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Misc Flashcards

1
Q

Risk factors for patient-prosthesis mismatch (PPM)

A

small valve, large BSA, female, low LVEF, young age, Afib, severe MR or TR

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2
Q

What vessel causes high lateral MI

A

OM

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3
Q

At what timepoints should asymptomatic patients with bpMVR get TTEs?

A

5yrs post-op, 10yrs, then annually

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4
Q

Quantitative TTE findings in severe MR

A

EROA >/= 0.4 cm^2
RF >/= 50%
RVol >/= 60 mL
VCV >/= 0.7 cm

(Every Fat Vegan Cooks: E-F-V-C, 4-5-6-7)

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5
Q

Echo criteria for bpAV patient-prosthesis mismatch

A
  1. DVI 0.25-0.29
  2. AT <100ms
  3. Normal valve
  4. EOA index <0.65
  5. LV stroke volume normal
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6
Q

What is Galectin-3?

A

Mediator of cardiac fibrosis. Class IIb for HF risk stratification, associated with increased HF readmission, arrhythmias, and mortality.

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7
Q

Agaston score cutoff (by sex) for severe AS in suspected LFLG AS

A

Women: >1300
Men: >2000

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8
Q

Hibernating myocardium is defined as:

A

Bimodal response for a hypokinetic area on dobutamine stress echo.
Low dose –> improves (contractile reserve)
Peak stress –> akinetic (ischemic response)

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9
Q

Post-MI 1* prevention ICD indication

A

LVEF <30% while receiving GDMT (regardless of NYHA functional class) >40 days post-MI

MADIT-II (NEJM, 2002)

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10
Q

Cilostazol mechanism

A

PDE3 inhibitor –> systemic vasodilation

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11
Q

Valvular criterion in revised Ghent nosology for Marfans

A

mitral valve prolapse

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12
Q

How often should aortic root be imaged in Marfan

A

At time of diagnosis then 6mo later to ensure stability
Then Annually (more frequent if >4.5cm)

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13
Q

Where are Lambl’s excrescences seen?

A

Ventricular surface of AV

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14
Q

How is cancer therapy-related cardiac dysfunction (CRTCD) defined?

A

Drop in LVEF >/=10% in asx patients or >/=5% in sx patients

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15
Q

Surgical bpAVR or bpMVR antithrombotic regimen

A

Initial 3-6mo: warfarin (INR goal 2.5)
Lifelong: Aspirin 81mg daily

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16
Q

Provoking factors for Brugada

A

Flecainide, procainamide (Class I AADs–use to challenge type 2+3)
Cocaine
Fever
Anesthesia (propofol, lidocaine)
TCAs
RV ischemia/PE

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17
Q

What does PCSK9 stand for

A

proprotein convertase subtilisin/kexin type 9

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18
Q

Agents used to test for vasospastic angina during LHC

A

methylergonovine
acetylcholine

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19
Q

STEMI criteria

A

> /=2mm STE (1.5 in women) V2-3 or 1mm in any 2 other contiguous leads
/=0.5mm isolate STD in V1-3

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20
Q

PCI door to balloon time goal

A

90 minutes if PCI-capable hospital
120 minutes if transfer

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21
Q

What is Fabry disease?

A

X-linked alpha-galactosidase deficiency –> sphingolipid myocardial deposition –> biV thickening (with increased QRS voltage)

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22
Q

How does amiodarone increase digoxin levels?

A

Amio inhibits p-glycoprotein

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23
Q

EOA index indicating severe mitral PPM

A

</=0.9 cm^2/m^2

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24
Q

Doppler parameters of prosthetic MV function suggesting significant stenosis

A

pV >/= 2.5m/s
MG > 10mmHg
VTIprmv/VTIlvot > 2.5
EOA < 1cm^2
PHT >200ms

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25
Treatment for C. albicans endocarditis
Surgical removal of valve (class I indication)
26
Fabry disease MRI LGE pattern
basal-inferolateral mid-wall
27
ICD indications in HCM
1. Prior SCD or sustained VT (class I) 2. SCD in first degree relative (IIa) 3. wall thickness >30mm (IIa) 4. Unexplained recent syncope (IIa) 5. LVEF <50% or apical aneurysm (IIa) 6. NSVT on holter or LGE >15% burden on MRI (IIb)
28
Fabry manifestations
angiokeratomas acroparesthesias (severe episodes of distal limb pain) anhidrosis
29
MVA equation and cutoff for severe
MVA=220/PHT Severe <1.5
30
CMR finding in hereditary hemochromatosis
T2* relaxation time <20ms (<10ms = more severe disease)
31
Diagnostic rest/exercise PCWP for HFpEF diagnosis
>15 mmHg at rest or >25 mmHg with exercise
32
Most common pathogens for myocarditis
Classically: enteroviruses such as coxsackievirus More recently: parvovirus B19 and human herpesvirus 6
33
neprilyisin action
breaks down BNP, allowing for its continued effects on LV remodeling/RAAS system (sac/val --> higher BNP, lower NT-proBNP
34
HTN definition for 24h mean, daytime mean, and nighttime mean
24h: >130/80 Day: >135/85 Night: >120/70
35
Class IV AADs & mechanism
CCBs Prolongs phase 2
36
Five steroid-sparing agents for 2nd/3rd line sarcoid tx
mycophenolate methotrexate infliximab adalimumab azathioprine
37
Cardioprotective agent against anthracycline-induced cardiotoxicity and cumulative doxorubicin dose to qualify for it
Dexrazoxane >300 mg/m^2 doxorubicin
38
When does anthracycline cardiotoxicity present and what cumulative dose of doxorubicin significantly increases risk for toxicity?
within 12 months
39
In a normal pregnancy, when is the greatest reduction in BP seen?
18 weeks gestation (progesterone -> drop SVR)
40
Indications for aortic surgery in bicuspid aortopathy
Class 1: Root >5.5cm (regardless of need for AVR) Class 2a: Root >5cm plus additional risk factor (fam hx dissection, growth >0.5cm in one year, coarctation) Class 2a: Root >4.5cm if performing AVR anyways
41
Early afterdepolarizations are a type of triggered activity that lead to…
TdP or PMVY
42
Delayed afterdepolarizations are a type of triggered activity that occur in…
Acute MI Digoxin toxicity (bidirectional VT) CPVT
43
Most common cause of flail MV leaflet
Myxomatous MV disease
44
LMCA IVUS MLA for revasc benefit
<6 mm^2 (LITRO study)
45
Loeys-Dietz manifestations
TAA, bifid uvula, easy brusing
46
Hakki equation
AVA = CO / sqrt(peak-peak gradient)
47
Ezetimibe MOA
Inhibit Niemann-Pick C1-Like 1 protein --> inhibit intestinal cholesterol absorption
48
Which class III AAD increases the defibrillation threshold
Amiodarone
49
Mean 24h BP to diagnose HTN
125/75
50
QP/QS formula
QP/QS = Ao-MV / PV-PA
51
What flower is atropine from
Bella Donna
52
What flower is dig from
Foxglove
53
Collectively, the imaging criteria used to diagnose ICI myocarditis are known as…
2018 Lake Louise Criteria
54
Keshan disease's etiology has been linked to what two things?
Coxsackie virus Selenium deficiency (Causes a DCM and arrhtymia, endemic to northern China)
55
This bevarage leads to QT prolongation
Grapefruit juice
56
Eponym and disease state: loss of the radial pulse by rotating head to the ipsilateral side with extended neck following deep inspiration
Adson sign Thoracic outlet syndrome
56
This rare inherted condition leads to accumulation of plant sterols in the blood
Sitosterolemia (involves ABC transporter)
56
Treatment for sitosterolemia
ezetimibe
57
What are type I and II sinoatrial exit blocks?
SA exit block: SA node prodoced sign, but it fails to spread to rest of atria (ie, no P wave) Type I: progressive P-P shortening, then drop P type II: consistent P-P interval, then drop
58
Key features of Yip-Saw Type I, II, III for SCAD
I: multiple radiolucent lumen II: long, diffuse, smooth narrowing III: focal or tubular stenosis (mimic ASCVD)

Cardiology (11 decks)

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