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Prometheus Qs > Module 1: Cardiothoracics > Flashcards

Module 1: Cardiothoracics Flashcards

1
Q

right atrium is defined by

A

the IVC

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2
Q

what is the crista terminalis

A

muscular ridge from superior to inferior vena cava.

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3
Q

right ventricle is defined by the

A

moderator band

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4
Q

tricuspide papillary muiscles inert on the

A

septum

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5
Q

crista supraventricularis is what

A

thick muscle sperating AV and tricuspid valve

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6
Q

aortic and mitral realtion

A

side by side, no muscle between them

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7
Q

chest xr double density sign is

A

direct sign of left atrium enlargement

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8
Q

other signs of dilated left atrium

A

splaying of the carina (over 90 degrees)

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9
Q

mitral valve connected to papillary muscles via

A

chordae tendinae

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10
Q

papillary uscles of the left ventricle insert on to l

A

lateral and posteiror walls

NOT septum like the right side

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11
Q

echogenic focus in left ventricle on prenatal scanning is ax with

A

increase risk of downs

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12
Q

dumbell appearance of fat desnity in atrial septum

A

lipomatous hypertrophy of the intra atrial septum

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13
Q

Lipomatous hypertrophy of intra atrial septum spares the

A

fossa ovalis

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14
Q

why is lipomatous hypertrophy hot on PET

A

made of brown fat

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15
Q

RCA perfuses the SA node by

A

60%

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16
Q

RCA perfuses the AV node by

A

90%

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17
Q

most common and most serious malignant origin of coronary artery

A

LCA form the right coronary sinus coursing between aorta and pulmonary artery

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18
Q

What to do if anomolous left off the right cusp

A

always repair

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19
Q

what does ALCAPA stand for

A

Anomalous left coronary from the pulmonary artery

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20
Q

two types of ALCAPA are

A

infantile
- steal syndrome.

adult

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21
Q

what is steal syndrome in ALCAPA-

A

reversal of flow in LCA as pressure decreases in the pulmonary circulation

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22
Q

what is myocardial bridging?

A

intramyocardial course of a coronary artery.

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23
Q

definition of coronary artery aneurysm

A

diamter of 1.5x normal

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24
Q

common cause of coronary aneurysm

A

atherosclerosis

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25
Q

Coronary fistula defined

A

connection between coronary artery and cardiac chamber

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26
Q

contraindications to beta block in cardiac CT

A

severe asthma
heart block
acute chest pain

recent cocaine

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27
Q

which types of heart block are contraindicated to beta blockers

A

2nd and 3rd.

1st is not

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28
Q

contraindications to GTN

A

hypotensive
severe aortic stenosis
hypertrophic obstructive cardiomyopathy
Viagra use

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29
Q

how to quantiy velocity of blood in MRI

A

Velocity mapping also called phase-contrastr imaging

also called velocity encoded cine MR imaging

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30
Q

cause of congenital aortic stenosis

A

bicuspid

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31
Q

dilatation of the ascending aorta from stenotic valve due to

A

Jet phenomenon

  • valvular (most common)
  • subvalvular
  • supravalvular
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32
Q

Williams syndrome is which stenosis

A

supravalvular stenosis of aorta

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33
Q

Bicuspid aortic valve and coarctation think

A

turners syndrome

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34
Q

most common congential heart disease

A

bicuspid valve

then VSD

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35
Q

associations of biscupid aortc valve

A

Turners and coarctation
Cystic medial necorsis
PKD

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36
Q

aortic regurg is seen in which conditions

A

bicuspid valve
bac endo
marfans
HTN dilated aortic root
aortic dissection

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37
Q

commonest cause of mitral stenosis

A

rheumatic heart disease

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38
Q

common cuae of mitral regurgitation

A

endocarditis or papillary muscle/chordal rupture post MI

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39
Q

isolated right upper lobe pulmonary oedema is ax with

A

mitral regurgitation

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40
Q

pulmonary stenosis is ax with

A

Noonan syndrome

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41
Q

Peripheral pulmonary stenosis is seen in

A

Alagille syndrome

which is a disease where kids wijh absent bile ducts

diverse disease, rare

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42
Q

what is rheumatic heart disease

A

immune modulated response to Group A beta haemolytic stre

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43
Q

Tricupsid regurg is common form of tricuspid disease due to

A

weak annulus

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44
Q

How does tricuspid regurg happen in carcinoid

A

serotonin degrades the calve

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45
Q

Triscupsid Regurg causes what in the right ventricle

A

RV dilatation

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46
Q

What is Ebsteins anomaly

A

kids whose mums were on lithium

tricuspid valve is hypoplastic and psoterior lead is displaced apically.

enalrged RA, decreased RV and TR

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47
Q

Tricuspid atresia - occurs in what congenital anomaly

A

RV hypoplasia

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48
Q

Tricuspid atresia will also have

A

an ASD or PFO
asplenia

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49
Q

carcinoid induced valve disease only happens after what

A

mets to the liver

50
Q

why does carcinoid valve disease affect on the right side

A

lungs get rid of vasoactive substance

if left sided disease either shunt or lung mets

51
Q

most common great vesell anomaly

A

bovine arch

brachiocephalic and left common carotid common origin

52
Q

right arhc with aberrant LEFT …

A

Subclavian artery

vascular ring via the liagment arterisoum on the left, copletes the ring

53
Q

mirror image right arch is ax with

A

TOF
congential heart disease

54
Q

LEFT arch, aberrant right subclavian passes posterior to the oesophagus

A

dysphagia lusoria

55
Q

if the origin of the aberrant right subclavian artery is dilated

A

divertiuculum of Kommerell

56
Q

most common vascular ring

A

double aortic arch.

57
Q

what is subclavian steal syndrome / phenomenon

A

Phneomenon: Stenosis and or occlusion of the proximal subclavian with retrograde flow in the ipsilateral vertebral artery

Syndrome:
Stenosis and/or occlusion of the proximal subclavian artery with retrograde flow in the ipsilateral vertebral artery AND cerebral ischaemic symptoms

58
Q

causes of subclavian steal

A

always athersclerosis

Takayasu arteritis
radiation
preductal aortic coarctation
blalock-taussig shunt

59
Q

CXR egg on string

A

Transpostion

60
Q

CXR
Snowman

A

TAPVR

Supracardiac

61
Q

CXR
bootshaped

A

TOF

62
Q

Figure 3

CXR sign
3

A

coarctation

63
Q

CXR
box shaped mediastinum

A

Ebsteins

64
Q

CXR
scimitar sword

A

PAPVR with hypoplasia

65
Q

the causes of Cyanotic heart

6T

A

TOF
TAPVR
Transposition
Truncus
Tricupsid atresia

66
Q

not cyanotic disorders

A

ASD
VSD
PDA
PAPVR
Aortic coarctation

67
Q

Cyanotic, left arch, massive heart

A

Ebsteins
or pulmonary atresia

68
Q

Cyanotic, left arch, increased pulmonary blood flow

A

TAPVR
D-transpotion
Truncus
Tingle Ventricle

69
Q

cyanotic, left arch
decrease pulmonary blood flow

A

TOF
Ebsteins
Tricupid atresia

70
Q

cyanotic, RIGHT arch

Increase pulmonary vasculature

A

Truncus

71
Q

Cyanotic, RIGHT arch

Decreased pulmonary vasculature

A

TOF

72
Q

TAPVR, survival depends on

A
73
Q

TOF, survival depends on

A

VSD

74
Q

Tricuspid atresia depends on

A

VSD

75
Q

PDA consider

A

prematurity
maternal rubella
cyanotic heart disease

76
Q

most common type of ASD

A

secundum

77
Q

largest subtype of ASD by size of defect is

A

Primum

78
Q

Which ASD will close on its own

A

Secundums

79
Q

why can ASD primums not be closed by device?

A

too close to the AV valve rtissue

80
Q

Downs get which ASD

A

Ostium primum / endocardial cushion defect

81
Q

When I say sinus venosus ASD

A

you say PAPVR

82
Q

define PAPVR

A

one one of the four pulmonary veins into the right atrium.

83
Q

PAPVR is ax with

A

venosus ASD

84
Q

Toal APVR survival depends on

A

Large PFO or ASD required for survival

85
Q

types of TAPVR

A

supracaridac - snowman

cardiac

infracardiac - pulmonary oedema

86
Q

commonest cause of cyanosis in first 24 horus

A

TGA

87
Q

who gets TGA

A

infatns of diabetic mothers

88
Q

survival of TGA

A

ASD, VSD or PDA

normally a VSD

89
Q

types of TGA

A

D and L

L - lucky

D - only PDA

90
Q

D type TGA

what to do

A

intra-atrial baffle

(mustard or Senning)

91
Q

L type TGA

what to do

A

double discordance so is compatible

92
Q

LeCompte Maneuver

A

operation to fix a D type TGA.

moustache over the aorta.

93
Q

tetrology of fallot is what four things

A

VSD
RVOT obstruction
overiding aorta
RV hypertrophy

94
Q

Truncus Arteriosus ax with

A

CATCH22 genese like DiGeorge

95
Q

coarctation of aorta ax with

A

TURNERS SYNDROME

96
Q

why does rib notching not exist in the 1st and 2nd in coarc

A

1st and 2nd are fed by costocervical trunk

97
Q

hypoplastic heart must have

A

ASD or large PFO

typically large PDA to get blood into the arch

98
Q

associations of hypoplastic left heart

A

aortic coarctation

endocardial fibroelastosis

99
Q

Cor Triatratium Sinistrum

A

left atrium gets pulmonary vein WITH a muscle layer

looks like three atriums

100
Q

in MI

what does stunned myocardium mean?

A

after acute injury
dysfunction of myocardium persists even after restoration of blood flow

oerfusion study will be normal but contractility is bad

101
Q

Hibernating myocardium

A

chronic process from severe CAD. Chronic hypoperfusion.

but takes up more tracer on PET

102
Q

what does scar mean in MI

A

dead tissue

103
Q

why is microsvascular obstruciton a poor prognostic indicator in MI

A

lack of funcitonal recovery

104
Q

true ventricular aneurysm vs flase ventricular aneurysm

A

true
- mouth wider than body. Myocardium intact. anterolateral wall.

False
- Mouth is nrrow. Myocardium not intact.
Posterior-lateral wall. Higher risk of rupture

105
Q

Viability post MI based on wal thickness

A

<25% - improve with PCI
25 - 50% may improve with PCI
5o% < unlikely to recover

106
Q

post MI sequelae timeframes

4 weeks

A

dresslers

107
Q

2-7 days

post MI sequelae timeframes

A

papillary uscle rupture

108
Q

post MI sequelae timeframes

7 days

A

ventriuclar pseudoaneurysm

109
Q

Months
post MI sequelae timeframes

A

Ventricular aneurysm

needs remodelling time

110
Q

post MI sequelae timeframes

myocardial rupture

A

within 3 days

111
Q

causes of dilated cardiomyopathy

A

idopathic
ischaemic

aEtoh
doxorubicin
cyclosporine
chages

ltos

112
Q

ischaemic dilated cardiomyopathy will show enhancement where

A

subendocardial enhancement

113
Q

idiopathic dilated cardiomyopathy will show what enhacnement

A

linear mid-myocardial enhacnement

114
Q

commonest cause of restritice cardiomyopathy

A

amyloid

115
Q

difficult to supress the myocardium think

A

amyloid

needs a longer T1.

116
Q

Loeffler syndrome is

A

Eosinophilic cardiomyopathy

117
Q

what is eosinophilic cardiomyopathy

A

bilateral ventricular thrombus is the classic phrase / buzzword.

long t1 to show the thormbus

left ventricular apical obliteration by laminar thrombosis

118
Q

causes of constrictive pericarditis

A

used to be viral / TB

now radiotherapy or CABG

119
Q

myocarditis - type of Gf enhacnement

A

late

non vascular distribution

lateral free wall

eipcardial or midwall

120
Q

Sarcoid on cardiac MR

A

T2 increased and early Gd increase
Gd pattern - middle and epicardial, non vascular

focal wall thickening from edema can mimic hypertrophic cardiomyopathy.
involves septum

121
Q
A

Prometheus Qs (9 decks)

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