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18 Cards in this Set
- Front
- Back
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What is the difference between blowing and harsh murmurs?
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blowing - blood flowing wrong way across a valve that should be closed.
harsh - blood hitting tissue, such as a stenotic valve. |
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What are the major heart murmurs?
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Aortic stenosis - harsh SYSTOLIC murmur. Due to age or congenital bicuspid valve.
Aortic regurge - blowing DIASTOLIC murmur. Due to leutic aneurysm, HPTN, dissecting aortic aneurysm, ankylosing spondylitis Mitral Stenosis - harsh DIASTOLIC murmur. Due rheumatic heart dx Mitral Regurge - blowing SYSTOLIC murmur. Due to mitral valve prolapse, rheumatic HD, infectious endocaarditis, papillary muscle rupture, CHF Mitral valve prolapse - midsystolic click. Marfans, Ehlers-Danlos, Fragile X. |
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What are the different Cyanotic heart defects?
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Tetralogy of Fallot - VSD + subpulmonic stenosis + overriding aorta + RV hypertrophy
Transposition of great vessels - aorta connects to RV and pulmonary artery connects to LV Persistent Truncus arteriosus - great vessels aren't separated Eisenmengers Syndrome - reversal of a left to right shunt (VSD) to a right to left shunt from pulmonary HPTN |
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What are the two types of Coarctation of Aorta?
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infant type - preductal narrowing of the aorta - fatal early in life
adult type - postductal narrowing of the aorta - pts live to adulthood (High BP upperbody, Low BP lowerbody) |
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What is the difference between stable and unstable angina?
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S - decreased cardiac perfusion with increased demand. Due to a persistent but unchanged atherosclerotic plaque that limits blood flow - gets worse with exercise.
U - disruption of plaque followed by formation of a superimposing thrombosis with potential embolization, resulting in an occlusive platelet thrombus. Pain is spontaneous and if not treated can lead to MI |
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What are the 2 types of MI?
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Subendocardial - non-Q wave; NSTEMI - inner 1/3 to 1/2 of wall infarcted
Transmural - Q wave; STEMI - whole wall infarcted - more deadly |
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What is the difference between left and right sided heart failure
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LS - due to chronic HPTN, MI, valve path. Results in pulmonary edema and fluid overload - can't pump blood to the body. Activates ARR system. Dyspnea, orthopnea, fatigue.
RS - due to LSHF, pulmonary HPTN, lung path. Results in peripheral edema and nutmeg liver. Ankle edema, JVD |
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What is the cause of acute infective endocarditis? Subacute?
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A - skin microbes - Staph aureus, Strep spp. - most common in IV drug users and diabetics
S - prior valve pathology. usually by mouth/GI organisms (Strep spp of viridans group in mouth, E.Coli and other G- bacteria in bowel) but can also be from skin/respiratory organisms. Bacteria aren't cleared away as well due to the valve path. |
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What are the 3 types of non-infective endocarditis?
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Acute rheumatic fever - Ab attack of heart following Strep pyogenes infection. Pancarditis. Severe mitral valve damage
Marantic Endocarditis - thrombi develop in endocardium. Higher risk in those with severe/chronic illness, adenocarcinoma Libman-Sacks - only in SLE pts. Huge vegetations of Ab-Ag complexes form on valve - severe valve damage. |
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What are the 3 types of pericarditis?
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fibrinous - most common in world. Due to transmural MI or Dresslers
Serous - most common in US. Due to Coxsackie B, uremia, acute rheumatic fever, scleroderma, rheumatic HD, SLE Suppurative - purulent (pus) - Due to direct invasion of organisms into the pericardium (strep pneumo or staph aureus) |
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What histologically classifies classic Acute Rheumatic Fever?
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Aschoff Bodies - focal area of myocardial inflammation. Contains collagen, enlarged myocytes, and Aschoff cells (multinucleated giant cells)
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What is obstructive lung disese
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increased restriction to airflow during forced expiration. Air can't exit well.
Low FEV1 (forced expiratory volume) becuse less air can get out than normal. total lung capacity is high because lung is hyperinflated. COPD and asthma Tx: Beta agonists (albuterol), anticholinergics (ipratropium), O2 |
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What are the common terms for Pulmonary emphysema and chronic bronchitis?
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Pulmonary - pink puffer - adequately oxygenated early in dx + does pursed lip breathing to maintain positive pressure in lungs.
Bronchitis - blue bloater - inadequate oxygenation early in disease, with later edema secondaary to Right heart failure |
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What is asthma
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IgE mediated response, airway inflammation, airway obstruction, increased airway responsiveness to stimuli..
Spasm of muscles, edema of airway mucosa, increased muscoasl secretions. Low FEV - gets better w abuterol cough, dyspnea, wheezing, tachypnea Charcot-Leyden crystals and Curshmann spirals in mucus |
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What is Restrictive lung disease?
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lung is restricted from taking in adequate amount of air. Lung is small and not adequately expandable.
FEV1 is normal or low owing to fibrosis and decreased lung function *TLC - always low because lung is incapable of expanding adequately, usually due to scarring and fibrosis. |
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What is the process for adult ARDS
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Endothelial damage - plasma and blood leak into interstitial and interalveolar spaces (1st phase 2-3 days)
alveolar flooding and atelectasis (due to diluted surfactant) - (2nd phase) interstitial and bronchoalveolar inflammation with epithelial and interstitial cell proliferation (3rd phase) Collagen accumulates rapidly resulting in severe interstitial fibrosis (within 2-3 weeks of initial endothelial damage) |
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What are the different types of Pneumoconiosis?
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Asbestosis - inhalation of asbestos. Ferruginous bodies. Mostly lower lobes, initially causing fibrotic plaques of pleura. Increased risk for SCC of lung and Malignant mesothelioma
Anthracosis - Coal workers pneumoconiosis - black lung from coal dust. Bronchiectasis, pulmonary HPTN (pul A thickens), severe restrictive lung dx, RHF. Mainly upper lung Berylliosis - from beryllium inhalation. primary lower lobes silicosis - inhalation of quartz dust. Raises chances of TB. Mainly upper lung lobes. |
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What is Goodpasture's Syndrome?
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Autoimmune disease mediated by anti-glomerular basement membrane antibodies. The antibodies destroy the glomerular and pulmonary basement membrane, causing fibrosis.
severe glomerulonephritis, pulmnoary hemorrhage, dyspnea. |
