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61 Cards in this Set
- Front
- Back
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presents as a harsh systolic murmur that is best heard at the 2nd r intercostal space?
what is this and what is it usually caused by? |
aortic stenosis
age (calcification) or due to congenital biscupsid valve |
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blowing diastolic murmur at the 2nd right intercostal space?
what is this and what is it caused by? |
aortic regurgitation
luetic aneurysm, chronic hypertension, dissecting aortic aneurysm, ankylosing spondylitisw |
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What does it mean if it is a harsh murmur vs a blowing murmur?
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harsh - blood hitting tissue, ie stenotic valve
blowing - blood flowing the wrong way across valves |
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harsh diastolic murmur best heard at the apex of the heart?
what is it and where is it due to? |
mitral stenosis
rheumatic heart disease |
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blowing systolic murmur best heard at apex
what is it and what is it due to? |
mitral regurgitation
due to advanced mitral valve prolapse, rheumatic heart disease, damage from infectious endocarditis, papillary muscle rupture secondary to MI, CHF |
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mid systolic click - apex
What is it and what is it most common in? |
MVP
Marfans, Ehlers-Danlos, Fragile X syndrome |
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harsh systolic murmur best heard at left 2nd intercostal space
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pulmonary stenosis
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blowing diastolic murmur heard best at the left 2nd intercostal space
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pulmonary regurgitaiton
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harsh diastolic murmur heard best at the left sternal border at 4th and 5th intercostal spaces
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tricuspid stenosis
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blowing systolic at 4th and 5th intercostal spaces
gets louder with inspiration |
tricuspid regurg --> never radiates to the axilla
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What are the two types of ASD and is it cyanotic or acyanotic?
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ostium primum --> defect next to AV valve
ostium secundum --> defect is comprised of a fenestrated ovale fossa (90% of ASDs) it is acyanotic (VSD and PDAs are also acyanotic) |
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What does the PDA connect?
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pulmonary artery to aorta (acyanotic)
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What type of congenital defect is coarctation of the aorta and what are the types of it?
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obstructive
infant type = preductal = coarctation is before the former PDA adult type = postductal = coarctation is after the former PDA (presents with high BP in UE and low BP in the LE) |
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How long does it take for unstable angina to turn into an MI?
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30 minutes
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What should you give a patient when they come into the ER complaining of chest pain?
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MONA
(morphine) oxygen nitroglycerin aspirin |
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In a MI, when is the dead tissue replaced by scar tissue?
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by ~8 weeks
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dyspnea, orthopnea, fatigue
what kind of heart failure and what is this due to? |
left-sided heart failure
due to chornic HTN, MI, and valve pathology which results in pulmonary edema and fluid overload (due to act of RAAS) |
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ankle edema, jugular venous distention, peripheral edema, nutmeg liver
what kind of heart failure and what it due to? |
right-sided heart failure
due to left-sided heart failure, pulmonary hypertension, lung pathology |
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what are small retinal hemorrhages secondary to emboli called?
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Roth spots
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What are red macules on palms and soles secondary to emboli called?
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Janeway lesions
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What are red, painful papules on fingers and toes secondary to emboli called?
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Osler nodes
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What are Roth spots, Janeway lesions, and Osler nodes all associated with?
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Infective Endocarditis
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What type of endocarditis are IV drug users and people with diabetes most likely to get and what type of bacteria are associated with this?
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acute infective endocarditis (acute onset chills and high fever)
Staph aureus, Strept spp |
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People who have prior valve pathologies who get infections caused by mouth or GI organisms are most likely to get what type of endocarditis and what are the organisms associated with this?
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Subacute Infective Endocarditis
Streptocccus spp of the viridians group (from mouth) E. coli and other gram - bacteria (from bowel) must prophylax |
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acute rheumatic fever is associated with what bug?
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Streptococcus pyogenes
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Marantic endocarditis is what?
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when thrombi develop on the endocardium and there is a higher risk in those with severe or chronic illness, especially adenocarcinoma
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what is libman-sacks endocarditis associated with?
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SLE; huge vegetations comprised of antigen-antibody complexes form on a valve, causing severe valve damage
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What are the different types of pericarditis and what are they due to?
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fibrinous - number 1 type in world due to transmural MI or Dressler syndrome
serous - number 1 type in US and due to Coxsackie's B virus, uremia, acute rheumatic fever, scleroderma, rheumatic heart disease, SLE suppurative - purulent - due to direct invasion by organisms into the pericadium (usually Strep pneumo or Staph aureus) |
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What is acute rheumaticfever due to and what is it classically associated with?
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type II hypersensity with molecular mimicry
long-term tissue famage sustained from immune attack Aschoff Body which is a focal area of myocardial inflammation which contains collagen, enlarged myocytes (Anitschkow myocytes), and some Aschoff cells (multinucleated giant cells found in this lesion) |
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What are the types of Obstructive lung disease and what are the values associated with them?
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pulmonary emphysema, chronic bronchitis, bronchiectasis
decreased FEV1, high TLC, low FEV1/FVC ratio |
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A patient presents as a "pink puffer" with pursed-lip breathing, barrel chest, dyspnea, DECREASED OR ABSENT breath sounds on auscultation with hyperinflated lungs and depressed diaphragms on chest x-ray. What do they have and what are the two major types?
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Pulmonary emphysema
panacinar - scattered throughout lobule and associated with alpha-1 antitrypsin deficiency centrilobular - in the center of the lobule and associated with smoking |
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What disease presents as a "blue bloater" who is hypoexemia early in diease with later edema secondary to right heart failure with a wet, producitve cough and dyspnea and rhonci on ausculation and how long does this have to be present to make a diagnosis?
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Chronic bronchitis
symptoms must be present for at least 3 months for 2 consecutive years |
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What are the diseases usually associated with bronchiectasis?
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Kartagener syndrome and Cystic fibrosis
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What are the findings on Restrictive Lung Disease?
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normal or low FEV1
TLC is always low FEV1/FVx is generally normal |
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What presents with non-caseating graunlomas in lung with dyspnea, cough, nigt weats and bilateral hilar adenopathy on CXR +/- panda sign and what type of disease is this?
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Sarcoidosis
Restrictive lung disease |
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What is characterized by pulmonary edema, respiratory distress, hypoexima that results from diffuse injury to the endothelium of the lungs and what type of disease is this?
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Adult ARDs
Restrictive lung disease |
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What results when Lectin:Sphingomyelin ratio is <2.0?
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neonatal ARDS
RLD |
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What the different types of Pneumoconiosis (RLD) affect the lower lobes?
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abestosis - (homes, ship yards) lower lobes, increased risk of squamous cell carcinoma and malignant mesothelioma
berylliosis - high-tech electronics, fluorescent light bulbs |
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What different types of Pneumonociosis (RLD) affect the upper lobes?
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anthracosis - coal workers - black lung disease
silicosis - quartz dust - sand blasting, granite cutting - sig raised susceptibility to TB |
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What is also known as extrinsic allergic alveolitis and results from repeated inhation of particular allergens that cause inflammaotry response and fibosis?
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Hypersensitivity pneumonitis (RLDs)
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What results in a honeycomb lung that occurs when the lung tissue is replaced by scar tissue but keeps original architecutre?
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diffuse idiopathic fibrosis
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This occurs when chronic inflammation can start the cycle to a restrictive lung disease
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collagen vascular disorders (type of hypersensitivity pneumonitis)
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How does Rifampin work and what does is it used for?
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transcription inhibitor
Mycobacterial infections (including leprosys, TB, atypical mycobacterial infections) also used for contact prophylaxis for meningococcus (N. meningitidis) and H. influenzae MAC - one of a 3 drug regimen |
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What is rifampin a DOC for?
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one of a 3 drug regimen for Mycobacterium avium complex
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What are the AE of doxorubicin
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red urine and dilated cardiomyopathy (and same as as Actinomycin D --> dose-limiting bone marrow suppsuression, alopecia, stomatitis (inflammation of the mouth), and overall immunosuppression
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What are the drug combo choices to treat ALL?
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Actinomycin OR 6-MP OR
Prednisone and vincristine (blocks tubulin from forming microtubules and causes peripheral neuropathy and phlebitis) OR POMP = predisone, oncovine, methotrexate, purimethanol |
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What is the treatment for Wilm's tumor?
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Dactinomycin and cinvristine
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What is the treatment for Hodgkin's disease?
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ABVD = adriamycine, bleomycin, vinblastine, dacarbazine (v. emtogenic)
OR 2nd line MOPP = mechlorethamine (alkylates guanine- can causes herpes zoster if present and blisters), oncovin, prednisone, procarbazine (inhibits DNA and RNA syn --> causes neurotoxicity) |
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What is the worst AE of cisplatin and how does this chemotherapeutic drug work?
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alkylating agent that becomes active after biotransformation by P450 --> destroys DNA
AE: hemorrhagic cystitis that may progress to bladder fibrosis |
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What is 6-MP a DOC for?
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ALL
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What is cytarabine a DOC for?
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AML
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What is Bleomycin a DOC for?
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testicular cancer
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What is vincristine a DOC for?
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Hodgkin's lymphoma
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What is vinblastine a DOC for?
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testicular cancer and can be used for lymphoma
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What is cisplatin a DOC for?
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testicular and bladder cancers
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What are Leuprolide and flutamide used in the treatment of, what are their MOAs, and AEs?
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used in treatment of prostate cancer
Leuprolide --> synthetic analog of GnRH and causes hot flashes Flutamide --> antagonizes the testosterone receptor and AE is gynecomastia |
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What drug induces the synthesis of fetal hemoglobin so can used in the treatment of sickle cell and inhibits ribonucleotide reductase so is an effective inhibiutor of WBC proliferation?
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hydroxyurea
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What are the functions of NSAIDs?
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decrease inflammation (anti-inflammatory)
decrease pain (analgesia) decrease fever (anti-pyretic |
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What is aspirin CI in and what is the DOC for and what does OD (general) causes?
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CI in gout
DOC in RA OD causes upcoupling of ox phos |
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What is acetominophen the DOC for and where does it not work?
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DOC for children with viral infections but has to peripheral anti-inflammatory action
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What NSAIDs can increase risk of miscarriage?
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non-selective and COX-2 selective but NOT acetominophen
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