex deposition

IgA nephropathy can come with it (from the URI)

Question 18

Hep B with vasculitis?

Tx?

Answer 18

Polyarteritis Nodosa

Corticosteroids wither without cyclophosphamide (same tx as wagerers)

Question 19

Temporalis wasting adnd big pulsating temporal artery?

Answer 19

temporal giant cell arteritis and tx with corticosteroids

Question 20

Low pulse of arms with young asian women? Night sweats, arthritis and myalgia?

Answer 20

Takayasu arteritis (basically same as gian tecll arteritis) just of Aorta (lots of A’s)

Corticosteroids is tx

Question 21

Strawberry hemangioma?

Answer 21

Benign hemangioma of cutaneous surface of capillaries in infants

Spontaneously regresses.

DONT CONFUSE WITH PORT WINE STAIN (darker and won’t go away)

Question 22

Pyogenic granuloma?

Answer 22

Raised capillary hemangioma and associated with preggers/trauma

Question 23

Cystic hygroma?

Answer 23

cavernous lymphangioma of neck associated with Turner syndrome

Question 24

Glomus tumor?

Answer 24

benign painful tumor under fingernails

Question 25

Describe kaposi sarcoma in older men vs AIDS?

Answer 25

Endothelial malignancy. Prolif of vessels and/or lymphatics

Mistaken for bacillary angiomatosis.

Most common in HIV and HHV8: NEED TO BIOPSY

Question 26

Angiosarcoma?

Answer 26

Blood vessel malignancy in face, scalp, neck and breast

Associated with prior radiation therapy

Question 27

High Yield vasculitis q’s on pg 185 of DIT

Answer 27

Nice.