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CPR II > Week 1 (Exam 1) > Flashcards

Week 1 (Exam 1) Flashcards

1
Q

Strawberry Tongue
Conjuctivitis
Palm / Sole Erythema

A

Kawasaki Disease (Large / Med Vessel Arteritis)

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2
Q

Carcinoid Tumor secretions

A

Serotonin: Induces plaque-like endocardial and valvular thickening

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3
Q

Mid-Systolic Click (+/- murmur)

A

Mitral Valve Prolapse

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4
Q

Crescendo Pattern chest pain occurring at rest

A

Unstable Angina
Usually a rupture of an atherosclerotic plaque with partial thrombus (crescendo can be caused by progressive mechanical obstruction)

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5
Q

Pre-Existing conditions leading to infective endocarditis

A

Valvular Disease
Prosthetic Heart Valve
Structural Heart Disease

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6
Q

Most common cause of sudden death due to Ischemia-Induced-Arrhythmia

A

Coronary Artery Disease

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7
Q

Causes of Myocardial Vascular Contraction (vasospasm)

A

Lots of Vasoactive Mediators (coke, catecholamines)
Lots of Thyroid Hormones (catecholamine sensitive)
AutoAbs and T cells in Scleroderma

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8
Q

Cause of Rheumatic Fever

A

Abs and CD4+ T Cell reactions against M Strep Ag

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9
Q

CATCH-22

A

Cardiac Abnormalities, Abnormal Facies, Thymic Aplasia, Cleft Palate, Hypocalcemia, 22q11 Deletioin

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10
Q

Fever, Pleuritic Pain, Pericardial Effusion

A

Dressler / Post-MI syndrome

Auto-immune fibrous pericarditis

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11
Q

Maintaining oxygenation with Tricuspid Atresia

A

ASD/PFO and a VSD

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12
Q

Ball Valve Obstruction and Mechanical Valve Damage from “wrecking ball embolism”.

A

Cardiac Myxoma
Elaborates IL-6, causing Fever and Malaise
Tumor “plop” on auscultation

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13
Q

Major Giant Cell Arteritis Sx

A

Vision Loss Can Occur

Headache, facial pain, fever, ocular sx

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14
Q

MacCallum Plaques

A

Acute Rheumatic Fever

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15
Q

Risk factors for Myocardial Rupture

A

First MI, Age, No LV Hypertrophy

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16
Q

Down syndrome Cardiac Defects

A

AV or Ventricular Septal Defects

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17
Q

Thoracic Aortic Dissection Sx

A

Triad: Thoracic Pain + Pulse Abnormalities + Mediastinal Widening on CXR

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18
Q

Conequence of AVM

A

High Output Cardiac Failure

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19
Q

SA node damage

A

Sick Sinus Syndrome: Bradycardia

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20
Q

How do the heart chambers change with age?

A 
Left ventricle cavity reduces in size (esp w/ HTN)
Atria Dilate (from fibrous mitral valve)
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21
Q

Tibial and Radial Artery Vasculitis

A

Most Likely Thromboangiitis Obliterans (Buerger)

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22
Q

Aschoff bodies with Anitschkow Cells

A

Histology of Acute Rheumatic Fever

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23
Q

Turner syndrome (45X) CV defect

A

Coarctation of the aorta

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24
Q

Causes of Systolic Dysfunction

A

Ischemic Injury, Dilated Cardiomyopathy, Valve Regurg

this decreases the ejection fraction

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25
Q

Serious but rare complications of mitral valve prolapse

A

Infective Endocarditis
Mitral Insufficiency (+/- cord rupture)
Arrhythmias
Thromboembolism

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26
Q

ACE

A

Converts Angiotensin I to II

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27
Q

Turner syndrome common lymphanioma

A

Cavernous (aka cystic hygroma)

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28
Q

IV drug use and the heart

A

Right Sided Endocarditis

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29
Q

T cell Mediated dz with 2/3 showing endothelial and anti-SM ABs

A

Giant Cell Arteritis

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30
Q

Undercooked pork

A

Trichenosis: infective myocarditis

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31
Q

Raynaud’s, Then Claudication, then severe pain at rest, then ulceration, than gangrene of the digits. Whats up

A

Thromboangiitis Obliterans / Buerger Dz

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32
Q

Test for Pheochromocytoma

A

Elevated Urinary or Plasma Metanephrines

it causes HTN

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33
Q

Eisenmenger Syndrome

A

Shunt Reversal

Identified by Thickened pulmonary A walls, occlusion

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34
Q

Most Common Cardiac tumor in adults vs tumors

A

Adults: Myxoma
Children: Rhabdomyoma

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35
Q

Heart Attack with No Angina

A

Silent MI: results from denervated transplant

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36
Q

Causes or R to L cardiac shunts (symptomatic)

A

Tetrology of Fallot
Transposition of Great Arteries
Tricuspid Atresia
Patent Foramen Ovale (with increased pressure)

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37
Q

Diseases associated with berry aneurisms

A

AD Polycystic Kidney Disease
Marfan Syndrome
Ehlers Danlos

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38
Q

Arteriolosclerosis

A

Hyaline and Hyperplastic Arteriolosclerosis
Small Arteries and Arterioles
Downstream Ischemic Injury

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39
Q

Renal A Stenosis

A

Causes HTN
From Atherosclerosis or Fibromuscular Dysplasia
Abdominal Bruit

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40
Q

NSTEMI

A

plaque rupture and thrombus formation with partial occlusion causing injury and infarct to subendocardial myocardium

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41
Q

Rapidly Accelerating HTN

Abdominal pain and bloody stool, myalgia, peripheral neuritis

A

Polyarteritis Nodosa (ass’d w/ Hep B), usually renal vessels and GI teact vasculitis

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42
Q

Ruptured vs Non-ruptured symptomatic AAA

A

Non: Pain in abdomen / back
Rupture: Severe acute pain, pulsatile mass, hypotension

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43
Q

Endocardial Fibroelastosis

A

Thickening of Left Ventricular Endocardium during first two years of life
Associated with congenital heart defects

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44
Q

Causes of L to R cardiac shunts (asymptomatic)

A

ASD / VSD

PDA

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45
Q

Rhabdomyoma mutations

A

TSC1 (Hamartin) and TSC2 (Tuberin)

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46
Q

What causes Cor Pulmonale?

A

Any cause of Pulmonary HTN:
1. Parenchymal Lung Disease
Others: Lung Thromboemboli, Primary Pulmonary HTN

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47
Q

Lethal Effects of Churg-Strauss

A

Cardiomyopathy/Myocarditis and Infarction

Almost half the deaths

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48
Q

Prolonged PR interval

A

First Degree Heart Block

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49
Q

Hyaline Arteriolosclerosis

A

Found in Chronic Hypertension
Increased SM Matrix and Plasma Protein leakage
Narrows lumen, happens in kidneys too

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50
Q

VSD Murmur

A

Holosystolic

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51
Q

Causes of Fibrinous and Serofibrinous Pericarditis

A

Acute MI, Dressler’s, Uremia (CKD with BUN increase)

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52
Q

Where would you likely find a cardiac myxoma?

A

Left Atrium, beginning in septal region of Fossa Ovalis

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53
Q

Factors lowering LDL

A

Fiber

Statins

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54
Q

Polyostic Fibrous Dysplasia, Cafe au Last Spots, Endocrine abnormalities, and myxomas. Whats the mutation?

A

GNAS1 (McCune-Albright Syndrome)

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55
Q

Flushing, Diarrhea, dermatitis, bronchoconstriction

A

Carcinoid Heart Disease

similar to taking fenfluramine or ergot alkaloids for appetite suppression or migraine, respectively

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56
Q

Effects of HTN on the Brain and Eye

A

Multi-Infarct Dementia and Cerebrovascular Hemorrhage
Increased intracranial pressure/papilledema
Retinopathy

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57
Q

Most common cause of sudden death after exertion

A

Long QT syndrome

K channel LOF, Caveolin/Na Current GOF

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58
Q

Causes of restrictive cardiomyopathy

A

Senile Amyloidosis
Fibrosis (radiation)
Myeloma, Inflammation, Mut Transthyretin

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59
Q

Metabolic Syndrome Criteria:

A

3 of 5:

Abdominal Obesity, TAG increase, HDL decrease, High Blood Pressure, Insulin Resistance

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60
Q

What kind of pericarditis do you get from a malignant neoplasm?

A

Hemorrhagic Pericarditis

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61
Q

Deep tissue hemangioma with indistinct borders that’s more likely to bleed

A

Cavernous Hemangioma

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62
Q

Chronic mitral valve prolapse sx

A

Dyspnea

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63
Q

Common cause of acute lymphangitis

A

Group A b-hemolytic Strep

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64
Q

CRP

A

Increases with IL-6, CV Risk

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65
Q

Anomalous Pulmonary Venous Return

A

Sinus Venosa Defect (ASD): Near SVC entrance

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66
Q

VSD cardiac shunting effects

A

R Ventricular Hypertrophy
Pulmonary HTN
Eventually shunt reversal, causing cyanosis and death

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67
Q

CKMB time to normalization

A

48 - 72 hours

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68
Q

Osler Weber Rendu mutation

A

AD mut of TGF-b signaling pathway, leading to hemorrhagic telangiectasia and AV malformations

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69
Q

Plakoglobin mutation

A

Naxos Syndrome: ARVC + Plantar/Palmar Hyperkeratosis + Wooly Hair

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70
Q

Indomethacin

A

Closes PDA

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71
Q

Effects of HTN on Kidney

A

Renal Dysfuntion and Failure

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72
Q

Signs and Symptoms of Hypertrophic Cardiomyopathy

A

Sudden Death in young athletes
Systolic Ejection Murmur from Mitral Valve
Exertional Dyspnea and Angina
Palpitations: A Fib and Mural Thrombus

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73
Q

Right sided heart lesions

A

Probably carcinoid tumor: the left side is protected by the liver against mediators

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74
Q

Main mutation of hypertrophic cardiomyopathy

A

Sarcomeric proteins, b-Myocin Heavy Chain

b-MHC

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75
Q

Major risk factor of Atherosclerosis

A

AAA

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76
Q

Causes of Aortic Dissection

A

HTN

CT disorders

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77
Q

Purulent or suppurative pericarditis

A

Active infection from microbe

78
Q

Signs and Sx of Acute Rheumatic Fever (6)

A 
101+ fever
Migratory Polyarthritis
Pancarditis
Subcutaneous Nodules
Erythema Marginatum
Sydenham Chorea
79
Q

PR3-ANCA (c-ANCA)

A

Associated with Granulomatosis with Polyangiitis

80
Q

Deadly unless a shunt allows for life. Trouble breathing almost always present after birth

A

Transposition of Great Vessels

81
Q

Major risk factor of Ehler Danlos

A

Mitral Valve Prolapse

Abnormal Wound Healing

82
Q

Takotsubo cardiomyopathy

A

Broken heart syndrome: catecholamine release causing ischemic coronary artery constriction

83
Q

Systolic Murmur, Angina, Syncope, CHF

A

Calcific Aortic Stenosis (leads to left ventricular hypertrophy)

84
Q

HFE

A

hemochromatosis can cause dilated cardiomyopathy

85
Q

Most common cause of right heart failure

A

Left heart failure

86
Q

Angiotensin II

A

Stimulates Adrenal Cortex to release Aldosterone

87
Q

Possible compression sx associated with Thoracic Aortic Aneurysm

A

Respiratory tree: Breathing difficulty
Esophagus: Dysphagia
Recurrent Laryngeal Nerve: Couch

88
Q

Most common cause of Arrhythmias

A

Ischemic Heart Disease

89
Q

Rib Notching

A

Long Standing Coarctation of the Aorta

90
Q

Prostaglandin E

A

Keeps PDA open

91
Q

Lentigines, Endocrine dysfunctions, myxomas. Mutation?

A

PRKAR1A Null Mutation (Carney Complex)

92
Q

Etiology of Arrhythmogenic Right Ventricular Cardiomyopathy

A

Defective desmosomes that link myocytes

Familial ones are AD

93
Q

STEMI

A

Complete occlusion of bv lumen

transmural injury and infarct to myocardium

94
Q

Possible causes of non-infective endocarditis

A

Cytokines from Sepsis
Procoagulant release from Tumors
Antiphospholipid Syndrome
SLE (Libman-Sacks): vegetations on mitral valve

95
Q

CKMB and cTnl peak

A

24 hours

96
Q

Onion Skin Lumen

A

Hyperplastic Arteriolosclerosis from Severe HTN

97
Q

Asthma, Hypereosinophilia, Lung Infiltrates
Palpable Purpura
GI tract Bleeding
Renal Disease

A

Churg-Strauss Syndrome (less than half are ANCA positive)

98
Q

Marfan syndrome CV Defects

A

Aortic Aneurisms and Dissections

99
Q

Spider telangiectasia caues

A

Can be from increased estrogen (pregnancy, liver dz)

100
Q

Tetrology of Fallot

A

VSD
Right Ventricular Hypertrophy
Pulmonary Valve Stenosis
Overriding Aorta

101
Q

CKMB, cTnT, cTnl time to elevation

A

3 - 12 hours

102
Q

Findings in Chronic Rheumatic Heart Disease

A 
Valvular Leaflet Thickening, Short Chordae Tendonae, Fusion, Regurgitation
Valvular Stenosis (MITRAL>aortic>tricuspid)
Mitral Stenosis (diastolic rumbling murmur)
103
Q

Secundum ASD

A

90% of all ASDs, in the center of the atrial septum

104
Q

Pedunculated, globular, hard mottled gelatinous mass

A

Cardiac Myxoma

105
Q

Pseudo-Aneurysm

A

Defect through the wall of the vessel, communicating with an extravascular hematoma that freely communicates with the intravascular space
AKA Pulsating Hematoma

106
Q

Hyperhomocysteinemia

A

Increases coronary Atherosclerosis, vascular disease, stroke

107
Q

Lung cavities, bleeding, infiltrates
Nose stuffiness, bleeding, SADDLING
Crescentic Glomerulonephritis

A

Granulomatosis with Polyangiitis

108
Q

Causes of Diastolic Dysfunction

A

HTN, Aortic Stenosis, Hypertrophic Cardiomyopathy, Fibrosis (previous ischemic injury)
(this has a normal ejection fraction)

109
Q

Systolic vs Diastolic cardiomyopathies

A

Systolic: Dilated
Diastolic: Hypertrophic and Restrictive

110
Q

Dilated Cardiomyopathy genetics

A

TTN gene, coding for Titin Protein

111
Q

“worst headache of my life”

Neck pain, vomiting, double vision, seizures, LOC

A

Ruptured Berry Aneurism

112
Q

Most likely organism involved with prosthetic valve stuff

A

Staph Epidermitis

113
Q

Etiology of pyogenic granulomas

A

Can be in the gingiva of pregnant women
25% develop following trauma
Its a capillary granuloma btw, neither pyogenic nor granulomatous

114
Q

Exercise-Induced chest pain

A

Stable Angina

Stenotic occlusion of Coronary A

115
Q

Growth Factors causing Smooth Muscle Cell Proliferation

A

PDGF, Fibroblast Growth Factor, TGF-a

Contributes to atherosclerosis

116
Q

Factors lowering HDL

A

Obesity and Smoking

117
Q

Principal causes of Left Heart Failure

A

Myocardial Ischemia, HTN, Left-sided valve disease

118
Q

Chest pain worse when laying with leg up
Chest pain better when seated upright
Fever, Friction rub, EKG

A

Pericarditis

119
Q

Kawasaki Disease Infectious Trigger

A

Activated T Cells

120
Q

Hypercoaguability state risk factors for thrombophlebitis (DVT) from tumor

A

Thrombotic paraneoplastic syndrome

Migratory thrombophlebitis / Trousseau sign

121
Q

CV risk of Tertiary Syphillis

A

Obliterative Endarteritis of Vasa Vasorum causing Thoracic Aneurysm
Aortic Valve Regurgitation

122
Q

Port wine stain along Trigeminal N

A 
Sturge-Weber:
Mental retardation, seizures, hemiplegia
Leptomeningeal capillary-venous malformation
Skull Radio-opacities
Glaucoma
123
Q

Head, neck, chest, arm veinous dilation
Face swelling, neurologic manifestations
Respiratory distress

A

Superior Vena Cava Syndrome

From Lung CA, Lymphoma (also aneurism, AV fistula, fibrosis)

124
Q

Most common site of berry aneurism

A

Anterior Cerebral Artery Branch Point

125
Q

Major risk factor for a Thoracic Aortic Aneurysm

A

Hypertension (also syphilic aortitis, CT disease, vasculitis)

126
Q

Glomus Tumor

A

Usually on the fingers, can be subungual

Made from modified smooth muscle from the glomus body (responsible for thermoregulation)

127
Q

Possible Cause of AVM

A

Penetrating wound, rupturing arterial aneurism into adjacent vein
Inflammatory Necrosis of Vessels
Surgical AV Fistula for chemo or dialysis

128
Q

Cardiac Muscle CK

A

MB Heterodimer

129
Q

Amyloid

A

Insoluble b-Pleated Sheet

Apple Green Birefringence on Congo Red

130
Q

Lower extremity edema

dissension of superficial lower abdominal veins

A

Inferior vena cava syndrome

From HCC, Renal Cell Carcinoma, Thrombosis

131
Q

What happens if you get calcifications on your valves?

A

Aortic Stenosis

132
Q

Arteriovenous Malformation (AVM)

A

Tangle of worm-like vascular channels with A to V shunts

133
Q

Antiphospholipid Syndrome

A

Can cause Fetal Loss during pregnancy
Primary or associated with Lupus
Auto-Abs against the endothelial membrane

134
Q

What kind of pericarditis do you get from Tb?

A

Caseous Pericarditis

135
Q

Cyanosis, Holosystolic Murmur, Systolic Ejection Murmur, Syncope / Cyanosis episodes

A

Tetrology of Fallot

136
Q

Diseases associated with asymmetric / secondary Raynaud’s

A

SLE, Scleroderma, Thromboangiitis Obliterans

137
Q

Premenopausal estrogenized women protective effect

A

MI

138
Q

cTnl, cTnT time to normalization

A

more than 5 days

139
Q

Peau d’orange

A

Draining lymphatics of skin overlying breast cancer filled with tumor cells

140
Q

How does the epicardium and myocardium change with age?

A

Increase in lipofuscin, fat, and amyloid (transthyretin)

Myocyte loss and basophilic degeneration

141
Q

Most likely organism involved with poor dentition / invasive dental procedures

A

HACEK

homophiles, actinobacillus, cardiobacterium, eikenella, kingella

142
Q

Possible Side Effects of Chronic Rheumatic Fever

A

Infective Endocarditis

Left Atrial Enlargement causing A Fib, Thrombi (from mitral stenosis and regurgitation)

143
Q

String of Beads Angiography

A

Fibromuscular Dysplasia, commonly renal A

50% have epigastric abdominal bruit

144
Q

Major physical exam findings of infective endocarditis

A 
Subungual splinter hemorrhages
Janeway lesions (red dots on hands and feet)
Osler nodes (dark lumps on hands, fingers)
Roth Spots (dark spots on retina)
145
Q

Sx of Right Sided CHF

A

(all due to veinous congestion): Hepatosplenomegaly
Distended Jugular Veins
Effusions involving peritoneal, pleural, pericardial spaces
Edema (esp ankles)

146
Q

Results of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

A

RV myocardium replaced by adipose, fibrosis, dilation

V Tach or V Fib leading to Sudden Death

147
Q

Atherosclerosis

A

“gruel” and “hardening”
Atheromatous plaque formation
Stenosis / occlusion, plaque rupture, aneurysm

148
Q

HTN in UE, Hypotension in LE

Possible eventual concentric LV Hypertrophy

A

Coarctation Without PDA
Often Asx
(remember: Coarctation is associated with Turners)

149
Q

Giant Cell Myocarditis with non-necrotizing granulomas

A

Myocardial Sarcoidosis

150
Q

Coarctation of the Aorta

A

Causes HTN

Hyperextension in UEs with Hypoextenion in LEs

151
Q

Harsh Systolic Murmur, Crescendo-Decrescendo

A

Calcific Aortic Stenosis

152
Q

Sea Anemone-Like lesions on the valves, resembling Lambl Excrescences

A

Papillary Fibroelastoma

153
Q

Cushing Syndrome

A

Anterior Pituitary Tumor secreting ACTH (primary)

Tumor on Adrenal secreting Cortisol Directly

154
Q

Floppy valve

A

Mitral valve prolapses back into L Atrium during Systole
Associated with Marfan
Leaflets are thick and rubbery, with ballooning / hooding

155
Q

BB homodimer

A

Creatine Kinase Expressed in brain and lung.

156
Q

Marfan syndrome Risk

A

Aortic Aneurysm and Aortic Dissection

157
Q

Most common thoracic Aorta Dissection

A

Proximal to Left Common Carotid A

DeBakey 1

158
Q

Coxsackievirus B

A

Most common cause of infectious myocarditis

159
Q

Factors Increasing HDL

A

Exercise

Moderate Alcohol

160
Q

What happens if you get a fibrous mitral valve?

A

Buckling prolapse during systole, causing Atrial Dilation and Arrhythmia

161
Q

Effects of HTN on the heart and aorta

A

Cardiac Hypertrophy and CHF
Ischemic Heart Disease
Aortic Dysfunction

162
Q

Nephritis, Hemoptysis, Cutaneous Purpura, muscle weakness, bowel pain and bleeding

A

Microscopic Polyangiitis

163
Q

Confirmatory Tests for Acute Rheumatic Fever

A

Abs to Streptolysin O and DNase B

164
Q

Causes of Mycotic Aneurism

A

Septic Emboli (infective endocarditis)
Extension of adjacent infectious process
Circulating organisms directly infecting arterial wall

165
Q

Causes of Calcific Aortic Stenosis

A

Chronic HTN
Hyperlipidemia
Inflammation
Accelerated by bicuspid aortic valve

166
Q

Diastolic Dysfunction

A

Left Atrial Enlargement -> A Fib

167
Q

Risk factors of angiosarcoma

A

Liver (arsenic, thorotrast, PVC production)
Lymphedema s/p axillary LN dissection
Radiation

168
Q

Takayasu Arteritis

A

Thickening of Aorta and Major Branch Vessels

Weakening of Pulses with Ocular Disturbances

169
Q

Serous Pericarditis

A

Viral or Noninfectious

170
Q

Enlarged Atria, Normal Ventricles

A

Restrictive Cardiomyopathy

171
Q

Inflamed Eyes
Mouth Ulcers
Genital Ulcers

A

Behcet’s Disease: HLA-B51, Neutrophilic vasculitis

172
Q

Bacillary Angiomatosis is a vascular proliferation due to what?

A

Bartonella, seen on silver stain (warthog starry stain)

Treat with Abx

173
Q

Rheumatic Fever effects on the heart

A

Pericarditis, Myocarditis, +/- Endocarditis
Verrucae formation at mitral valve
MacCallum Plaques

174
Q

Boot Shaped Heart

A

Tetrology of Fallot

175
Q

Eosinophilic Infiltrative Fibrosis associated with Myoproliferation (leukemia/lymphoma)

A

Loeffler Endocarditis

176
Q

Hypertensive Crisis

A

Systolic over 180-200

Diastolic over 120

177
Q

MPO-ANCA

A

Associated with Microscopic Polyangiitis

178
Q

Kerley B Lines, Hemosiderin-laden Macrophages, Pulmonary Edema

A

Left Sided CHF

179
Q

Hypertensive Emergency

A

HTN Crisis + end organ damage

180
Q

Doxorubicin

A

Can cause dilated cardiomyopathy

181
Q

Hypoxia, Increased Pulmonary Vascular Pressure

Harsh, Machinery-like Murmur

A

PDA

182
Q

Cor Pulmonale Etiology

A

Pulmonary HTN

Large Pulmonary Embolus

183
Q

Most likely organism in native, structurally abnormal valves

A

Step Viridans

184
Q

Marfan Gene mutation

A

FBN1 Fibrillin Gene

Increased TGF-B: elastic tissue weakening

185
Q

MM Homodimer

A

Creatine Kinase Expressed in cardiac and skeletal muscle

186
Q

Mönckenberg Medial Sclerosis

A

Age related degenerative process
Calcification of muscular arteries, internal elastic membranes
No Narrowing of lumen, usually not clinically significant

187
Q

Episodic Coronary Artery spasm, relieved with vasodilators

A

Prinzmetal Variant Angina

Unrelated to Physical Activity

188
Q

Most common malignant heart tumor

A

Angiosarcoma

189
Q

Factors Increasing LDL

A

Animal Products

Trans Fat

190
Q

Lower half of body cyanotic, absent femoral pulses

Heart failure / shock

A

Infantile (+PDA) Coarctation of Aorta

191
Q

Mitral Valve Annular Calcification

A

Nidus for Thrombus and infective endocarditis

Usually normal, progresses to regurgitation, stenosis, arrhythmias (heart block, sudden death)

CPR II (8 decks)

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