Rx_1.13 (Cardio) Flashcards

1
Q

Histologic description of Aschoff bodies

A
  • aschoff body = indicates rheumatic heart dz
  • aschoff body = non-caseating granuloma w/multi-nucleated giant cells
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2
Q

Anatomical location of jugular vein

A
  • within carotid sheath
  • lateral to the carotid artery
  • anterior to the vagus nerve
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3
Q

Young girl w/hypertension @ extremities + narrowing of thoracic aorta on aortogram ==> dx?

A
  • coarctation of aorta
  • possibly Turner Syndrome (XO), esp. if other features present
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4
Q

Common features of Turner’s Syndrome

A
  • short stature
  • webbed neck
  • coarctation of aorta
  • bicuspid aortic valve
  • streak ovaries
  • primary amenorrhea
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5
Q

Fick principle (for calculation of CO)

A

CO = (total O2 body consumption)/(arterial O2 - venous O2)

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6
Q

Intact right hemidiaphram elevated above left on (inspiratory) xray ==> dx?

A

damaged right phrenic nerve

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7
Q

Possible severe consequence of untreated UTI

A
  • pyelonephritis
  • sepsis
  • acute kidney failure ==> hyperkalemia
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8
Q

Common dangerous feature of acute kidney failure

A
  • indicators = high BUN, high creatinine
  • consequence = hyperkalemia ==> cardiac arrhytmias
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9
Q

ECG finding in hyperkalemia

A
  • peaked T waves
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10
Q

Presentation of Staph Aureus endocarditis

A
  • acute onset
  • IV drug user
  • tricuspid valve ==> systolic murmur
  • septic emboli from right side ==>
    • cough
    • pleuritic chest pain
    • diffuse pulmonary infiltrates
    • pyoneumothorax
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11
Q

Characteristics of S. aureus

A
  • gram +, facultative, cluster-forming anaerobe
  • catalase +, coagulase +
  • beta-hemolytic
  • produces golden yellow pigment in culture
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12
Q

Fxn of carotid sinus baroreceptors

A
  • facilitate response to hypotension
  • sends afferent signals via glossopharyngeal nerve to medulla to control sympathetic outflow
    • hypotension ==> decreased firing ==> increased sympathetic outflow
  • transduce pressures from 50-180mmHg
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13
Q

Fxn of aortic arch baroreceptors

A
  • respond to increases in blood pressure
  • less sensitive than carotid sinus
    • respond to stretch caused by BP @ 110-200 mmHg
    • receptors do not fire in hypotensive state
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14
Q

Characteristics of phases 1-4 of ventricular AP

A
  • 0 = rapid upstroke and depolarization
    • voltage-gated Na channels open
  • 1 = initial repolarization
    • inactivation of voltage-gated Na channels
    • K channels begin to open
  • 2 = plateau
    • Ca influx from volt-gate Ca channels balances K efflexu
    • Ca influx triggers release of Ca from sarc reticulum and myocyte contraction
  • 3 = rapid repolarization
    • massive K efflux due to opening of slow K channels and close of Ca channels
  • 4 = resting
    • high K permeability through K channels
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15
Q

fixed and widely split S2 ==> dx? (+mechanism)

A
  • Atrial Septal defect
  • normal cause for splitting:
    • inspiration ==> decreased intrathoracic pressure ==> increased venous return @ RA/RV ==> delayed closure of pulmonic valve
  • in ASD:
    • shunt ==> constant blood flow across from L => R leads to increased flow into RA/RV ==> constant delay of pulmonic valve independent of breath
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16
Q

3rd trimester pregnant woman + light-headedness when supine ==> dx?

A
  • Inferior vena cava compression by large uterus ==> reduced cardiac output
17
Q

Tx for pregnant woman w/IVC compression

A
  • lie on left side/prop up right hip
18
Q

Class of antiarrhytmics that prolong repolarization

A
  • Class III antiarrhythmics
    • amiodarone
    • sotalol
19
Q

Characteristics of sotalol

A
  • b-blocker
  • antiarrhytmic w/class II and class III properties
20
Q

Acebutolol: MOA, use

A
  • B1- selective antagonist
  • class II antiarrhymic agent
  • use: suppresses ventricular ectopic beats
21
Q

Esmolol: MOA, use

A
  • rapid-acting B antagonist
  • class II antiarrhytmic
  • use = IV control of afib
22
Q

Metoprolol: MOA, use

A
  • B1 - selective antagonist
  • class II antiarrhymic
23
Q

Propanolol: MOA, use

A
  • nonselective B antagonist
  • class II antiarrhytmic
  • use:
    • slows sinus rhythm
    • prolonged PR interval
24
Q

Dx + possible causes?

A
  • Torsades de pointes
    • potentially fatal rapid ventricular rhythm
  • causes
    • hypokalemia
      • can be caused by K channel blockers (e.g. sotalol)
    • congenital syndrome
      • e.g. long QT syndrome
    • quinidine (antiarrhythmic)
25
Q

“5 T’s” of neonatal cyanosis

A
  • Tetrology of Fallot
  • Transposistion of the great vessels
  • Truncal arteriosus
  • Tricuspid atresia
  • Total anomalous pulmonary venous return
26
Q

cyanotic newborn immediately after birth + mother w/DM ==> dx?

A
  • transposition of great vessels
27
Q

Tx of transposition of great vessels

A
  • create an atrial shunt if none exists
    • give prostaglandin E1 to maintain patent ductus arteriosis
  • corrective surgery once infant is stabilized
28
Q

Rates of conduction in cardiac electrical system

A
  • fastest to slowest:
    1. His-purkinje (1-4 m/s)
      1. large cells, many gap jxns
    2. SA node (1 m/s)
      1. small cells, few gap jxns
      2. less time to depolarize
    3. AV node (0.05 m/sec)
      1. small cells, few gap jxns
      2. slow-rising/low-amp APs
29
Q

Tx for Viridans strep endocarditis

A

Penicillin G

30
Q

Mitral stenosis murmur

A
  • late, rumbling diastolic murmur at apex
31
Q

Signs of acute rheumatic fever

A
  • FEVERSS:
    • Fever
    • Erythema marginatum
      • nonpruritic, circular, pink eruption on trunk
    • Vavular damage
    • Erythrocyte sedimentation rate increased
    • Red-hto joints
    • Subcutaneous nodule
    • Saint Vitus’ dance