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Z - M2 Cardiology > M2 Cardiology Formatives Key Points > Flashcards

M2 Cardiology Formatives Key Points Flashcards

1
Q

Point on ECG Corresponding to Ventricle Ca+ Rise

A

QRS

Week 1

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2
Q

Soft S1 Causes (4)

A

Leaflets Close Together

1) Long PR (1st Degree AV Block)
2) Severe Mitral Stenosis
3) Mitral Regurgitation
4) HTN (LVH)

Week 1

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3
Q

Loud S1 Causes (3)

A

Leaflets Far Apart

1) Mild Mitral Stenosis
2) Short PR (Junctional Escape Rhythm)
3) High CO (Tachycardia for anemia/exercise)

Week 1

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4
Q

Causes of Pathological S2 Splitting (3)

A 
Fixed = ASD
Widened = RBBB + Pulmonic Stenosis
Paraxodical = LBBB + Aortic Stenosis

Week 1

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5
Q

S3 vs. S4 in CHF

A 
S3 = Systolic Heart Failure 
S4 = Diastolic Heart Failure

Week 1

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6
Q

Long QT - Key Points (3)

A

1) Not Hypercalemia (Hypo)
2) Long Duration AP
3) Increase HR = Decrease Long QT

Week 1

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7
Q

Isoprotenenol Keys (3)

A

1) Increase Chronotropy + Inotropy without Increase BP (decreases peripheral resistance
2) Not good for shock (no increase in BP)
3) Beta Selective

Week 1

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8
Q

Alpha Blockers - Uses (4)

A

Resistant HTN
Pheochromocytoma
BPH
HTN Crisis

Week 1

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9
Q

Phenylephrine Keys (2)

A

A1 Agonist - Used in Neurogenic Shock + Nasal De-congestion
Will Increase HTN/MI/Stroke

Week 1

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10
Q

AE of Beta Blocker (4) vs. Alpha Blocker (2)

A

Alpha - Increased Ocular Pressure + Arrythmias
Beta - Bronchoconstriction + AV Block + HF + Sleep Issues

Week 1

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11
Q

Elderly HTN (3) vs. Young HTN (3)

A

Elderly - Systolic with high pulse pressure + loss of vessel compliance
Young - Diastolic with low pulse pressure + increased risk of secondary cause

Week 1

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12
Q

Hypovolemic Shock vs. Cardiogenic Shock vs. Septic - Swanz Ganz Changes

A

Hypovolumic - All Decrease (RA/RV + PA + Wedge)
Cardiogenic - All Increase (RA/RV + PA + Wedge)
Septic - No Change

Week 1

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13
Q

Hydralazine - Key Points (3)

A

1) Vasodilator (NO Release)
2) Secondary/Resistant HTN in Africans
3) Pregnancy HTN with A-Methyldopa
4) SE = Headache + Symp Stim (Palpitation + High HR)

Week 1

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14
Q

Adenosine - Key Points - Uses + Toxicity (4) + Contraindications (3)

A

1) First line for Supraventricular Tachycardia (Reentry + AVNRT + AVRT (Orthodontic) + Atrail Tachy)
2) Used with Vagal Massage + Valsalva
Toxicity = Chest Pain + Nausea + Flushing (Short-Lived) + Bronchspasm (Severe)
Contraindicated in Heart Transplant + Wide QRS + COPD

Week 2

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15
Q

Steps for Supraventricular Tachycardia Treatment (4)

A

1) Vagal Massage + Valsalva
2) Adenosine
3) Class IV (Ca-Block) - Recurrent
4) Class II (B-Block) - Recurrent - AVNRT more than AVRT

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16
Q

Treatment of Afib - #1 Option

A

1C - Flex

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17
Q

Treatment of Post MI V-Tach - #1 Option

A

1B - Lidocaine - Reduced Abnormal Automaticity

18
Q

Treatment of Post MI V-Tach - 2/3/4 Option

A 
1 = Lidocaine 
4 = Amilodine (III) + B-Block - Get Defibilator in!
19
Q

Torsades Drugs (3)

A

Levofloxan + IA + III (Less with Amilodine)

20
Q

Monomorphic V-Tach - Cause + 2 ECG Features

A

Reentry = #1 Cause
Normal Similar QRS with Regular Rate vs. Polymorphic (Caning QRS with Irregular Rate)

Week 2

21
Q

Reentry - V-Tach - Associated ECG + 3 Main Criteria + Result

A 
ECG = Monomorphic with Regular Rate/QRS
3 Main Causes Criteria for Reentry 
1) Multiple Parallel Pathways 
2) Unidirection Conduction Block
3) Conduction time (CT) > Effective Refractory Period (ERP)

Result = Unidirection block through a branch point with delay conduction that allows reentry formation

Week 2

22
Q

<24 Hours Post MI - Histopathology

A

Wavy fibers with edema - Then Coagulative Necrosis

Week 2

23
Q

Hypertrophic Cardiomyopathy - Histopathology

A

Myofiber Disarray (not in series)

Week 3

24
Q

Myocardial Demand Factors
Increase (3) + 4 Pathologies
Decrease (1) + 1 Pathology

A

Increase O2 Demand
Increase Ventricular Wall Stress + HR + Contracility
Pathology
Aortic Stenosis + HTN (High Pressure)
Mitral + Aortic Regurg (Increase LV FIlling + Radius)
All Decreased by Nitrates (Left Wall Stress + Volume Decreased by vasodilation)

Decrease O2 Demand
Increased Wall thinkness = Dereased O2 Demand
LVH = Less O2 Consumption

Week 2

25
Q

Nitrates - Specific Mechanism (3)

A

Decrease LV Wall Stress
Decease LV Volume
Increase Systemic Venous Reserve/Capacitance (Preload)

Week 2

26
Q

Mitral and Aortic Stenosis - Most Common Causes

A

Mitral - Rhemuatic Fever
Aortic - Age > 65 = Calcium
Aortic - Age - 65-40 Bicuspid AV (or Rheumatic with fusion of the commisure)

Week 2

27
Q

SLE Causes Drugs (2)

A

Procaimide + A-Methyldopa

28
Q

Toursades des Pointes - Pathophysiolgoy + Causes (4)

A

Triggered Activity - Early Afterdepolarizations
Long QT

Congential Long QT
Hypokalemia
Hypomagnesium
Anti-Arrhythmia Drugs - IA + IC + III

Week 2

29
Q

Infectious Endocarditis - Key Signs/Sympomts (8)

A

1) Murmur (Mitral or Aortic)
2) Patechiae
3) Nail BEd Hemorrhage
4) Rential Hemorrhage (Roth Spot)
5) Immune Mediated Vasculitis
6) Painless Palm Lesion - Janeway
7) Painful Finger Tip Nodes - Osler

30
Q

Hypoplastic Left Heart Syndrome - Key Points (5)

A

1) Slit Like Left Ventricle with Atretic Valves
2) PFO + ASD
3) Ventricular Septum Intact
4) PDA Keeps the patient alive (PFO brings blood back + PDA gets it to circulation)
5) Early Cyanosis

31
Q

Sudden Death - Think MI - 4-24 Hour Pathology

A

1) Contraction Band Coagulative Necrosis

Nuclei Out + “blurry” myocytes with internal white lines

32
Q

Acute Rhematic Fever - Presentation (2)

A

Aschoff Body = Big Circle with waves in middle of myocardium

Strep. Pydrimidans or Staph Aureus

33
Q

Acute Rheumatic Fever - Long Term Implications

A

1) Carditis - Long Term = Mitral Valve Most Likely
2) Aortic Valve = 2nd
3) Tricuspid in Staph

34
Q

Heart Failure - Always Look for Side - Left Alone vs. Right Alone vs. Both Chambers

A

DO IT

35
Q

Low EF Cardiomyopathy - Key Points

A

1) Dilated Cardiomyopathy - Look for S3
2) Both Chambers of the Heart
3) Most Common Lymphocyte Rich Inflitrate Dilated Cardiomyopathy = Coxsackie A/B
4) South America Carditis - Trypanzsoma = Protazoa
5) Alcohol and Pregancny can cause Dilated Cardiomyopathy

36
Q

Transposition of Great Arteries - Keys

A

1) Worses as PDA Closes (Cyanosis)

2) Don’t give imosaide - need to keep it open not close - Want to Elevate PGE

37
Q

Hypertrophic Cardiomyopathy - Murmur

A

Murmur results from obstruction of the ventricular outflow tract by the valve leaflet - Aortic Stenosis

38
Q

Pressure Volume - Systolic Failure

A

1) Increased Afterload/Decreased Contractility
2) Move Up and Right
Decrease in ESPVR Curve
Increase ESV and EDV
Decrease EF and SV

39
Q

Pressure Volume - Diasolic Failure

A 
Increased Preload
Move Left and Smaller 
Increased EDPVR
Decreased EDV 
Increased EDP
40
Q

Hypertropic Cardiomyopathy - Keys

A

1) Younger + cause of sudden death
2) Mitral Valve Prolapse - Less with less volume - Left Sternal Border Systolic Murmur
3) Young Patient with septal enlargement
4) Mutate Sarcomere proteins

Z - M2 Cardiology (5 decks)

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