Tuesday wk 2 Cardio 1 Flashcards
__ rejection is common in heart transplantation
usually is __ mediated w/in 4 wks
dense infiltration of __ cells, mostly __ cells
T cells directed against graft __ antigens
sx include SOB/PND
patchy necrosis w granulation tissue indicates __ damage to donor heart
perivsacular infiltrate w abundant eosinophils indicates __ mycoarditis, usually __ related
scant inflamm w interstital fibrosis is seen in __ reject
acute
cell
mononuclear, T
MHC
ischeic
hypersensitivity, drug
chronic
stable angina is fixed atheromatous obstruction of coronary arteries occuluding __% of CSA
ulcerated atherosclerotic plaque w partially occlusive thrombus indicates __ angina or subendocardial __
chest pain is a single __
coronary artery vasospasm seen in __ angina
transmural ischemia w __ elevation on ECG
not assc w __, but does respond to N_ and C__
75
unstable, infarct
episode
Prizmental
ST segment
plaques, nitro, CCB
low freq, late diastolic sound just before S1 indicates __ heart sound
indicates reduced ventricular __, such as w HTN, AS, HCM
sudden rise in __ pressure w atrial contraction
this is __ dysfxn
ventricular gallop just after s2 is __ heart sound
rapid filling of __ in diastole
assc w m__ and __ HF, volume __ and HO __
S4
compliance
end diastolic
diastolic
S3
ventricles
MR, systolic, overload, cardiac states
congenital coarctation of the aorta affects region __ to LSCA
in infancy, may have __ of LE progressing to HF/shock
in child/adult, sx of LE __ and __ discrepancy
congenital is assc w __ syndrome
DiGeorge Syndrome assc w interrupted __
poor LE __, RDS, and __
also T__
Down syndrome assc w __ cushion defects
such as OP __ and regurg __ valves
Marfan assc w cystic __ necrosis/dissection and MVP
distal
cyanosis
claudication, BP
turner
aortic arch
pulses, cyanosis
Tet of Fallot
endocardial
ASD, AV
medial
__ is class 3 antiarrhthmic
mostly ___
can cause __ due to dec production of TSH
or _ due to inc TSH synth
or __ thyroiditis w release of preformed TSH
other SE
sinus B__ and heart block
can prolong __
IPF inc \_\_ leading to hepatitis \_\_ neuropathy and deposits skin \_\_ peripheral \_\_
Amiodrane, iodine
hypothyroid
hyperthyroid
destructive
bradycarida
QT
LFT
optic
discoloration
neuropathy
__ assc w endothelial cells, VSMCs and luekocytes
chronic hemodynamic stress/hyperlipidemia leads to __ cell injury
inc expression of __ inc adherence of monos/T cells
releases cytokines/GF to promote __ into intima
VSMC release ECM proteins like __ to form the fibrous cap
macros/MMP promote __ and potential for release
disruption can lead to __
atherosclerosis endothelial, VCAM VSMC collagen MI
remodeling
serum sickness is assc w infections like __ and drugs like __
midsystolic click w mid-late systolic murmur at apex is __ murmur
sudden tensing of __, due to malalignment of the valve
Squatting inc __ and LV volume, so leaflets are in normal alignment
will __ MVP
usually sporadic disorder w __ degen of CT
Secondary MVP assc w __/__/__
proliferation of __ in valve leaflets, fragmented _ fibers and inc in mucopolysaccharide/T3 collagen
HepB, penicillin
MVP
chordae tendinae
venous return
dec
myxomatous
EDS/Marfan/OI
spongiosa, elastin
inspiration __ VR to right heart
__ VR to left heart
inc __ murmurs, dec __ murmurs
Valsalva/standing __ preload/afteload
inc __/__ murmur, dec others
squatting inc __/__
passive leg raise in p__
majority of murmurs __
MVP/HCM __
handgrip inc A__
inc A/M/V
dec H/A
inc
dec
Rh, LH
dec
MVP/HCM
preload/afterload
preload
inc
dec
afteroload
AR/MR/VSD
HCM, AS
central lines threaded into __
derived from common __
all veins in developing embryo drain into the __, and eventully RH
__ vein forms portal system
__ veins form systemic venous circ
__/__ derived from truncus arteriousus
NCC migration __ via twisting of truncal/bulbar ridges
SVC
cardinal veins
sinus venosus
vitelline
cardinal
AA, PA
separates
young pt, sudden onset palpitations has PSVT__
reentrant impulse bw slow/rapid conducting segents of __
vagal maneuver like __ massage, Valsalva, __ immersion improve it
carotid sinus travels to __ nucleus via CN 9
efferents travel in __nerve carrying PNS input to SA node
inc __ tone to slow __ by AV node, prolonging refractory period
use __ filter in pt predisposed to DVT but contraindicated for anticoags
on CT, found on pt __ of AA
should be below __ and next to __
paroxysmal supraventricular tacchycardia AV node carotid sinus, cold water vagal vagus PNS, conduction
IVC
right
duodenum, R kidney
cardiac cath access __ artery in leg or __ artery in arm
arterial puncutre above the __ inc risk of retroperitoneal hemorrhage
bleeding here cannot be __
becomes the __ in the pelvic cavity
hemorrhage into thing muscles produces __ syndrome w severe pain and absent distal pulse
in cardiac pacemaker cells, phase 0 depolarization mediated by influx of __
phase 4 mediated by ___
differs from cardio__ and __ fibers, which depolarize from __
common femoral, radial
inguinal ligament
controlled
external iliac
compartment
CA
Na
myocytes, perkinje
Na
best indicator for Mitral stenosis severity is length bw S2 (A2 caused by __ closre) and __
as it worsens, LA pressures rise, causing valve to open ___
presystolic __ occurs due to inc __ flow w LA contraction
transposition of GA caused by linear development of __ septum
aorta is __ connected to RV
PA is posterior and connected to __
incompatable w life unless there is another __
failed conotruncal __ results in truncus arteriosus
echo shows single __ trunk overlying VSD
Aortic valce, opening snap
sooner
accentuation, transvalvular
aorticopulmonary
anterior
LV
shunt
septation
arterial
meds w neg chronotropic effect B blockers M/A nondihydropyridine CCB V/D Cardiac glycoside D A/S cholinergic agonist P/R
BB titrated to HR of __
when used w nondihydropyridines, there is an added __ effect on HR, AV node conduction and myocardial contractility
can lead to sinus __ and hypo__
metoprolol, atenolol verapamil, diltiazam digoxin amiodarone, sotalol pilocarpine, rivastigmine
55-60
neg
bradycarida, hypoTN
Isovolumetric contraction is spot __
closing of __ valve as LV contracts, __ inc
no blood leaves bc __ closed
Ventricular ejection is point _
__ valve opens as LV pressure rises
Isovolumetric relaxation occurs bw __ and __
closing of __ as pressure drops, no blood enters
Ventricular filling bw __ and __
opening of __ as ventricular pressure falls below __
in MS, opening snap occurs at point __ due to halting of leaflet motion
diastolic rumble then occurs as blood flows across __ valve in bw __A
A
mitral, pressure
A/M
B
aortic
C and D
AV
D and A
mitral valve, atrium
D
stenotic, D and A
__ endocarditis occurs in elderly man usually w manipulation of GI/GU tract
typically __ hemoltyic, catalase __ gram positive cocci that can grow in hypertonic saline/bile
tx w A__ and __
in left heart cath, passive filling of LA w blood from pulm veins should be timed w __ systole
LA pressure max is around __ mmHg
in MR, LA pressure will be markedly __, w an early/large V wave
Enterococci
gamma, neg
ampicilin, aminoglycosides
LV
10
inc
