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Cardio II > Medi-systemic disease > Flashcards

Medi-systemic disease Flashcards

1
Q

True or false:

DM is an independent risk factor for CAD

A

True

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2
Q

True or false:

CAD is the most common cause of death in adults with DM

A

True

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3
Q

Treatment of Type II DM

A
  • treat them as though they’ve had an MI
    1. Aspirin
    2. Control blood sugars (A1c <7)
    3. Control HTN (ACEI or ARB)
    4. Control lipids (statins, LDL <70)
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4
Q

Cardiometabolic syndrome

A

Must have 3/5

  1. HTN
  2. High LDL
  3. Low HDL
  4. Glucose intolerance
  5. Large waist circumference
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5
Q

Obesity causes eccentric cardiac hypertrophy with ventricular dilation. This leads to:
1.
2.
3.

A
  1. Increased circulating blood volume
  2. Increased CO
  3. Increased LV filling pressure
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6
Q

What are some functions of thyroid hormone?

A
  • metabolism
  • oxygen consumption
  • inotropic and chronotropic effects
  • increases synthesis of myosin and Na-K ATPase
  • increases # of beta adrenergic receptors
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7
Q

Effects of hyperthyroidism on CV system

A
  • palpitations (forceful contractions, sinus tach, a fib)
  • systolic and pulmonary HTN
  • fatigue
  • HF and angina
  • hyper dynamic precordium
  • widened pulse pressure
  • LV hypertrophy
  • 3rd heart sound
  • increased 1st heart sound
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8
Q

Treatment of hyperthyroidism

A

TREAT SYMPTOMS FIRST

  • beta blockers for symptoms (propranolol or atenolol)
  • anticoagulants for pts in a fib
  • diuretics or digitalis for HF
  • radioactive iodine or anti-thyroid (PTU or mithimazol) to treat hyperthyroidism
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9
Q

Effects of hyperthyroidism on CV system

A
  • decreased CO (bradycardia, decreased SV)
  • HTN (increased systemic vascular resistance)
  • decreased exercise tolerance (dyspnea on exertion)
  • fatigue
  • HF and angina
  • pericardial effusions
  • hypercholesterolemia
  • hyperhomocysteinemia
  • lower extremity edema
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10
Q

Treatment of hypothyroidism

A

T4 replacement

Caution of iatrogenic hyperthyroidism

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11
Q

Classic triad of pheochromocytoma (too much NE and Epi)

*other symptoms?

A

Sweating
Tachycardia
Episodic headache
*paroxysmal HTN, orthostatic hypotension (decreased plasma volume), dilated cardiomyopathy (toxic effect of catecholamines, secondary erythocytosis)

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12
Q

True or false:

Hypothyroidism and hyperthyroidism can have the exact same symptoms

A

True

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13
Q

Symptoms of Acromegaly

A
  1. HTN (suppression of RAS, increase in total body Na and plasma volume)
  2. LV hypertrophy
  3. Cardiomyopathy (diastolic dysfunction, arrhythmias)
  4. Increased prevalence of valvular heart disease
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14
Q

RA increases risks for what?

A

CAD
HF
Pericarditis
Myocarditis

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15
Q

Cardiac disease is very common in Systemic Lupus Erytematosus

A

Pericardial
Myocardial
CAD
Valvular heart disease

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16
Q

SLE

Valvular disease:

A
  • Systolic murmurs (structural, anemia, fever, tachycardia)
  • mitral valve is most commonly effected (prolapse, vegetations, regurgitation, stenosis)
  • Libman-Sacks endocarditis (verrucous endocarditis)
17
Q

Libman-Sacks endocarditis is most common of ____ valves

A

Aortic and mitral valves near the edge

18
Q

Sub sternal chest pain
Most common cause of symptomatic cardiac involvement in SLE
Treat with NSAIDs and steroids

A

Pericarditis

19
Q 
Rare
May cause conduction abnormalities
Suspect if there is resting tachycardia with unexplained cardiomegaly 
Systolic and/or diastolic dysfunction 
May present with HF symptoms
A

SLE myocarditis

20
Q

First degree heart block, often transient

Higher degrees of blocks and arrhythmias are uncommon in adults congenital heart block as part of neonatal lupus

A

SLE Conduction abnormalities

21
Q

Antibodies tested in pregnant women with lupus (because they can cause congenital heart blocks)

A

Anti-Ro

Anti-La

22
Q

In severe protein calorie malnutrition what happens?

A 
Weakened, hypokinetic heart muscle
Edema from decreased oncotic pressure
AIDS 
Anorexia Nervosa
HF patients
23
Q

What happens with thiamine deficiency?

A 
Wet Beriberi
High-out failure (edema everywhere)
Tachycardia
Elevated ventricular filling pressures
Rapid response to thiamine replacement
24
Q

What happens in vitamin B6, B12, and Folate deficiencies?

A

Hyperhomocyteinemia
Increased atherosclerotic risk
*replacement doesn’t decrease risk

25
Q

Causes of high output cardiac failure

A
  1. Systemic AV fistulas
  2. Hyperthyroidism
  3. Anemia
  4. Beriberi
  5. Dermatologic disorders
  6. Renal disease
  7. Hepatic disease
  8. Skeletal disorders (Paget’s, multiple myeloma)
  9. Hyperkinetic heart syndrome

Cardio II (16 decks)

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