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BECOM 3 > Exam #2 > Flashcards

Exam #2 Flashcards

1
Q

Left Ventricle Hypertrophy (EKG)

A

V1-V2: deep S wave
V5-V6: tall R wave
ST-T abnormalities: V6

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2
Q

Right Ventricle Hypertrophy (EKG)

A

V1: dominant tall R wave
V5-V6: deep S wave
ST-T abnormalities: inverted T wave at V1-V3

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3
Q

Right Atrial Abnormalities (EKG)

A

Lead II: peaked P wave

Lead V1: first pos. P wave larger than second neg. P wave (80:20)

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4
Q

Coarctation of the Aorta is common found in pateints w

A

Turner Syndrome

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5
Q

4-24hrs post MI Morphological Changes

A

dark mottling - coagulation necrosis

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6
Q

1-3 days post MI Morphological Changes

A

yellow palor - neutrophil infiltrate

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7
Q

4-7 days post MI Morphological Changes

A

hyperemic border w central yellow palor - dead cells phagocytize by macrophages

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8
Q

7-10 days post MI Morphological Changes

A

yellow palor centre w depressed red-tan margins - granulation tissue at margins

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9
Q

10-14 days post MI Morphological Changes

A

red gray borders - established granulation tissues

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10
Q

> 2 months post MI Morphological Changes

A

white gray color - collagen scarring

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11
Q

Hypertrophic Cardiomyopathy causes

A

Autosomal dominant mutation in

  • B myosin chain
  • myosin binding protein C
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12
Q

Restrictive Cardiomyopathy cause

A

Amyloidosis leading to formation of B-pleaded sheets

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13
Q

heat beat box count

A 
300
150
100
75
60
50
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14
Q

AV Nodal Re-Entrant Tachycardia ECG finding

A

Retrograde P wave following the QRS complex

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15
Q

Atrioventricular Re-Entrant Tachycardia (Wolff Parkinson White syndrome) EKG

A

Short PR interval with slurred wide QRS

Delta wave

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16
Q

Orthodromic AVRT motion and ekg

A
  • through AV node then through accessory pathway back to atrium
  • Retrograde P wave after QRS complex
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17
Q

Antidromic AVRT motion and ekg

A
  • through accessory pathway then through AV node back to atrium
  • Large wide bizarre QRS followed by retrograde P wave
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18
Q

AV block 2nd Degree Mobitz Type III EKG

A

2 P wave for every 1 QRS complex

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19
Q

AV block 3rd Degree EKG

A

Loss of conduction between atria and ventricle resulting in the ventricle pacing themselves
P wave and QRS have no correlation
Normal sinus rhythm (QRS are consistent)

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20
Q

Right Bundle Branch Block EKG

A

WIDE QRS
V1: QRS will be pointing up
V1-V3: inverted T wave
V6: pos. R wave w wide S wave

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21
Q

Left Bundle Branch Block EKG

A

WIDE QRS
V1: QRS will be pointing down
V1-V3: positive T wave

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22
Q

Myoglobin used in MI

A

to assess for reperfusion after thrombolysis

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23
Q

management of MI

A

HOBANACS

Heparin 
Oxygen
Beta blocker
Aspirin
Nitroglycerin
ACE inhibitor 
Clopidogrel (antiplatelet)
Statins
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24
Q

Aortic stenosis murmur

A

(Harsh, systolic, crescendo-decrescendo murmur

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25
Q

Aortic Valve Regurgitation murmur

A

Diastolic, high pitch, blowing decrescendo murmur

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26
Q

Mitral Valve Stenosis murmur

A

Opening snap followed by mid-diastolic rumbling murmur

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27
Q

Acute Mitral Valve Regurgitation

A

S3 and systolic murmur at apex

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28
Q

Chronic Mitral Regurgitation

A

Pansytolic murmur at apex radiating to the axilla (holosystolic)

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29
Q

clinical for aortic stenosis symptoms

A

TRIAD: angina, syncope, and left sided HF

-Pulsus parvus et tardus (weak/delayed carotid pulse)

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30
Q

Aortic Valve Regurgitation features

A
  • Wide pulse pressure
  • Water hammer pulse
  • head bobbing
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31
Q

Mitral Valve Stenosis causes

A
  • rheumatic Mitral Stenosis

- pregnancy

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32
Q

Mitral valve stenosis can cause

A

Atrial fibrillation

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33
Q

Prophylaxis for endocarditis

A

standard: amoxiciliin

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34
Q

high Thyroxine leads to

A
  • increases contraction

- Increases B1 receptors on heart (increase HR)

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35
Q

high Insulin (generally insulin resistant diabetes)

A
  • high causes smooth muscle hypertrophy decreasing compliance of blood vessels
  • increase sympathetic activity
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36
Q

Hypertension Effect on Kidneys

A
  • Afferent arterial looses sensitivity to inc pressure
  • Mesangial cell proliferation: line bowman’s capsule and causes less filtration
  • Loss of Glomeruli: dec in GFR
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37
Q

Hypertension
Stage 1
Stage 2

A

Stage 1: 130-139 or diastolic 80-89

Stage 2: >140 or diastolic >90

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38
Q

Peripheral Artery Disease symptoms

A
  • pain in lower legs on exertion due to lactic build up bc low O2,
  • different BPs in different locations (should be no more than 10mm difference in different locations)
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39
Q

Microalbuminuria defintion and marker

A

early marker for renal failure

-marked increase in albumin in urine

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40
Q

Renovascular Hypertension definiton

A

obstruction of flow in the renal arteries w under perfusion of the kidney resulting in activation of RAAS

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41
Q

Renovascular Hypertension definiton key symptom

A
  • Controlled hypertension with “flash” pulmonary edema

- string of pearls on arteriogram

42
Q

Renal Parenchymal Hypertension definition and diagnosis

A

Any disease that causes renal damage can lead to increased bp leading to activation of RAAS
-Diagnosis: inc in BUN/creatinine and proteinuria

43
Q

Primary Aldosteronism

diagnosis

A

recognized by hypokalemia and high aldosterone but suppressed renin levels

44
Q

Cushing Syndrome diagnosis

A
  • Diagnosis: elevation of urine free cortisol in a 24- hour urine collection
  • Can also have weight gain, abdominal striae, truncal obesity
45
Q

Fibromuscular Dysplasia

A

irregular thickening in medial and intimal hyperplasia and fibrosis of large muscular arteries

46
Q

Hyaline arteriolosclerosis

A

plasma leaking into damaged endothelial walls resulting in vascular thickening

47
Q

Nephrosclerosis

A

hyaline arteriolosclerosis causes vessel narrowing leading to impaired renal flow and glomerular scarring

48
Q

Hyperplastic arteriolosclerosis

-appearance

A

thickening of vessel walls due to hyperplasia of smooth muscle
-“onion skin” appearance

49
Q

Atherosclerosis effects what vessels

A

lower abdominal aorta > coronary arteries > popliteal arteries > internal carotid arteries > vessels of circle of Willis

50
Q

postitive for PR3-ANCA, previously c-ANCA

A

Granulomatosis with Polyangiiti (Wegener’s granulomatosis)

51
Q

Giant Cell (Temporal) Arteritis cause and treatment

A

can lead to blindness

treat w steroids

52
Q

Polyarteritis nodosa (PAN) effects and association

A
  • effects main organs but spares the lungs

- associated with hepatitis B w deposits containing HBsAg-HBsAb complexes

53
Q

Kawasaki Disease presentation

A
  • child w red rash of palms and soles
  • red tongue
  • conjunctivitis
54
Q

positive for MPO-ANCA, previously p-ANCA

A

Eosinophilic Granulomatosis with Polyangiitisor (Churg-Strauss syndrome)

55
Q

Port wine stain association

A

distribution of trigeminal nerve are associated with Sturge-Weber syndrome

56
Q

Kaposi sarcoma cause

A

HHV-8

57
Q

Kaposi sarcoma

  • classic
  • african endemic
  • transplant associated
  • AIDS associated
A
  • Classic KS: Older men, uncommon in US
  • Endemic African KS: Typically in HIV-seronegative individuals
  • Transplant-associated KS: Occurs in solid organ transplant recipients in setting of T-cell immunosuppression
  • AIDS-associated (epidemic) KS: Is AIDS-defining illness
58
Q

Angiosarcoma

A

endothelial cell marker CD31

59
Q

HF w Reduced EF (Systolic HF) cause

A

1 CA disease

Alc
Chemotherapy

60
Q

Secondary myocarditis causes

A
  • SLE (autoimmune), medications, chemicals
  • CHEMOTHERAPIES (oxidative stress causes apoptosis)
  • COCAINE
61
Q

colon cancer endocarditis

A

Strep gallolyticus (formerly Strep bovis)

62
Q

Lemierre syndrome definition, microbe, and common location

A

endovascular infection associated with infected thrombus and bacteremia

  • Fusobacterium
  • jugular vein
63
Q

Infective Myocarditis causes

A

Adenovirus
Coxsackie
Enteroviruses
Chaga’s Disease (Trypanosoma cruzi - parasite)

64
Q

mutation in what can lead to cardiomyopathy

A

dystrophin

65
Q

Worms that effect lungs

A
  • Ascaris lumbricoides (Giant Roundworm)
  • Necator americanus/Ancylostoma duodenale(Hookworms)
  • Strongyloides sterocalis (Threadworm)
66
Q

scotch tape preparation used for

A

Enterobius vermicularis (pinworm)

67
Q

Trichinellosis source and how it looks on history

A
  • walrus, pork, bear

- spiral appearance

68
Q

Gallbladder Cancer fluke

Bladder Cancer fluke

A
  • Gallbladder Cancer: Clonorchis sinesis

- Bladder Cancer: Schistosoma

69
Q

high affinity for b12

A

Diphyllobothrium latum

70
Q

Taenia solium vs T. saginata

A
  • Taenia solum (soo bad): can lead to Cysticercosis which is a tissue infection (cysts) that can lead to neurocysticercosis
  • Taenia saginata (not-so-bad) - localized in intestines
71
Q

cause lymphatic filariasis

A

Wuchereria bancrofti
Brugia malayi
Brugia timori

72
Q

Differentiate Loa loa and Onchocerca volvulus in terms of their respective vectors, clinical presentation, and likelihood of causing vision loss

A

Loa Loa

  • Vector: Deer fly and Crysops (mango fly)
  • Clinical Presentation: Calabar swellings,
  • Vision Loss: NO

Onchocerca volvulus

  • Vector: Simulium flies (blackfly or buffalo gnat)
  • Clinical Presentation: nodules in dermis and subcutaneous tissue
  • Vision Loss: YES
73
Q

Dracunculus medininsis treatment

A

Extract worm slowly 1 cm per day

74
Q

Rapid Fermenters

A

E. Coli
Klebsiella
Enterobacter

75
Q

Slow Fermenters

A

Citrobacter

Serratia

76
Q

fermenters appearance on MacConkey agar

A

purple/pink

77
Q

symptoms of Pseudomonas aeruginosa

A 
(BE PSEUDO)
B urns
E ndocarditis
P neumonia
S epsis
E xternal otitis
U TI
D rug use
O steomyelitis
78
Q

Pseudomonas aeruginosa

  • Oxidase
  • Smell
A

Oxidase POSITIVE

Odor: GRAPES

79
Q

Red pigments

A

Serratia

80
Q

Currant jelly sputum

A

Klebsiella pneumoniae

81
Q

Rose Spots

A

Salmonella typhi

82
Q

Hotel air-conditioner cooling tank

A

Legionella

83
Q

GNR that causes Hyponatremia

A

Legionella

84
Q
  • obligate anaerobe
  • Infections usually follows breach of mucosal barrier
  • Commonly found with E. col/GNRs
A

Bacteroides fragilis

85
Q

Describe the classical presentation of Salmonella typhi and how it differs from infection with non-typhoidal strains of Salmonella

A

Salmonella typhi
Presentation: classically seen with rose spots, high fever, and slow pulse pressure
Non-typhoidal strains normally present with nausea, vomiting, cramps, and bloody diarrhea but NO fever

86
Q

E. coli 0157:H7 most commonly and symptoms

A

EHEC

HUS
Thrombocytopenia
Acute renal failure (uremia)

87
Q

Positive Fecal Leukocyte Test

A

EIEC, Salmonella, Shigella

88
Q 
EHEC: 
EIEC:
EPEC: 
ETEC: 
characterization
A

EHEC: hemorrhagic
EIEC: shigella like toxin
EPEC: children’s diarrhea
ETEC: traveler’s diarrhea (clear, watery)

89
Q

Ehrlichia vs Anaplasma

  • tick
  • cell type
A

Ehrlichia: monocyte
- Lone Star Tick
Anaplasma: neutrophil
- Ixodes scapularis

90
Q

Bartonellosis
Oganism:
Animal Vector:
Presentation:

A

Oganism: Bartonella henselae
Animal Vector: cats (fleas)
Presentation: erythemous and swollen where cat scratched leading to regional lymphadenopathy
Chronic: red striations (similar to stretch marks)

91
Q

Brucellosis
Oganism:
Animal Vector:

A

Brucellosis
Oganism: Brucella melintensis
Animal Vector: goats/sheep, cows, pigs and dogs (meat processor0

92
Q

Psittacosis
Oganism:
Animal Vector:

A

(“Parrot Fever”)
Oganism: Chlamydophila psittaci
Animal Vector: parrot feces (pet store owner)

93
Q

Q fever
Oganism:
Animal Vector:

A

Oganism: Coxiella burnetiI

Animal Vector: Goats, Sheep and Cattle

94
Q

Tularemia
Oganism:
Animal Vector:
Presentation

A

Oganism: Francisella tularensis
Animal Vector: rabbits, ticks, deer flies
Presentation: ulceroglandular form most common
cyclical fever, skin ulcers where contact was made, and swollen/painful regional lymphadenopathy
pneumonic is most serious form

95
Q

Pasteurellosis
Oganism:
Animal Vector:
Presentation:

A

Oganism: Pasteurella multocida
Animal Vector: normal mouth flora of cats and dogs
Presentation: Rapid onset of pain, tenderness, swelling/erythema following scratch or bite

96
Q

conjunctival suffusion

A

Conjunctival Suffusion: appears early in Weil’s disease which leads to liver damage (jaundice), renal failure, & bleeding
-leptospirosis

97
Q

Explain how leptospirosis is transmitted, describe a classical case

A
  • Transmission: infected animals shed in urine and contaminates water
  • Classic Case: surfer/swimmer in tropics (freshwater)
98
Q

Match the pathogens, vector and illness name for the three rickettsias discussed in class

A

R. prowazekii (Epidemic typhus)
Vector: body lice

R. typhi (Murine typhus)
Vector: Rat flees

R. rickettsia (Rocky Mountain Spotted Fever)
Vector: Dog Tick (Dermacentar

99
Q

list the triad of symptoms caused by RMSF

A 
R. rickettsia 
Triad of Symptoms:
-Headache
-Fever 
-Rash: starts on wrist and spreads everywhere (includes palms and soles)
100
Q

Identify the cause of bubonic plague and its vector; describe a Bubo.

A

Yersinia pestis
Vector: rat/prairie dog/ squirrel flea bites

Bubos: intense swollen lymph nodes

  • Erythema and edema of overlying skin
  • Inguinal region most frequent
101
Q

Turbulence equation

A

velocity x vessels diameter x blood density / viscosity

102
Q

moderate/severe mitral regurg can lead to

A

diastolic murmur

BECOM 3 (8 decks)

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