⭐️INTERNAL MEDICINE Flashcards
Formula for cardiac output
CO = HR x SV
Formula for BP
BP= CO x TPR
Formula for pulse pressure
Systole-diastole
Formula for mean arterial pressure
1/3 systole + 2/3 diastole
Normal pressure at the large arteries
<120/80
Normal pressure at the systemic capillaries
17mmhg
Normal pressure at the vena cava
0 mmhg
Normal pressure at the pulmonary artery
25/8
Normal pressure at the pulmonary capillaries
7 mmhg
Physiologic basis of the T wave
Ventricular repolarization
Two types of 2nd degree AV block
MOBITZ I- prolongation of PR before dropped QRS
Mobitz II - no prolongation of PR before dropped QRS
Mnemonic: roman numeral I getting bigger and II with equal heights :)
Most efficient extractor of oxygen from the blood
Heart
Most metabolic organ
Brain
An increase in venous return will increase heart rate
Bainbridge reflex
An increase in venous return will increase stroke volume
Frank-Starling mechanism
AV block that causes fainting due to the initially suppressed state of the Purkinje fibers
Stokes-Adams syndrome
Cushing reflex
Hypertension, irregular respirationand bradycardia due to activation of the CNS ischemic response and baroreceptor reflex in patients with increased intracranial pressure.
Define. White coat hypertension
3 clinic based blood pressures >140/90
2 non-clinic blood pressure <140/90
Absence of target organ damage
Define. orthostatic hypertension
Fall in SBP>20mmhg or dbp >10mmhg in response to change in posture from a supine to an upright position within 3 minutes
Define. Resistant hypertension.
Blood pressure persistently >140/90 mmhg despite taking >3 antihypertensive agents, including a diuretic.
Define. Chronotropic incompetence.
Failure to appropriately increase heart rate during exercise.
Unable to achieve 85% of predicted maximal heart rate at peak exercise.
Chest discomfort associated with physical exertion or stress, Relieved within 5~10 min by rest and/or sublingual nitroglycerin
Stable angina pectoris
What is unstable angina?
Angina pectoris with at least one of three features:
1. Occurs with minimal exertion or at rest, usually lasting >10 min
- Severe and of new onset (within the prior 4-6 weeks)
- Has a crescendo pattern (i.e., distinctly more severe, prolonged, or frequent than previous)
How do you elicit abdominojugular reflux?
Apply pressure on the right upper quadrant for 10 seconds. Positive response: rise of > 3cm in JVP for at least 15 seconds after release of pressure.
Holosystolic murmur of tricuspid regurgitation becomes louder during inspiration and diminishes during expiration
Carvallo’s sign
Murmur of aortic stenosis is transmitted downward to the apex (Confused with the systolic murmur of mitral regurgitation)
Gallavardin effect
High-pitched, diastolic, decrescendo blowing murmur along the left sternal border due to the dilation of the pulmonary valve ring
Occurs in mitral valve disease and severe pulmonary hypertension
Graham steel murmur of pulmonary regurgitation