Boards Cardiovasc- Note: The First Cardiology Cards Are In The 5/31 Set

Front 1

Anatomy of Coronary Vasculature: FA 280

1) 2 arts that supply blood to heart?

2) 2 branches of LCA?

3) SA and AV nodes are usually supplied by this artery?

4) What art usually supplies the inferior part of the Left Vent?

Back 1

1) RCA and LCA

2) L CFX
LAD

3) RCA

4) RCA via the PD

Front 2

1) Which art usually supplies the Ant IV septum?

2) Which coronary artery is most often occluded --> what pathology?

Back 2

1) LAD

2) LAD --> Ant MI

Front 3

1) Since the most posterior part of the heart is the L. atrium, enlargement of the LA can compress what 2 nerves --> what 2 sx?

Back 3

1) Esophageal nerve --> dysphagia
Recurrent Laryngeal nerve --> Hoarseness

Front 4

Congenital Cardiac Defect Associations:

Which congenital dz is associated w/:
1) Truncus arteriosus, TOF?
2) ASD, VSD, AV septal defect (endocardial cushion defect)
3) Septal defects, PDA, Pulm Art stenosis
4) Preductal coarctation of aorta?
5) Late aortic insufficiency
6) TFA

Back 4

1) 22q11 syndromes
2) Down's syndrome
3) Congenital Rubella
4) Turner's syndrome
5) Marfans
6) Infant of diabetic mother

Front 5

What type of ARTERIOsclerosis do the following describe:

1) Calcification of the tunica MEDIA;
"Pipestem" arteries

2) Hyaline thickening of small arteries;
Essential HTN;
DM

3) Fibrous plaques, fatty streaks and atheromas

Back 5

1) Monckeberg

2) Arteriolosclerosis

3) Atherosclerosis

Front 6

More Info on Atherosclerosis:
(Fibrous plaques, fatty streaks and atheromas)

1) This is a dz of what type of arteries?

2) What kicks off atherosclerosis?

3) When macs accum LDL what develops?

4) One part of the process of atherosclerosis is smooth muscle migration from media to intima. What stimulates this?

5) Give the 4 areas where atherosclerosis usually occurs, in order of MC --> LC?

6) NOTE:
*SX of atherosclerosis:
Angina, Claudication, Asx-ic

*Complications of atherosclerosis: Aneurysms, Ischemia, Infarcts, Periph Vasc Dz, Thrombus, Embolus

Back 6

1) elastic, large and medium arts

2) Endothelial cell damage

3) Foam cells

4) PDGF and TGF-beta

5) ABD Aorta > Coronary Arts > Popliteal arts > Carotid Arts

6) NOTE:
*SX of atherosclerosis:
Angina, Claudication, Asx-ic

*Complications of atherosclerosis: Aneurysms, Ischemia, Infarcts, Periph Vasc Dz, Thrombus, Embolus

Front 7

Ischemic Heart Dz:

1) What type of Angina do the following describe:
A) ST Depression;
Retrosternal chest pain upon exertion;
Secondary to Ath-sclerosis;
B) ST Elevation;
Occurs @ rest;
Secondary to coronary artery vasospasm

2) What type of angina has ST depression? ST elevation?

3) What do the following Describe:
A) Vasodilator --> shunting of blood from stenosed vessel to vessel of higher perfusion --> exacerbation of ischemia
B) Coronary art ATH-sclerosis -->
Thrombosis -->
Myocyte necrosis
C) Death within 1 hr of sx onset, usually from a lethal arrhythmia?

Back 7

1)
A) STABLE angina
B) Prinzmetal's Angina

2) Stable. Prinzmetals

3)
A) Coronary steal syndrome
B) MI
C) Sudden cardiac death

Front 8

MI:
1) Which coronary arts are most often occluded?

**NOTE: Sx include diaphoresis, nausea, vomiting, retrosternal pain, pain in L. arm or jaw, SOB

***NOTE: See DIT CV 31 for evolution of MI and pathological findings***

Back 8

1) LAD > RCA > Circumflex

**NOTE: Sx include diaphoresis, nausea, vomiting, retrosternal pain, pain in L. arm or jaw, SOB

Front 9

MI Dx:

1) Gold standard of MI dx is?
A) Transmural Infarct = what EKG 2 changes?
B) Subendocardial infarct = what EKG change?

2) Which cardiac enzyme is more sPecific than the others?

3) Why is CK-MB not as specific for MI as TnI?
A) Useful for dx-ing what?

4) Which enz could be found in cardiac, liver and skeletal muscle cells?

Back 9

1) EKG
A) ST elevation; Q-waves
B) ST depression

2) TnI

3) CK-MB is also found in skeletal muscle
A) Reinfarction

4) AST

Front 10

What part of heart is especially vulnerable to ischemia?

Back 10

subendocardium

Front 11

For the following arteries give:
Part of heart perfused; EKG leads it corresponds to

1) LAD

2) L. Circumflex

3) R. Coronary Art

4) R. Coronary Art

Back 11

1) Ant wall V1-V4, V5

2) Lat Wall aVL, V5, V6

3) Inf Wall II, III, aVF

4) Post wall R. sided EKG V4

Front 12

MI complications:

1) What is the most common and important cause of death from an MI?

2) What 2 types of pericarditis can occur post-MI?

Back 12

1) Arrhythmia

2) Post-infarction pericarditis: 3-5 days post MI
Dressler's Syndrome:
auto-immune pericarditis several weeks post-MI

Front 13

Cardiomyopathies: Probs w/ the muscle itself

1) 3 Types Cardiomyopathies?

2) Dilated cardiomyopathy is the MC:
A) It results in what type of hypertrophy?
B) Ets of dilated cardiomyopathy?
C) What heart sound is heard in a dilated cardiomyopathy?

Back 13

1) Dilated (Congestive) Cardiomyopathy,
Hypertrophic cardiomyopathy,
Restrictive cardiomyopathy

2)
A) Eccentric hypertrophy
B) ABCCCD
Alcohol abuse,
wet Ber1 Ber1,
Coxsackie B,
Cocaine,
Chagas dz,
Doxorubicin,
Hemochromatosis,
Peripartum cardiomyopathy
C) S3

Front 14

1) What type of cardiomyopathy is the result of a hypertrophied IV septum and vent --> outflow tract obstruction?

2) H-trophic cardiomyopathy is assoc w/ what neurological problem?

3) H-trophic cardiomyopathy is cause of sudden death in who?

4) H-trophic cardiomyop --> what heart sound?

5) What pulse will be increased?

6) What murmur?

7) Tx for hypertrophic cardiomyopathy?

8) What type of hypertrophy?

Back 14

1) Hypertrophic cardiomyopathy

2) Friederich's ataxia

3) Young atheletes

4) S4

5) Apical impulse

6) Systolic murmur (makes sense bc it causes outflow obstruction) --> Syncope

7) beta-blocker
OR
non-dihydropyridine calcium channel blocker (Verapamil)

8) Concentric hypertrophy

Front 15

Restrictive Cardiomyopathy:

1) This is the result of the deposition of stuff in the myocardium from what 4 cond'ns?
A) The deposition of this stuff in the myocardium --> what?

2) Assoc w/ what 2 cond'ns?

Back 15

1) Sarcoidosis (sarcoid)
Amyloidosis (amyloid)
Fibroelastosis
Fibrosis
A) Stiff vents and TF a diastolic dysfnctn

2) Loffler's syndrome
Hemochromatosis

Front 16

What is the MCC of R. heart failure?

Why might you use thiazide or loops diuretics and nitrates for CHF?

Back 16

L. heart failure

Sx-ic relief

Front 17

1) What Cond'n does this describe:
Infection / inflammation of the endocardium including the AV valves?

2) What type of bacterial endocarditis-
results from Staph aureus,
has LARGE vegetations on PREVIOUSLY NORMAL valves,
Rapid onset

3) What type of bacterial endocardtis -
results from Strep viridans,
SMALLER vegetations on ABNORMAL valves,
slow and insidious onset,
Result of dental procedures

4) Which valve is MCly involved? What about in IV drug users?

5) 8 s/s?

Back 17

1) Bacterial (infective) endocarditis

2) Acute Endocarditis

3) Subacute Endocarditis

4) Mitral Valve
IV Rx Users: Tricuspid

5) FROM JANE
Fever (MC Sx)
Roth Spots: on Retina
Oslers Nodes: Painful on finger pads
Murmur

Janeway Lesions - Painless on P&S
Anemia
Nail-bed hemorrhage
Emboli

Front 18

1) What Pathology:
Hx of beta-hemolytic strep pharyngitis now presents w/ cardiac probs?

2) 2 Pathological Findings in RF?

3) 1 lab finding in RF?

4) Give pathogenesis of RF?
A) TF what type hypersensitivity?

5) Give the JONES criteria for rheumatic fever?

Back 18

1) RF (Rheumatic Fever)

2) Aschoff bodies (granulomas w/ giant cells)
Anitschkow cells (activated histiocytes)

3) Elevated ASO titers

4) Ab develop against streptococcal M PRO which looks like cardiac Ag -->
Ab attack heart
A) Type II

5) JONES
Joints: Migratory, Poly-Arthritis
Carditis
Nodules (Sub-Q)
Erythema Marginatum
Syndenham Chorea

Front 19

What's the Pathology:
1) Sharp chest pain, aggravated w/ inspiration and relieved by sitting up and leaning forward?

2) MC type of pericarditis?

3) 2 other types pericarditis?

Back 19

1) Pericarditis

2) Fibrinous pericarditis: Includes dressler's syndrome and uremic pericarditis

3) Serous pericarditis
Suppurative / Purulent pericarditis: infxn

Front 20

What's the pathology:
1) Compression of heart from blood or effusions in pericardium --> Dec CO

2) Describe the diastolic pressures in all 4 chambers of the heart in someone w/ cardiac tamponade?

3) 1 Pulse Finding in Cardiac Tamponade?

4) 1 EKG finding in CT?

Back 20

1) Cardiac tamponade

2) Equal

3) Pulsus Paradoxicus:
An exaggeration of a normal physiologic occurrence in which:
Inspiration -->
Suck more blood into right side of heart -->
right heart pushes against left heart -->
dec L. heart filling and CO -->
Drop in SBP by 10 mmHg

4) Electrical Alteranans:
Alternanting large and small QRS complexes

Front 21

What pathology:
1) Dilation of aorta and aortic valve ring
+
Calcification of aortic root --> "tree bark" appearance of aorta?

Back 21

1) Tertiary syphilis

Front 22

Cardiac Tumors:
1) MC PRIMARY cardiac tumor in ADULTS?
A) Where are myxomas usually found?
B) Myxomas can obstruct blood flow in R. atrium and --> what?

2) What is the MC PRIMARY cardiac tumor in KIDS?

3) What is the MC cardiac tumor OVERALL (primary and otherwise)?

4) Cardiac tumors may show what PE sign?

Back 22

1) Myxomas (usually L. atrium)
A) L. Atrium
B) Syncopal episodes

2) Rhabdomyoma

3) Mets from melanoma or lymphoma

4) Kussmaul's Sign: Inc JV Pressure on inspiration

Front 23

What Pathology:
1) Dilated, tortuous veins due to increased venous pressure?

2) 2 sequlae of varicose veins?

3) Is thromboembolism from varicose veins common?

Back 23

1) Varicose veins

2) Poor wound healing
Venous stasis ulcers

3) No, it's rare. Thromboemobolism from deep veins are common.

Front 24

What pathology:
1) Dec blood flow to skin - esp fingers and toes- due to arteriolar vasospasm in cold temps or after emotional stress?

2) Assoc w/ what 3 AI cond'ns?

3) Why is Raynaud's called the "Patriotic Dz"

Back 24

1) Raynaud's

2) Mixed CT dz
SLE
CREST Scleroderma

3) Red, White and Blue Extremities

White: Initial dec blood flow
Blue: LT dec blood flow
Red: Reperfusion

Front 25

VASCULITIDES (singular vasculitis)

Back 25

VASCULITIDES (singular vasculitis)

Front 26

1) Name that vasculitis:
Elderly females
Unilateral HA
Jaw Claudication
High ESR

2) Major complication?
A) from obstruction of which artery?

3) Tx?

4) Definitive dx?

Back 26

1) Temporal (giant cell) arteritis

2) Blindness
A) Obstruction of ophthalmic art

3) High Dose steroids

4) Temporal Art Biopsy

Front 27

Name That Vasculitis:
1) Asian Females
Weak UE pulses
Inc ESR

Back 27

Takayasu's Arteritis

Front 28

Name that vasculitis:
1) Hep B
Spares vessels of lungs
p-ANCA
Immune Complex mediated

2) Tx of PAN?

Back 28

1) Polyarteritis Nodosa

2) Corticosteroids,
Cyclophsphamide

Front 29

Name that vasculitis:
1) Asian kids < 4
Fever
Conjunctivitis
Changes in mucosa of lips and mouth
"Strawberry tongue"
Dequamation

2) 1 really bad AE?

3) 2 Tx?

Back 29

1) Kawasaki's

2) Coronary aneurysm

3) IVIg and ASA

Front 30

Name that vasculitis:
1) Heavy smokers
Males > 40
Claudication
Raynaud's

2) 1 Tx?

Back 30

1) Buerger's dz (thrombophlebitis obliterans) - NOTE this is NOT the kidney buerger's dz

2) Stop smoking

Front 31

Name that vasculitis:
1) Palpable purpura that's p-
No granulomas
Pauci-immune glomerulonephritis (FX kidney arts)
ANCA positive

Back 31

1) Microscopic polyangitis

Front 32

Name that vasculitis:
1) URIs
LRIs
Hematuria & Casts
c-ANCA

2) What's the classic triad of wegener's granulomatosis?

3) Tx?

Back 32

1) Wegener's Granulomatosis

2) Focal necrotizing vasculitis
Necrotizing granulomas in lung and upper airway
Necrotizing glomerulonephritis

3) Cyclophosphamide, Corticosteroids

Front 33

Name that vasculitis:
1) EOSINOPHILIA
Asthma
Peripheral Neuropathy (foot and wrist drop)
p-ANCA

Back 33

1) Churg-Strauss Syndrome

Front 34

Name That Vasculitis:
1) MC childhood vasculitis
post-URI
Palpable purpura on butt and legs
Arthralgia
GI abd pain and melena
IgA complexes!!

Back 34

1) Henoch-Shoenlein Purpura

Front 35

DONE w/ VASCULITIDES

Back 35

DONE w/ VASCULITIDES

Front 36

Name That Pathology:
Port-wine stain (nevus flemmeus) on face
Intracerebral AVM --> Leptomeningeal angiomatosis
Seizures

Back 36

Sturge-Weber

Front 37

VASCULAR TUMORS

Back 37

VASCULAR TUMORS

Front 38

Name That Vascular Tumor:
Benign Capillary Hemangioma of infancy
Grows rapidly
Spontaneously regresses

Back 38

Strawberry Hemangioma

Front 39

Benign Capillary Hemangioma
Elderly
DOES NOT regress

Back 39

Cherry Hemangioma

Front 40

Hemangioma that ulcerates and bleeds
Assoc w/ trauma and preggos

Back 40

Pyogenic Granuloma

Front 41

Cavernous lymphangioma of neck
Assoc w/ turner's syndrome

Back 41

Cystic Hygroma

Front 42

Red blue tumor UNDER fingernails

Back 42

Glomus tumor

Front 43

AIDS pts
Infxn in Bartonella henselae
Mistaken for Kaposi's Sarcoma

Back 43

Bacillary Angiomatosis

Front 44

HIGHLY LETHAL Malig of liver
Exposure to Vinyl Chloride, Arsenic, ThO2 (Thorotrast)

Back 44

Angiosarcoma

Front 45

Angiosarcoma is a highly lethal malignancy of what organ?

Back 45

Liver

Front 46

Lymphatic malignancy assoc w/ persistent lymphedema often times post-radical mastectomy

Back 46

Lymphangiosarcoma

Front 47

Endothelial malig of skin assoc w/ HHV-8 and HIV

Mistaken for Bacillary Angiomatosis

Back 47

Kaposi's Sarcoma