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Step 1 Clues > PP Clues Hrt/Lung > Flashcards

PP Clues Hrt/Lung Flashcards

1
Q

How do you calculate SV?

A

EDV – ESV = SV

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2
Q

How do you calculate CO?

A

SV * HR = CO

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3
Q

What is normal CO?

A

5L/minute

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4
Q

How much of this CO goes to the brain, heart, and kidney?

A

20% = 1L minute or 60L an hour

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5
Q

How do you calculate CPP?

A

MAP – ICP = CPP

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6
Q

What organs have resistance in series?

A

placenta
liver
kidney
spleen
Lungs

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7
Q

What organs have resistance in parallel?

A

All the rest
except:
placenta
liver
kidney
spleen
Lungs

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8
Q

What organ has the highest A-VO2 difference at rest?

A

Heart

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9
Q

What organ has the highest
A-VO2 difference after exercise?

A

Muscle

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10
Q

What organ has the highest A-VO2 difference after meal?

A

Gut

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11
Q

What organ has the highest
A-VO2 difference during a test?

A

Brain

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12
Q

What organ has the lowest A-VO2 difference?

A

Kidney

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13
Q

What is A-V 02 tell you

A

metabolic activity of the organ
how much 02 is extracted from the arterial compare to the veinous end

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14
Q

Where does Type A thoracic aortic dissection occur?

A

Ascending aorta (occurs in cystic medial necrosis, syphilis)

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15
Q

Where does Type B thoracic aortic dissection occur?

A

Descending aorta (occurs in trauma, atherosclerosis)

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16
Q

What layers does a true aortic aneurysm occur?

A

Intima, media, and adventitia

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17
Q

What layers does a
pseudo aortic aneurysm occur?

A

Intima and media

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18
Q

What is pulse pressure?

A

Systolic – Diastolic pressure

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19
Q

What vessel has the thickest layer of smooth muscle?

A

Aorta

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20
Q

What vessels have the most smooth muscle?

A

Arterioles

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21
Q

What vessels have the largest cross- sectional area?

A

Capillaries

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22
Q

What vessel has the highest compliance?

A

Aorta

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23
Q

What vessels have the highest capacitance?

A

Veins and venules
hold 60% of circulating volume

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24
Q

What are the three causes of HTN?

A

Increase
1) Volume: SV
2) Rate: HR
3) Resistance: TPR

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25
Q

What is your max heart rate?

A

220 – age (in years)

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26
Q

What is Stable angina?

A

Pain with exertion (atherosclerosis)

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27
Q

What is Unstable angina?

A

Pain at rest (transient clots)

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28
Q

What is Prinzmetal’s angina?

A

Intermittent pain (coronary artery spasm)

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29
Q

What is Amyloidosis?

Lab?

A

Deposition of abnormal protein

Stains Congo red, Echo Apple-green birefringence; deposition of proteins

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30
Q

What is Hemochromatosis?

A

Fe deposit in organs => hyperpigmentation, arthritis, DM

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31
Q

What is Cardiac tamponade?

A

Pressure equalizes in all 4 chambers, quiet precordium, no pulse or BP, Kussmaul sign, pulsus paradoxicus (↓ >10mm Hg BP w/ insp)

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32
Q

What is a Transudate?

A

An effusion with mostly water
Too much water:
* Heart failure
Hypothyroidism
* Renal failure
Not enough protein:
* Cirrhosis (can’t make protein)
* Nephrotic syndrome (pee protein out)

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33
Q

What is an Exudate?

A

An effusion with mostly protein
Too much protein:
* Purulent (bacteria)
* Hemorrhagic (trauma, cancer, PE)
* Fibrinous (collagen vascular dz, uremia, TB)
* Granulomatous (non-bacterial)

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34
Q

What is Systole?

A

Squish heart, ↓blood flow to coronary aa., more extraction of O2 (Phase 1 Korotkoff)

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35
Q

What is Diastole?

A

Fill heart, ↑blood flow to coronary aa., less extraction of O2 (Phase 5 Korotkoff)

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36
Q

What are the only arteries w/ deoxygenated blood?

A

Pulmonary arteries and umbilical arteries

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37
Q

What is the difference between a murmur and a bruit?

A

A murmur occurs in the heart
A bruit occurs in blood vessels 70%+ occlusion

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38
Q

What murmur has a Waterhammer pulse?

A

AR

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39
Q

What murmur has Pulsus tardus?

A

AS

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40
Q

What cardiomyopathy has
Pulsus alternans?

A

Dilated cardiomyopathy

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41
Q

What disease has Pulsus bisferiens

A

Idiopathic Hypertrophic Subaortic Stenosis

hcom

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42
Q

What murmur has an irregularly irregular pulse?

A

A Fib

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43
Q

What murmur has a regulary irregular pulse?

A

PVC
Premature ventricular contraction

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44
Q

What sound radiates to the neck?

A

AS/AR

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45
Q

What sound radiates to the axilla?

A

MR/MS

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46
Q

What sound radiates to the back?

A

PS

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47
Q

What disease has a boot-shaped x-ray?

A

Right ventricle hypertrophy

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48
Q

What disease has a banana- shaped x-ray?

A

IHSS

Idiopathic Hypertrophic Subaortic Stenosis

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49
Q

What disease has an egg-shaped x-ray?

A

Transposition of the great arteries

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50
Q

What disease has a snowman- shaped x- ray?

figure 8

A

Total Anomalous Pulmonary Venous Return

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51
Q

What disease has a “3” shaped x- ray?

A

Coarctation of the aorta

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52
Q

What is Osler-Weber-Rendu?

A

AVM in lung, gut, CNS => sequester platelets => telangectasias

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53
Q

What is Von Hippel-Lindau?

A

AVM in brain, retina => renal cell CA risk

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54
Q

When do valves make noise?

A

When valves close

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55
Q

What valves make noise during systole?

A

Mitral and tricuspid regurgitation

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56
Q

What are the most common causes of aortic stenosis?

A

Aging
Dystrophic calcification

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57
Q

What are the most common causes of aortic regurgitation?

A

Aging
Calcifications causing valve to sag

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58
Q

What are the most common causes of mitral stenosis?

A

Rheumatic fever

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59
Q

What are the most common causes of mitral regurgitation?

A

MVP
SBE
Collagen diseases

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60
Q

What are the most common causes of tricuspid stenosis?

A

Rheumatic fever
Carcinoid syndrome

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61
Q

What are the most common causes of tricuspid regurgitation?

A

Acute endocarditis (staph aureus secondary to IV drug abuse)

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62
Q

What murmurs occur during systole?

A

Holosystolic, ejection murmur or click

63
Q

What are the holosystolic murmurs?

A

TR, MR, or VSD

64
Q

What are the systolic ejection murmurs?

A

AS, PS, or HCM

65
Q

What valves make noise during diastole?

A

Aortic and pulmonic

66
Q

What are the diastolic murmurs?

A

Blowing and Rumbling

67
Q

What are the diastolic blowing murmurs?

A

AR or PR

68
Q

what are the diastolic rumbling murmurs?

A

TS or MS

69
Q

What are the continuous murmurs?

A

PDA or AVMs

70
Q

What has a friction rub while breathing?

A

Pleuritis

71
Q

What has a friction rub when holding breath?

A

Pericarditis

72
Q

What does a mid-systolic click tell you?

A

Mitral valve prolapse

73
Q

What does an ejection click tell you?

A

A/P stenosis

74
Q

What does an opening snap tell you?

A

M/T stenosis

75
Q

What does S2 splitting tell you?

A

Normal on inspiration (b/c pulmonic valve closes later)

76
Q

What does wide S2 splitting tell you?

A

↑O2, ↑RV volume, or delayed pulmonic valve opening

77
Q

What does fixed wide S2 splitting tell you?

A

ASD

78
Q

What does paradoxical S2 splitting tell you?

A

AS (or left bundle branch block)

79
Q

What do you see in left sided heart failure?

A

Pulmonary edema
Orthopnea
Paroxysmal nocturnal dyspnea

80
Q

What do you see in right sided heart failure?

A

Hepatomegaly
Peripheral Edema
Jugular venous distension

81
Q

What is cor pulmonale?

A

Pulmonary HTN => RV failure

82
Q

What is Eisenmenger’s?

A

Pulmonary HTN => reverse L-R to R-L shunt

83
Q

What is Transposition of the great arteries?

A

Aorticopulmonary septum did not spiral

84
Q

What is Tetrology of Fallot?

A
  • Overriding Aorta: aorta sits on IV septum over the VSD; pushes on PA
  • Pulmonary Stenosis “Tet spells”
  • RV hypertrophy => boot-shaped heart
  • VSD (L to R shunt)
85
Q

What is Total Anomalous Pulmonary Venous Return?

A

All pulmonary veins to RA, snowman x-ray

86
Q

What is Truncus Arteriosus?

A

Spiral membrane not develop => one A/P trunk, mixed blood

87
Q

What is Ebstein’s Anomaly?

A

Tricuspid prolapse,
Pregnant woman on Lithium increases risk

88
Q

What can Lithium do to Mom?

A

Nephrogenic Diabetes Insipidus

89
Q

What is Cinchonism?

A

Hearing loss, tinnitus, thrombocytopenia

90
Q

List four types of cells in the lungs?

A

Goblet: Mucus Production
Type I Pneumocyte: Macrophages (95%)
Type II Pneumocyte: Produce Surfactant
Clara/Dust (Macrophages): Ingest dust particles

91
Q

What is the histology of the trachea?

A

Top 1/3: Stratified Squamous Epithelium (Protect against abrasion)
Middle 1/3: Mixture
Lower 1/3: Tall Columnar Pseudo-stratified ciliated Epithelium

92
Q

What are the muscles needed to breathe in?

A

Innermost intercostals (contralateral chest wall)
External Intercostals (ipsilateral chest wall) Diaphragm

93
Q

What are the muscles needed to force air in?

A

Scalenes
SCM -sternocleidomastoid
Trapezius
Pectoralis Major/minor

94
Q

What are the muscles needed to breathe out?

A

Passive - recoil

95
Q

What are the muscles needed to force air out?

A

Internal/external oblique
Rectus abdominus
Transverse abdominus
Quadratus lumborum

96
Q

What is the difference between
a carotid body and a carotid sinus

A

Carotid body: chemoreceptor
Carotid sinus: baroreceptor

97
Q

What color is air on an x-ray?

A

Black “radiolucent”

98
Q

What color is fluid/solid on x-ray?

A

White “radiopaque”

99
Q

What disease has a steeple
sign on neck film?

A

Croup

100
Q

What disease has a thumb sign on neck film?

A

Epiglottitis

101
Q

What is a “blue bloater”?

A

Bronchitis (chronic)

102
Q

What is a “pink puffer”?

A

Emphysema

103
Q

What diseases have pulmonary eosinophilia?

A

Aspergillosis, Strongyloides

104
Q

What drugs cause pulmonary eosinophilia?

A

Nitrofurantoin, Sulfonamides

105
Q

What are the risk factors for lung cancer?

A

Smoking, Radon, 2nd hand smoke, pneumoconiosis (except anthracosis)

106
Q

What diseases have hemoptysis?

A

Bronchiectasis, bronchitis, pneumonia, TB, lung cancer

107
Q

Where is a Bokdalek hernia?

A

Back of diaphragm

108
Q

Where is a Morgagni hernia?

A

Middle of diaphragm

109
Q

What diseases have respiratory alkalosis?

A

Restrictive Lung Dz (anxiety, pregnancy, Gram – sepsis, PE)

110
Q

What diseases have respiratory acidosis?

A

Obstructive Lung Dz

111
Q

What diseases have metabolic alkalosis?

A

Low Volume State (vomiting, diuretics, GI blood loss)

112
Q

What is the obstructive pattern of blood gases?

A

↑pCO2 -> ↓pH,
↑RR–>↑pO2

113
Q

What is the obstructive pattern of blood gasses?

A

↓ pO2 –> ↑RR –> ↓pCO2 -> ↑pH

114
Q

What does stridor tell you?

A

Extrathoracic narrowing => narrows when breathe in => neck x-ray

115
Q

What does wheezing tell you?

A

Intrathoracic narrowing => narrows when breathe out => chest x-ray

116
Q

What does rhonchi tell you?

A

Mucus in airway => obstructive lung disease

117
Q

What does grunting tell you?

A

Blows collapsed alveoli open => restrictive lung disease

118
Q

What does dull percussion tell you?

A

Something b/w airspace and chest wall absorbing sound (fluid or solid)

119
Q

What does hyperresonance tell you?

A

Lungs hyperinflated with air

120
Q

What does tracheal deviation tell you?

A

Away from pneumothorax OR toward atelectasis “air-phobic”

121
Q

What does fremitus, egophony, and

A

Consolidation=> pathognomonic for pneumonia

122
Q

What is Restrictive lung disease?

A

Small stiff lungs, trouble breathing in

123
Q

What is Obstructive lung disease?

A

Big mucus-filled lungs, trouble breathing
out

124
Q

What is Epiglottitis?

A

X-ray thumb sign, drooling

125
Q

What is Croup?

A

X-ray steeple sign, barking cough

126
Q

What is Tracheitis?

A

Look toxic, grey pseudomembrane, leukocytosis

127
Q

What is Asthma?

A

Wheeze on expiration, IgE, eosinophils

128
Q

What is Bronchiolitis?

A

Asthma in kids <2 y/o

129
Q

What is Maxillary Sinusitis?

A

Teeth pain worse with bending forward

130
Q

What is Bronchiectasis?

A

Bad breath, purulent sputum, hemoptysis

131
Q

What is Chronic Bronchitis?

A

Lots of sputum, “blue bloater”

132
Q

What is Emphysema?

A

Restrictive to obstructive pattern, “pink puffer”

133
Q

What is Laryngomalacia?

A

Epiglottis roll in from side-to-side

134
Q

What is Pneumonia?

A

Consolidation of airway

135
Q

What is Pneumothorax?

A

Air outside of lungs; hyperresonnace on same side

136
Q

How do you detect a Pulomary Embolus?

A

Tachypnea, increased V/Q scan, EKG: S1Q3T3

137
Q

What is Tamponade?

A

Decreased breath sounds/BP; increased JVD; fluid in pericardial sac

138
Q

What is Tracheomalacia?

A

Soft cartilage, stridor since birth

139
Q

What is Cystic Fibrosis?

A

Meconium ileus, steatorrhea,bronchiectasis

140
Q

What is Aspergillosis?

A

Allergy to mold, dead plants, compost piles

141
Q

Who gets Asbestosis?

A

Shipyard workers, pipe fitters, brake mechanics, insulation installers

142
Q

Who gets Silicosis?

A

Sandblasters, glassblowers

143
Q

Who gets Byssinosis?

A

Cotton workers

144
Q

Who gets Beryliosis?

A

Radio, TV welders, those working with bulbs

145
Q

What is Anthracosis?

A

Coal workers, massive fibrosis

146
Q

What is Sarcoidosis?

A

Non-caseating granulomas, eggshell calcification of lymph nodes

147
Q

What is Carcinoid syndrome?

A

Flushing, wheezing, diarrhea

148
Q

What is Small cell CA?

A

At carina, malignant, Cushing’s, SIADH, SVC syndrome

149
Q

What is Large cell CA?

A

Large stuff

150
Q

What is Squamous cell CA?

A

Smoker, high PTH, high Ca ++

151
Q

What is Bronchealveolar CA?

A

Looks like pneumonia; due to pneumoconiosis

152
Q

severe aortic stenosis in pt with scattered bleeding angiodysplasia
pathophys

A

acquire vW factor deficiency

153
Q

3 action of vW

A
  1. bind sites of endothelial injury for platelet aggregation
  2. promote platelet aggregation at high shearing pressure
  3. carrier protein for Factor 8
154
Q

how is vW affected in AS

acquire vWF deficiency

A

the high shearing site allows ADAMTS 13 to cleave vW multimers causing vWF deficiency

Step 1 Clues (27 decks)

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