Set 7 (Vascular) Flashcards
1
Q
Diastolic
Opening snap
A
Mitral valve stenosis
2
Q
Xanthoma
Premature coronary dz and PVD
A
Familial dysbetalipoproteinemia
Type III hyperlipoproteinemia
3
Q
APOA-I
A
LCAT activation (cholesterol esterification in HDL)
4
Q
APOB-48
A
Intestine chylomicron assembly and secretion
5
Q
ApoB-100
A
EXTRAhepatic cell LDL particle uptake
6
Q
ApoC-II
A
LPL activation (c= "cut" up chylomicrones)
7
Q
ApoE3, ApoE4
A
LIVER: VLDL and chylomicron remnant uptake
8
Q
ApoC-II deficiency
A
hyperCHYLOMICRONemia
Type 1 hyperlipoproteinemia
9
Q
ApoA-1 and LCAT deficiency
A
Low HDL
Increased circulating free cholesterol levels
10
Q
Epidural hematoma: BP and HR
A
HYPERtension
BRADYcardia
(Cushing’s response to increased ICP)
(If herniation –> HYPOtension)
11
Q
IVC is formed by?
A
Union of common iliac vein (L4-5)
12
Q
Thoracic duct enter thrax through?
A
Aortic hiatus
13
Q
Great saphenous vein location
A
Originates on MEDIAL side of foot
Course anterior to medial malleolus
Drain into femoral vein inferolateral to pubic tubercle
14
Q
Penetrating injury to region below ASIS
A
Damage:
Lateral cutaneous n. of thigh
15
Q
Femoral triangle
A
Inguinal ligament (superior) Sartorius muscle (lateral) Adductor longus (medial)
16
Q
Berkson’s bias
A
Selection bias (by selecting hospitalized patients as CONTROL group)
17
Q
ACE inhibitor –> raise in serum creatinine
A
Blocks efferent arteriole vasoconstriction (decrease GFR)
18
Q
Drug induced GLOMERULAR dz
A
Immune mediated usually:
Heroin, Pamidronate –> focal segmental glomerulosclerosis
Gold therapy –> membranous nephropathy
19
Q
Drug induced TUBULAR necrosis
A
Direct toxicity or Ischemic Aminoglycosides, Amphotericin B Foscarnet Cisplatin Radiocontrast media
20
Q
Highest oxygen extraction
A
Myocardium
21
Q
DOC for pts:
Diabetes + HTN
A
ACEI
22
Q
Thiazides are NOT first line for these HTN patients
A
Diabetic
Gout
Hypercalcemiain
23
Q
Eplerenone
A
Aldosterone antagonist
24
Q
HTN + Cardiovascular dz: first line?
A
Cardioselective BB (Carvedilol, Metoprolol, Bisoprolol)
25
AV shunt: effect on heart
Increased preload
Decrease afterload
(can result in HIGH output cardiac failure)
26
Compare two means vs. Compare categorical data
Means: two-sample T test
Categorical: Chi-square
27
ANP and BMP activate?
Guanylate cycalse (increase cGMP) --> vasodilation
28
```
a wave
c wave
x wave
v wave
y wave
```
```
a= atrial contraction
c= tricuspid valve bulging (RV contraction)
x= right atrial relaxation
v= continued inflow of venous blood
y= passive emptying of right atrium after tricuspid valve opening
```
29
JVD Wave that is absent in patinet w/ atrial fibrillation
Atrial fibrillation
30
Calcification and thickening of pericardium >4mm
Constrictive pericarditis
(slowly progressive dyspnea, peripheral edema, ascites)
(radiation therapy, cardiac surgery, TB)
31
All nitrates cause A/E of?
Headache
Facial flushing
(vasodilatory effect in meninges and skin)
32
Urinary retention: caused by what drugs?
```
Anticholinergics (atropine)
Anticholinergic effects (TCA, antihistamines)
```
33
Cold extremities may be A/E of what drugs?
BB
| Ergotamine (migraine headaches)
34
Thiazide: A/E
HYPER: uricemia, calcemia, hyperglycemia, hyperlipidemia
35
Nephrolithiasis + HTN: can use?
Thiazide (decrease hyperURIcemia)
36
Myopathy: lipid drugs combination
Statins (myopathy)
+
Fibrates (gem increase cc of most statins, feonofibrate cause myopathy itself)
37
Cholesterol stone: lipid drug combination
Fibrates
+
Bile acid-binding resins
38
First dose hypotension
ACEI
39
Lower LDL but Significantly increase TG
Bile acid-binding resins
40
Ezetimibe used mainly for?
Hypercholesterolemia (high LDL)
41
Fibrates are used for?
HyperTG
| HyperTG can cause pancreatitis
42
Niacin: drug interference
Niacin = vasodilatory + insulin resistance so:
Decrease needed dose of HTN meds
Increase needed dose of Diabetic meds
43
Conn's Syndrome
Aldosterone secreting adenoma
44
Aldosterone causes?
Sodium and Water reabsorption
| K+ and H+ wasting (alkalosis)
45
Aldosterone antagonist (for treating Conn's syndrome)
Eplerenone
| Spironolactone
46
Migratory thrombophlebitis (Trousseau's syndrome)
Cancer or Small vessel hypersensitivity type vasculitis
47
Use for intermittent claudication
Cilostazol
| PDE inhibitor/inhibit platelet aggregation; direct arterial vasodilator
48
Increase platelet cAMP
DECREASE aggregation
49
Dipyridamole
| Cilostazol
Decrease activity of platelet phosphodiesterase
| Increase cAMP --> decrease platelet aggregation
50
Argatorban
Direct thrombin inhibitor
| for tx of: Heparin-induced thrombocytopenia
51
tPA: MOA
Convert plasminogen to plasmin (fibrinolysis)
52
Ticlopidine
| Clopidogrel
Block ADP receptor (NOT allowing IIb/IIA receptor to work properly)
53
Abciximab
Inhibit platelet aggreagtion (target IIb/IIA receptor)
| Percutaneous coronary intervention
54
Tx of PVD: aspirin or Cilostazol
Cilostazol (anti-platelet aggregation, vasodilator)
55
Phenylephrine
Alpha AGONIST
56
Dopamine: low, high, higher dose
Low: D1 receptor: vasodilation of renal/mesenteric vasculature
High: B1 receptor
Higher: A1 receptor
57
Carcinoid syndrome: heart
RIGHT sided endocardial fibrosis --> pulmonary stenosis/restrictive CM
58
Syncope
Angina
Dyspnea
Aortic stenosis triad
59
Rheumatic heart dz
vs.
Infective endocarditis
(aortic valves)
Rheumatic: regurg and stenosis
Endocarditis: regurg
60
Common cardinal v.
SVC
| Systemic venous circulation
61
Genomic imprinting is produced by?
DNA methylation
62
Granulomatous inflammation of media
Temporal (Giant cell) arteritis
63
Transmural inflammation of arterial wall w/ FIBRINOID necrosis
PAN
64
Hyperplastic arteriolosclerosis
Malignant HTN
| onion-like concentric thickening or arteriolar walls
65
Nitrate w/ 100% bioavailability
Isosorbide mononitrate
| active metabolite of isosorbide dinitrate
66
Cyanide toxicity
Sodium nitroprusside
| tx. of HTN emergency
67
Bifurcation of abdominal aorta occurs at?
L4
68
Common iliac veins merge to become?
IVC (@ L4)
69
Nitroprusside
Short acting
BALANCED venous AND arterial vasoDILATOR
(Decrease preload AND afterload)
70
Nitroprusside CN toxicity antidote
Sodium thiosulfate
71
6th aortic arch
Pulmonary arteries
| Ductus arteriosus
72
Sinus venarum
Smooth portion of right atrium
| From sinus venosus
73
Smooth portion of L and R VENTRICLE
Bulbus cordis
| forms beginning of VOFT
74
Rough portion of L and R atrium
Primum atrium
75
IRREVERSIBLE a1 and a2 ANTAgonist
Phenoxybenzamine
| tx for pheochromocytoma
76
Niacin
Increase HDL level (inhibit hepatic VLDL and TG production)
77
B3
Niacin
78
Bile acid-binding resin: most important A/E
HyperTG
| avoid in patients who has HyperCHOLESTEROl + HyperTG
79
Prevent flushing due to Niacin w?
Pretreatment w/ ASA
80
Niacin: A/E
Flushing
HYPERuricemia
HYPERglycemia
Hepatotoxicity @ high doses
81
Hyperlipidemia patient:
avoid ________if hyperglycemic, gout.
avoid ________ if hypertTG.
avoid ________if cholesterol stones
HyperGlc, Gout: avoid niacin
HyperTG: avoid bile acid binding resin
Cholesterol stones: avoid bile acid binding resin, fibrates
82
Niacin flushing mediated by?
| Vancomycin "red man" mediated?
Niacin: prostaglandin
Vancomycin: histamine
83
Serotonin come from what a.a?
Tryptophan
84
Capsaicin reduce by?
Decreasing substance P
85
Low pitch holoSYSTolic murmur
Left sternal border
ACCENTUATED by handgrip (increase AFTERload)
VSD
86
CD31
Endothelial cell marker
| PECAM1
87
Arsenic
Thorotrast
Polyvinyl chloride
Hepatic angiosarcoma
88
BB: HYPERkalemia
B2 receptor: intracellular K+ uptake
89
K+ sparing diuretic
Amiloride
Triamterene
Spironolactone
(ACEI can cause hyperkalemia 2/2 decreased aldosterone + combined with one of the meds above)
90
Coarctation of aorta is a/w increased incidence of what other congenital defects?
Congenital berry aneurysms
91
Diastolic heart failure: LVEDP, LVEDV, EF
EF = normal
Volume = normal
PRESSURE MUST INCREASE to maintain SV
92
Systolic heart failure: LVEDP, LVEDV, EF
EF = decreased
| so: VOLUME AND PRESSURE must increase to maintain SV
93
Activate PPAR-alpha
Fibrates
94
Kussmaul sign
Pericardial knock
JVP
Constrictive pericarditis
95
Restrictive vs. Constrictive CM: heart sound
Restrictive: S3
Constrictive: Pericardial knock (more accentuated, earlier)
96
Abdominal aortic aneurysm: major risk factor
| Aortic dissection: major risk factor
AAA: atherosclerosis
AD: HTN
97
Osler-Weber-Rendu syndrome aka
Hereditary hemorrhagic telangiectasia
| AD
98
Match:
Capillary hemangioblastoma, renal cell carcinoma
Hamartomas, renal angiomyolipomas
Leptomeningiomas, "tram-track" calcification of skull
Hemagioblastoma + renal = VHL
Hamartomas + renal = OWR
Leptomeningiomas = SW
99
Biatleral schwannomas
| Multiple meningiomas
NF-2
100
Homocysteine --> Methionine: cofactor
B12 (cobalamin)
| also require methyl-tetrafolate
101
Elevated homocysteine: risk for?
Arterial and venous thrombosis
102
Homosysteine is elevated in?
| Methylmalonyl CoA is elevated in?
Homo: BOTH folate and B12 deficiency
| Methylmalonyl CoA: B12 deficiency ONLY
103
Obliterative endarteritis
Vasa vasorum involvement in tertiary syphilis
| increased risk of aortic aneurysms
