Board Review: Cardiovascular

Front 1

ergonovine

Back 1

α + 5HT stimulator

constricts VSMCs

used to prevent post-partum bleed out

used diagnostically to induced prinzmetal's angina

Hint 1

#pharmacology #autonomics
#cardiovascular #pathology #reproductive #diagnostics #drugs

Front 2

thiolase

Back 2

enzyme which conjugates 2 acetyl-CaA → acetoacetyl-CoA

the necessary substrate for HMG CoA Synthase in the formation of cholesterol

Hint 2

#biochemistry #molecules #cardiovascular

Front 3

Aminocaproic Acid

Back 3

inhibits plasminogen activation

used to inhibit fibrinolysis
ie tPA or streptokinase OD

[sibling Rx: tranexamic acid]

Hint 3

#drugs #pharmacology #cardiovascular

Front 4

Tranexamic Acid

Back 4

inhibits plasminogen activation

used to inhibit fibrinolysis
ie tPA or streptokinase OD

[sibling Rx: Aminocaproic Acid]

Hint 4

#drugs #pharmacology #cardiovascular

Front 5

DOC: tPA overload

Back 5

Aminocaproic Acid or Tranexamic Acid

inhibits plasminogen activation

used to inhibit fibrinolysis
ie tPA or streptokinase OD

Hint 5

#drugs #pharmacology #cardiovascular

Front 6

BP 180/70

Back 6

isolated systolic hypertension 2° age related aortic stiffening

also seen in panic attacks

Hint 6

#cardiovascular #pathology #geriatrics

Front 7

isolated systolic hypertension

Back 7

isolated systolic hypertension 2° age related aortic stiffening

common in elderly

also seen in panic attacks

Hint 7

#cardiovascular #pathology #geriatrics

Front 8

Bumetanide

Back 8

Loop Diuretic like Furosimide

[Loop Diuretic toxicities:
Ototixicity, Hypokalemia, Dehydration, Allergic Rxn, Interstitial Nephritis, Gout
Mn: OH DANG!]

Hint 8

#pharmacology #nephrology #cardiovascular

Front 9

c-myc fnx

Back 9

nuclear transcription factor

Hint 9

#molecules #pathology #neoplasia

Front 10

Radius vs Resistance

Back 10

R = viscosity * length / radius ^4

NB: ^4

Hint 10

#physiology
#cardiovascular

Front 11

DOC: Refractorily High LDL

Back 11

First Line Drug: Statin
Competitively (vs Mevalonate) inhibits HMG CoA Reductase
Hepatocytes ↑ LDL receptors to compensate
Tox: Hepatotixic, Rhabdotoxic

Refractory: Add Ezetimibe
Inhibits Brush Border Cholesterol Resorption
Tox: Rare, hepatotoxic

Hint 11

#pharmacology #cardiovascular #lipids

Front 12

DOC: Refractorily High TAGs

Back 12

First Line Drug: Fibrates
↑ LPL
Tox: Hepatotoxic, Rhabdotoxic, Gallstones

Refractory: Add Niacin
Inhibits TAG synthesis & VLDL secretion
Tox: Hyperglycemia, Hyperuricemia

Hint 12

#pharmacology #cardiovascular #lipids

Front 13

DOC: Refractorily Low HDL

Back 13

Niacin:
Inhibits TAG synthesis & VLDL secretion
Tox: Hyperglycemia, Hyperuricemia

No 2ndry Drug

Hint 13

#pharmacology #cardiovascular #lipids

Front 14

continuous murmur heard best at left infraclavicular regioj

Back 14

PDA

Hint 14

#cardiovascular #pathology
#anatomy

Front 15

new onset aortic stenosis in 50 yo

Back 15

bicuspid aortic valve


recently calcificied

Hint 15

#pathology #cardiovascular

Front 16

Causes of LV dilation

Back 16

CAD
Valvular Heat Dz
Dilated Cardiomyopathy
Arrhytmias

Hint 16

#pathology #cardiovascular

Front 17

Nimodipine

Back 17

calcium channel blocker

used both for hypertension and uniquely used to prevent mobidity following SubArachnoid Hemorrhage

Hint 17

#neurology #cardiovascular #pharmacology

Front 18

Cause of Death: Hypertrophic Cardiomyopathy

Back 18

Mitral Valve leaflets get sucked into the outflow tract

Hint 18

#pathology #cardiovascular

Front 19

Blue Babies

Back 19

5 T's

Tetrology of Fallot (most common)
Transposition fo GReat Vessels
Trucus Arteriosus (persistent, non-divided)
Tricuspid Atresia: hypoplastic RV + ASD + VSD
Total anamalous bulmonary venous return (2 systems)

Hint 19

#pathology #cardiovascular #neonatology

Front 20

New Onset Cyanosis in Children

Back 20

Eisenmenger

By Freq:
1. VSD
2. ASD (fixed split S2)
3. PDA

Hint 20

#pathology #cardiovascular

Front 21

DOC: Nitroprusside OD

Back 21

Nitroprosside: Ca2+ blocker which acts on both arteries an veins

Cyanide Toxicity

DOC: Sulfur ie Sodium Thiosulfate

provides extra substrate for liver rhodanase to form thiocyanate

Hint 21

#pharmacology #cardiovascular #toxicity

Front 22

what dz is assoc. w/ polyarteritis nodosum

Back 22

[fibrinoid necrosis of small/medium vessels]

HBV in some not all

Hint 22

#pathology #cardiovascular

Front 23

Double Barrel Aorta

Back 23

Aortic Dissection

Begins as an intimal tear

Hypertension is the most important risk factor

Hint 23

#pathology #cardiovascular

Front 24

homogenous hyalinization vs onion skinning of arteries

Back 24

hyaline: low level Htn

onion skinning: malignant htn

Hint 24

#pathology #cardiovascular

Front 25

Murmurs v Respiration

Back 25

Inspiration induces/increases Right Sided Murmurs

Expiration induces/increases Left Sided Murmurs

Hint 25

#pathology #cardiovascular #diagnostics

Front 26

Murmurs v Valsalva Maneuver

Back 26

same as standing

Most murmurs diminish except for

Hypertrophic Cardiomyopathy and Mitral Valve Prolapse

NB: these also the only mumurs to become quieter with passive leg raise/squatting

Hint 26

#pathology #cardiovascular #diagnostics

Front 27

Murmurs v Standing

Back 27

same as valsalva maneover

Most murmurs diminish except for

Hypertrophic Cardiomyopathy and Mitral Valve Prolapse

NB: these also the only mumurs to become quieter with passive leg raise/squatting

Hint 27

#pathology #cardiovascular #diagnostics

Front 28

Mumurs v Squatting

Back 28

same as passive leg raising

most murmurs become louder except hypertrophic cardiomyopathy and mitral valve prolapse

NB: these are also the only murmurs to become louder with valsalva maneuver/standing

Hint 28

#pathology #cardiovascular #diagnostics

Front 29

Murmurs v Passive Leg Raise

Back 29

same as passive leg raising

most murmurs become louder except hypertrophic cardiomyopathy and mitral valve prolapse

NB: these are also the only murmurs to become louder with valsalva maneuver/standing

Hint 29

#pathology #cardiovascular #diagnostics

Front 30

Murmurs v Handgrip

Back 30

MR, VSD, and AR become Louder

Hypertrophic Cardiomyopathy murmur becomes queiter

Hint 30

#pathology #cardiovascular #diagnostics

Front 31

Drug Interaxns of Niacin

Back 31

Potentiates Anti-Hypertensives

Induces Insulin Resistance

also causes hyperuricemia

Hint 31

#pharmacology #cardiovascular #toxicity

Front 32

Libman-Sacks Dz

Back 32

Libman Sacks Endocarditis of SLE

sterile endocarditis

likely IC deposition

may progress to regurgitation or stenosis

Hint 32

#pathology #cardiovascular #rheumatology

Front 33

Dressler's Dz

Back 33

autoimmune myocarditis which follows MI by months

Hint 33

#pathology #rheumatology #cardiovascular

Front 34

autoimmune myocarditis which follows MI by months

Back 34

Dressler's Dz

Hint 34

#pathology #rheumatology #cardiovascular

Front 35

Relative Conduction Speeds Throughout the Heart

Back 35

Purkinje
Atrial Muscle
Ventricular Muscle
AV Node

Mn: Park At VENTura AVenue

Hint 35

#physiology #cardiovascular

Front 36

Digoxin: mechanism of action

Back 36

1. Blocks NaK ATPase → ↑ [Ca2+]

2. ↑ PSNS tone → ↓ AV node condxn

Hint 36

#pharmacology #cardiovascular

Front 37

S3 indicative of

Back 37

stiff or partially filled

best heart in left lateral decupitus position at ventricular apex at end of expiration

Hint 37

#cardiovascular #pathology #diagnostics

Front 38

What signals drive angiogenesis

Back 38

VEGF: endothelial cell motility and proliferation

FGF: also contributes

Hint 38

#physiology #cardiovascular

Front 39

Dilated Cardiomyopathies

Back 39

90% of cardiomyopathies are dilated cariomyopathies

Pathogenesis: ↑ End Diastolic Volume
→ Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 39

#pathology #cardiovascular

Front 40

Alcoholic Cardiac Abnormality

Back 40

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 40

#pathology #cardiovascular

Front 41

Thiamine Deficiency Cardiac Abnormality

Back 41

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 41

#pathology #cardiovascular

Front 42

Coxsackie Cardiac Abnormality

Back 42

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 42

#pathology #cardiovascular

Front 43

Doxorubicin Cardiac Abnormality

Back 43

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 43

#pathology #cardiovascular

Front 44

Hemochromatosis Cardiac Abnormality

Back 44

May be Dilated or Restrictive Cardiomyopathy!

Dilated:
↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx
All chambers dilated, valvular insufficiencies, heart failure

Restrictive:
↓ compliance → diastolic dysnfx heart failure

Hint 44

#pathology #cardiovascular

Front 45

Cocaine Cardiac Abnormality

Back 45

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 45

#pathology #cardiovascular

Front 46

Chagas Cardiac Abnormality

Back 46

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 46

#pathology #cardiovascular

Front 47

Restrictive Cariomyopathy

Back 47

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes:
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 47

#pathology #cardiovascular

Front 48

Amyloidosis Cardiac Abnormality

Back 48

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes:
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 48

#pathology #cardiovascular

Front 49

Radiation Induced Cardiac Abnormality

Back 49

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes:
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 49

#pathology #cardiovascular

Front 50

Pompe's Dz Cardiac Abnormality

Back 50

deficiency of Lysosomal α 1,4 glucosidase (aka acid maltase)

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes of Restrictive Cardiomyopathy
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 50

#pathology #cardiovascular

Front 51

Kussmaul's Sign

Back 51

normally JVP decreases with inspiration

Kussmaul's sign is an increase in JVP w/ inspiration

indicative of constrictive pericarditis

-Kussmaul's Sign
-Pericardial Knock (earlier than S3 which normallly indicates rapid filling from dilated/weak ventricle)
-Pulsus Paradoxus

Hint 51

#cardiology #pathology #diagnostics

Front 52

Increase in JVP on inspiration

Back 52

normally JVP decreases with inspiration

Kussmaul's sign is an increase in JVP w/ inspiration

indicative of constrictive pericarditis

-Kussmaul's Sign
-Pericardial Knock (earlier than S3 which normallly indicates rapid filling from dilated/weak ventricle)
-Pulsus Paradoxus

Hint 52

#cardiology #pathology #diagnostics

Front 53

Decrease in JVP on inspiration

Back 53

Physiologic
_________________________
Kussmaul's sign is an increase in JVP w/ inspiration

indicative of constrictive pericarditis

-Kussmaul's Sign
-Pericardial Knock (earlier than S3 which normallly indicates rapid filling from dilated/weak ventricle)
-Pulsus Paradoxus

Hint 53

#cardiology #pathology #diagnostics

Front 54

Pericardial Knock

Back 54

Heart Sound heard before S3 indicative of extremely restricted filling

Restrictive Pericarditis
--Kussmaul's increase in JVP on inspiration
--Pericardial Knock
--Pulsus Paradoxus

Hint 54

#cardiology #pathology #diagnostics

Front 55

Heart sound immediately following S2

Back 55

Pericardial Knock

before S3 (ventricular splash from dilation)

indicative of restrictive pericarditis
--Kussmaul's increase in JVP on inspiration
--Pulsus Paradoxus
--Pericardial Knock

Hint 55

#pathology #cardiovascular #diagnostics

Front 56

Compare Subclasses of Class I antiarrhytmics

Back 56

1A (DQP)
prolonged QRS
intermediate inhibition of phase 0

1B
Shortened QRS
Weak inhibition of Phase 0

1C
∅Δ QRS
Strong inhibition phase zero

Hint 56

#cardiovascular #pharmacology

Front 57

Familial QT prolongation

Back 57

predisposes to TdP

accompanied by neurosensory deafness

Hint 57

#pathology #cardiovascular #neurology #geneticdzs

Front 58

Familial Neurosensory Deafness

Likely Accompanying Condition?

Back 58

Familial QT prolongation

predisposes to TdP

Hint 58

#pathology #cardiovascular #neurology #geneticdzs

Front 59

Pathogenesis of aortic aneurysm

Back 59

myxomatous changes in media of large arteries 2* gragementation of elastic ts

may be caused by marfan sro
β-aminopropionitrile (sweat peas) inhibits lysyl oxidase which cross links elastin

Hint 59

#pathology #cardiovascular

Front 60

Heart Abnormality of DiGeorge Sro

Back 60

Tetrology of Fallot

Hint 60

#pathology #cardiovascular #geneticdzs

Front 61

Heart Abnormality of Down Sro

Back 61

Endocardial Cushion Defects:
--ASD
--Regurgitant AV vales

Hint 61

#pathology #cardiovascular #geneticdzs

Front 62

Which heart chamber is closest to the esophagus?

Back 62

left atrium makes up the majority of heart's posterior surface

RA makes up the right border of X-ray
LV makes up the left border and paex
RV is the front of the heart and inferior border on X ray

Hint 62

#anatomy #cardiovascular

Front 63

Why doesn't blood flow back into lungs during atrial systole?

Back 63

cardiac muscle in proximal few cm of pulmonary veins fnx like sphincters

Hint 63

#phsyiology #cardiovascular

Front 64

Mechanism of Action: NO

Back 64

primarily a venodilator

↓ preload → ↓ cardiac O2 demand


large doses can affect arterioles → HA, flushing

Hint 64

#pharmacology #cardiovascular

Front 65

Regulation: precapillary sphincters

Back 65

pericytes

location dpt response to NE & E
dilate irt histamine, ↓ O2, ↑ CO2, ↓ pH

Hint 65

#physiology #cardiovascular

Front 66

Flecainide

Back 66

IC antiarrhytmic

blocks sodium channels and primarily acts by slowing phase 0 depolarization
no effect on duration of QT

contrast to
IA: Qunidine, Procainimide, Disopyramide
blocks K channels ↑ QT

IB: Lidocaine, Mixiletine, Tocainide
shortens QT by ↓ Funny Current (Background Na)

Hint 66

#drugs #cardiology #pharmacology

Front 67

Dofetilide

Back 67

Class III antiarrhthmic

blocks K⁺ channels

dofetilide, ibutilide, amiodarone, sotalol

Hint 67

#drugs #cardiology #pharmacology

Front 68

Ibutilide

Back 68

Class III antiarrhthmic

blocks K⁺ channels

dofetilide, ibutilide, amiodarone, sotalol

Hint 68

#drugs #cardiology #pharmacology

Front 69

Varicose Veins: most problematic complication

Back 69

skin

thrombi do occur, but no thromboemboli

all PE's from deep veins of leg (sic: DVT)
varicosities occur in superficial veins

Hint 69

#cardiovascular #pathology

Front 70

phlegmaisa alba dolens

Back 70

painful white leg

ilofemoral venous thrombosis which occurs in peripartum women 2° uterus pressure on deep pevic veins + hypercoagulaable state

non-ischemic state

if superficial flow lost also "Phlegmasia cerulea dolens"→ ischemia & gangrene

Hint 70

#reproductive #pathology #cardiovascular

Front 71

Ticlopidine

Back 71

Ticlopidine
ADP antagonist like Clopidogrel

2nd line drug for pts who are allergic to clopidogrel

serious side effects: neutropenia → fever & mouth ulcers

Hint 71

#pharmacology #cardiovascular #toxicities

Front 72

Most cardioselective calcium channel blocker

Back 72

Verapamil

Hint 72

#cardiovascular #pharmacology

Front 73

anti-arrhythmic which ↑ PR & QT intervals

Back 73

Sotalol

Class II: β1 blockade ↑ PR
Class III: K+ blockade ↑ QR

uniquely so

Hint 73

#pharmacology #cardiovascular

Front 74

Coronary Steal Effect

Back 74

Vessels in Ischemic Regions are often maximally dilated

addition of adenosine and dipyridamole (coronary-selective vasodilators) may dilate surrounding vessels and divert flow away from ischemic areas.

Hint 74

#pharmacology #cardiovascular #toxicity

Front 75

dipyridamole

Back 75

a coronary-selective vasodilator like adenosine

also inhibits thromboxane synthesis and prevents platelet thrombus formation

Hint 75

#pharmacology #cardiovascular

Front 76

Inferior wall STEMI

which artery?

Back 76

Right Coronary Artery

Sinus Bradycardia

Hint 76

#cardiovascular #pathology #diagnostics

Front 77

Anterior Wall STEMI

which artery?

Back 77

Left Anterior Descending

also supplies interventricular septum

Mobitz Type 2, 2° or 3° possible

Hint 77

#cardiovascular #pathology #diagnostics

Front 78

Left Lateral Wall STEMI

Which artery

Back 78

Left Circumflex

Hint 78

#cardiovascular #pathology #diagnostics

Front 79

Right Coronary Artery Ischemia: EKG Findings

Back 79

Inferior wall MI

Sinus bradycardia

Hint 79

#cardiovascular #pathology #diagnostics

Front 80

Left Anterior Descending Ischemia: EKG Findings

Back 80

Anterior Wall MI

also supplies interventricular septum:

Mobitz Type 2, 2° or 3° possible

Hint 80

#cardiovascular #pathology #diagnostics

Front 81

Left Circumflex Artery Ischemia: EKG Findings

Back 81

Left Lateral Wall MI

Hint 81

#cardiovascular #pathology #diagnostics

Front 82

Atrial Myxoma

Back 82

pedunculated gelatenous masses

scattered cells w/in mucopolysaccharide stroma

large amts of VEGF and IL6 produced
→ intrapeduncular hemorrhaging
→ constitutional sx

either embolize or obstruct valves

dyspnea improves lying down

most common cardiac neoplasm

Hint 82

#pathology #cardiology #neoplasia

Front 83

systemic inflammatory response, mid-diastolic murmur at apex, dyspnea which improves when supine

Back 83

pedunculated gelatenous masses

scattered cells w/in mucopolysaccharide stroma

large amts of VEGF and IL6 produced
→ intrapeduncular hemorrhaging
→ constitutional sx

either embolize or obstruct valves

dyspnea improves lying down

most common cardiac neoplasm

Hint 83

#pathology #cardiology #neoplasia

Front 84

Dysphagia 2° to Cardiac Hypertrophy,

which chamber?

causes?

Back 84

Left Atrium

mitral stensosis or ↑ Left Ventricular Pressure

Hint 84

#cardiology #pathology

Front 85

Vessels Spared by PAN

Back 85

Pulmonary Arteries & Bronchial Arteries

Chronically ongoing inflammation of medium & small arteries

Presents as livedo reticularis (purple network) or palpable purpura, propensity for bead like aneurysm

Segmentally distinct acute inflam → Mixed WBC infiltrate → Fibrinoid necrosis
(Contrast Mixed WBC Infitlrate to eosinophil dominated Churgg-Strauss, and PMN dominanted -ie leukocytoclastic- Microscopic polyangitis)

Histology: thick hyalinosis in adventitia

All stages concurrent around the body
(Contrast to Kawasaki's lock-step progression)

Not assoc with ANCA's
(Contrast to Wegener's and Microscopic Polyangitis)

Fatal if UnTx
Rx: immunosuppressents

Hint 85

#pathology #cardiovascular

Front 86

Where do the respiratory drive signals originate

Back 86

Hypercapnea (normal individuals):
-Medulla detects pH

Hypoxia (<60 mmHg or chronic hypercapnics)
-Chemoreceptors in aotic arch and carotid bodies via CN9

Hint 86

#cardiovascular
#pulmonary
#neurology
#physiology

Front 87

Heart Medicine which causes and AV block

Back 87

Class IV: Ca2+ channels

Verapamil, Diltiazem

non-dihydropyridine

↑ PR interval

Hint 87

#pharmacology #cardiovascular

Front 88

Regulation of ACE's

Back 88

Apparently the lung endothelium upregulates ACE's when BP is low I don't know I don't think that's true

Hint 88

#physiology #cardiovascular

Front 89

Acute onset chest pain relieved by sitting up

Back 89

pericarditis

friction rub, sero-firbinous exudate

Hint 89

#pathology #cardiovascular

Front 90

Fnx Mitral Regurgitation

Back 90

Mitral Regurgitation which dissappears upon reduction of afterload

Hint 90

#cardiovascular #pathology

Front 91

Myocardial Granulomas

Back 91

Aschoff bodies indicative of acute rheumatic carditis

plump M∅ w/ abundant cytoplasm and slender ribbons of chromatin = Anitschkow Cells (within Aschoff bodies)

Hint 91

#cardiovascular #pathology #microbiology #rheumatology

Front 92

Fixed splitting of S2

Back 92

A-V defect

Left-to-Right Shunt:
RA pressure normally <8
LA pressure up to 12

Abnormally large blood volume in RV → delays emptying

Eisenmenger Sro:
Left-to-Right Shunt → ↑ Pulmonary Flow → Pulmonary Hypertension → Right-to-Left Shunt

Hint 92

#cardiology #pathology

Front 93

Cardiac Ischemia:

How long until Contraxns Stop?
When does Injury Become Irreversible?

Back 93

Contraxn stops w/in first minute

damage permenant after 30 min

Hint 93

#pathology #cardiovascular

Front 94

Abnormal Breathing Pattern

Back 94

Cheyne-Stokes Breathing of Advanced CHF

delayed feedback to hypercapnea

start breathing hard to blow off CO2 → suppress drive

cyclic variation in tidal volume with periods of apnea

contrast to OSA which has on-off phenomenon not cyclic variation in tidal volume

Hint 94

#pathology #cardiovascular

Front 95

DOC: catheter endocarditis

Back 95

Staph epidermidis

Gram + Catalase +
Coagulase Neg Novobiocin Sensitive

Usually MRSE start with Vancomycin

Hint 95

#microbiology #pathology #cardiovascular #pharmacology #antimicrobials

Front 96

Sudden Cardiac Death:

pathogenesis

Back 96

Majority due to Coronary artery desiease

acute plaque rupture & thrombus → ischemia

ischemia → arrhytmias → ventricular fibrillation

Hint 96

#pathology #cardiovascular

Front 97

Heart Drug

Visual changes and GI disturbances

Back 97

Digoxin toxicity

Hint 97

#cardiovascular #pharmacology #toxicity

Front 98

How does nitroglycerin help the heart?

Back 98

cGMP → venodilation → decreased preload

nitrates do dilate the coronary arterioles, but this is not where the bulk of their effectiveness comes from, the bulk of the effectiveness comes from venorelaxn

Hint 98

#pharmacology #cardiovascular

Front 99

S3 & S4

Back 99

S4 = Atrial Kick
NB: caused by non-compliant ventricle

S3 = Opening Splash
caused by ↑ Atrial Pressure or Dilated ventricles
ie ↑ mitral regurg or end stage CHF
physiologic in children & pregnants

Hint 99

#cardiology #pathology

Front 100

Heart Problems on a Med

Nausea, Vomiting, Confusion, Visual Changes

Back 100

Digoxin used for atrial fib w/ undelrying systolic dysnfx

Not only ↑ contractility, but also induces vagal stim of AV node

Toxicity:
Nausea/Vomitting/Anorexia/Diarrhea
fatigue/HA/Dizziness/Confusion/Delerium
Blurry Vision, Δcolor perception

Hyperkalemia

Tx: activated charcoal
insulin, kayexalate or hemodyalysis for hyperK
avoid Ca2+ gluconate
3. Fab

NB: hypokalemic state ↑ susceptibility to digoxin tocitity

Hint 100

#cardiology #pharmacology #toxicity

Front 101

Where do the testicular and adrenal veins drain?

Back 101

Right Adrenal drains via right suprarenal vein directly into IVC
Right Testical Drains directly into IVC

Both left Adrenal and Left Testical Drain into Left Renal Vein

Hint 101

#anatomy #cardiovascular

Front 102

"Normal" Cardiac Abnormality

Back 102

1/4 of adult population has a patent foramen ovale

normal atrial pressures keep it closed

problems arise if RA pressures > LA pressures

thromboses/strokes

Hint 102

#cardiovascular #pathology

Front 103

Cardiovascular Defects of Turner Sro

Back 103

1. Bicuspid Aortic Valve <<most common
2. Coarctation of aorta

Hint 103

#pathology #genetics #cardiovascular

Front 104

Normal Pressures in each Chamber of Heart and Major Vessel

Back 104

(Min-Max)
RA: 0-8
RV: 4-25
Pulm Art: 9-25
LA: 2-12
LV: 9-130
Aorta: 70-130

Hint 104

#physiology #cardiovascular

Front 105

Losartan

Back 105

ARB: Angiotensin Receptor Blocker

all end in -artan

NB: similar effects to ACEI's w/o angioedema or dry cough

Hint 105

#pharmacology
#cardiovascular

Front 106

-artan

Back 106

ARB: Angiotensin Receptor Blocker

all end in -artan (eg Losartan)

NB: similar effects to ACEI's w/o angioedema or dry cough

Hint 106

#pharmacology
#cardiovascular

Front 107

ARB's

Back 107

ARB: Angiotensin Receptor Blocker

all end in -artan (eg Losartan)

NB: similar effects to ACEI's w/o angioedema or dry cough

Hint 107

#pharmacology
#cardiovascular

Front 108

Constrictive Pericarditis vs Cardiac Tamponade

Back 108

Constrictive Pericarditis takes months to produce tamponade

Tamponade is an acute onset

Hint 108

#physiology #cardiology

Front 109

Amlodipine

Back 109

Dihydropyridine calcium channel blocker

more selective for vasculature

relaxes arterioles to reduce TPR in angina pectoris

Hint 109

#pharmacology #cardiology

Front 110

Spontaeous Intraranial Hemorrhage in a young adult

Back 110

likely cocaine (or sympatheticomimetics)

coarctation of aorta → berry aneurysm (htn)

[AV malformation]

Hint 110

#pathology #cardiovascular #neurology

Front 111

Main cause of sudden cardiac death in previously healthy young adults

Back 111

Hypertrophic Cardiomyopathy

Autosomal Dominant: disoriented tangled cardiomyocytes

Dilated septum obstructs outflow tract → systolic murmur ↑ by ↓ venous return (standing, valsalva)

Main cause of sudden cardiac death in previously healthy young adults

assoc. c Friederick's ataxia
Tx: βblocker or non-dihydropyridine Ca2+ channel blocker, eg verpamil

Hint 111

#pathology #cardiovascular

Front 112

Hypertrophic Cardiomyopathy

Back 112

Hypertrophic Cardiomyopathy

Autosomal Dominant: disoriented tangled cardiomyocytes

Dilated septum obstructs outflow tract → systolic murmur ↑ by ↓ venous return (standing, valsalva)

Main cause of sudden cardiac death in previously healthy young adults

assoc. c Friederick's ataxia
Tx: βblocker or non-dihydropyridine Ca2+ channel blocker, eg verpamil

Hint 112

#pathology #cardiovascular

Front 113

Post MI Ventricular WallRupture

Back 113

10% of cases 3-7 days after MI when coagulative necrosis and PMN infiltrate have weakened most

LV hypertrophy prior to MI is rupture-protective

Hint 113

#pathology #cardiovascular

Front 114

Baroreceptor Reflex Physiology

Back 114

CN9
pressure ↑ firing rate → vagal discharge → ↑ AV reffractory preriod

Stimualtion good for Superventricular Tachycardia (AV reenterant tachycardias)

Hint 114

#physiology #cardiology #autonomics

Front 115

Acute Infective Endocarditis

Back 115

Staph aureus is most common cause

predisposed by undelrying host endotheial damage & fibrin/platelet deposition

Hint 115

#microbiology #pathology #cardiovascular

Front 116

anti-hyperlipidemic agent produces cutaneous flushing

Back 116

niacin/nicotinic acid

prostaglandin mediated flushing may be inhibited by aspirin

mech: inhibits VLDL secretion, ↑ HDL secretion & LPL fnx

Hint 116

#pharmacology #drugs #cardiovascular