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205 Cards in this Set
- Front
- Back
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blue babies |
r to L shunts |
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r to l shunts ? |
5Ts truncus arteriosus transposition tricuspid atresia tetralogy of fallot tapvr |
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PTA , why , co-condition? |
failure of aorticopulm. septum formation
failure of ncrcs migration vsd |
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egg on a string on cxr |
transposition of gv |
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tx of tpgv |
not compatible w/ life eout a shunt |
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tx of TA |
requires both asd and vsd |
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bootshaped heart on cxr |
tof |
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why tof occurs ? |
anteriosup. displacement of infundibular sept. pulm sten rvh overrid. aorta vsd |
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baby crying blue |
tet spells |
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menuver |
squatting inc svr , dec r to l shunt , improves cyanosis |
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chromosomal abnorm ass with tof |
22q11 syndrome |
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Li exposure in utero |
ebstein anomaly |
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EA asso. |
TR Accessory conduction pathways rHF |
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late cyanosis |
L to R shunt |
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polycythemia clubbing cyanosis |
eisenmenger syndrome |
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paradoxical emboli |
asd |
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asd ass. with chormo. abn? |
down synd |
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ostium primum defect |
Downs |
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fixed s2 split |
asd |
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differential (lower extrimity) cyanosis |
pda |
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machine like murmur |
pda |
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coarc of aort . adult form ass |
bicusp aort val. |
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coarct. of aort. infantile form ass. |
PDA (located after aortic arch but proximal to pda) |
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coarct of aort ass. |
turner syndrome |
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ue htn Le hypotn |
adult form coarct of aort |
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notching of ribs |
coarct of aorta , due to collateral circul |
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22q11 syndrome ass |
tof |
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diabet mother |
transpos of gv |
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turner syndrome |
coarct , bicusp aortic v |
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william syndrome |
supravalv aortic sten |
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lithium exp |
ebstein |
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marfan synd |
thoracic aort aneurysm thoracic aort dissection mvo ar |
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down synd |
AV septal defect ( endocardial cushion defect) ASD (ostium primum defect) |
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rubella |
pda |
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alcohol |
FAS vsd tof |
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htn bp? |
sbp ≥ 130mmhg dbp ≥ 80mmhg |
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essential /p° htn cause |
inc CO or inc TPR |
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2° htn in women of child bearing age due to? |
fibromuscular dysplasia of rena artrey |
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string beads appearance of renal artrey |
fibromusc dysp. of ra |
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2° htn in elderly male |
atherosclerosis of ra 1° hyperaldosteronism |
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htnsive urgency bp |
≥180/≥120 mmhg |
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htnsive emergency bp? |
>200 |
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xanthoma |
lipid laden histocytes in skin (mc in eyelids) |
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lipid dwposit in cornea , early life due to? |
hypercholestrolemia |
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lipid dep in cornea in alderly |
arcus senilis |
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pipestem appearance on xray |
mönkeberg sclerosis (medial calcific sclerosis |
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mönkeberg sclerosis , size of vessesl? cause ? site ? why blood flow is not obstructed ? |
medium calcification internal elastic lamina+media because intima is not involved |
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hyaline arteriolosclerosis ass ? |
essential htn + diabetes mellitus |
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onion skinning ? cause ? |
hyperplastic arteriolosclerosis due to severe htn (sm proliferation |
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what is atherosclerosis ? types ? |
build up of cholestrol plaques in intima. no types |
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what is arteriosclerosis ? types ? |
hardening of arteries with arterial wall thickening and loss of elasticity arteriolosclerosis monkeberg sclerosis |
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location of atherosclerosis |
abd aort>coronory art>popliteal art>carotid art>circle of willis |
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h/o atherosclerosis |
family history men age high smoker , dibetes , high ldl , htn |
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symptoms of atherosclerosis |
angina claudication asymptomatic |
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abd pain , pulsatile abd mass |
abd aortic aneurysm mostly infrarenal |
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abd aort aneur ass e |
atherosclerosis |
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thoracic aort aneur ass e |
cystic medial degeneration |
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causes of cystic medial degen |
connective tissue disease ( marfan synd) vasa vesorum disease ( 3° syphillis i.e obletirative endarteritis of vasa vasorum) |
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sudden onset of chest pain radiating backwards , mediastinal widening |
aortic dissection |
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aortic dissec h/o |
htn marfan synd |
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angina vs infarction |
no necrosis , necrosis no complete blood cut off , comp |
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angina 2° to ? |
coronary art narrowing/spasm |
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stable ang ? ecg? |
exertional chest pain st depression |
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stable ang 2° to ? |
atherosclerosis ≥70 percent blockage |
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stable ang tx ? |
nitroglycerine/rest |
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prinzmetal angina 2° to ? ecg ? |
coronary art spasm st elevation |
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prinzmetal ang triggered by ? 3 |
cocaine alcohol triptans |
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rf of prinzmetal ang? |
smoking (not htn/hypercholestrolemia) |
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pm angina tx? |
ccb , nitrates , smoking cessation |
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unstable angina 2° to ? ecg ? |
thrombosis with incomplete artery occlusion st depression t wave inversion |
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SCD ass e? |
HCM DCM CAD LQTS BS |
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MI 2° to ? |
thrombosis e complete artery occlusion |
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diagnostic fo MI? |
inc level of cardiac biomarkers |
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NSTEMI |
subendocardial infarct |
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STEMI |
transmural infarct |
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pale with tetrazolium stain? |
dark mottling in 0-24 hour |
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complication in 0-24 hr |
ventricular arthythmia HF cardiogenic shock |
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neutrophils on Lm |
1-3 days |
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complication in 1-3days |
postinfarct fibrinous pericarditis (neutrophils) |
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neutrophills + yellow pallor |
1-3 days |
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macrophages+yellow pallor |
3-7 days |
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complications in 3-7 days (4) |
free wall rupture , cardiac temponade
papillary muscle rupture , mr
Ivs rupture , L to R shunt
Lv pseudoaneurysm , rupture |
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complications after months of MI (4) |
Dressler synd
HF
arrhythmia
true vent aneurysm , mural thrombus |
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Dx of mi 0-6 hrs |
ECG |
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dx of mi 4hr onward |
Troponin I (more specific than other protein markers) |
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dx of reinfarction following acute mi |
CK-MB |
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evolving/old transmural infarcts? |
pathologic Qwaves poor R wave progression |
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24 hrs |
cardiac arrhythmias |
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1-3 days |
post infarction fibrinous pericarditis |
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2-7 days |
papillary muscle rupture |
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3-5 days |
iv septum rupture |
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3-14 days |
vent pseudoaneurysm dormation |
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5-14 |
ventricular free wall rupture |
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several weeks |
dressler syndrome |
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2wks to several months |
true ventricular aneurysm |
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LV failure and Pulm. edema can occur 2° to? |
LV infarction vsd free wall rupture pap muscle rupture e mr |
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S3 + balloon appearance on xray +systolic rugurg murmur +HF |
DCM |
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familial cause of DCM |
TTN gene mut . (codes for sarcomere protein , titin) |
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other causes of DCM (5) |
Drugs alcohol , cocaine , doxorubicin Imfections coxsackie B virus , chaga disease Systemic conitions hemochromatosis , sarcoidosis , thyrotoxicosis , wet beri beri peripartum cardiomyopathy ischemia |
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risk e dcm |
rEF HF (systolic dysfunction) |
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tx of dcm |
Na restriction ACEIs Beta blockers diuretics digoxin mineralcort rb icd |
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takotsubo cardiomyopathy cause |
broken heart syndrome ventricular apical ballooning likely due to excessive sympathetic stimulation |
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HOCMP ? |
concentric hypertrophic cm , often septal predominance |
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familial cause of hocm |
gene mutation encoding myosin bp c and beta myosin heavy chain |
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other causes |
vhronic htn friedreich ataxia |
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S4 , mr |
hocm |
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hocm leads to ? |
syncope during exercise sudden death |
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tx of hcom if syncope occurs |
icd |
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other tx? |
beta blockesrs , non-hp ccb |
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hocm leads to? |
nEF HF (diastolic dysfunction) |
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eosinophillic infiltrate in myocardium |
loffler endocarditis |
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causes of RCM/ICM |
postradiation fibrosis loffler endocarditis endocardial fibroelastosis amyloidosi , sarcoidosis , hemochromatosis |
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RCM/ICM leads to? |
nEF HF (dyastolic dysfunction) |
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low voltage ecg (2) |
RCM cardiac temponade(qrs comp only) |
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shortness of breath , difficulty breathing , fatigue , s3 , rales , juglar venous distension JVD , Pitting Edema |
Hf |
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mcc of rHF |
lHF |
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Drugs of HF dec mortality |
ACEIs/ARBs beta blocker spironolactone |
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beta blocker not given in |
acute decompensated hf |
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drugs of hf dec symptoms |
Loop and thiazide diuretics |
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drugs of hf dec mortality +symptoms |
hydralazine with nitrate therapy |
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orthopnea + PND + PE |
LHF |
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nutmeg liver |
RHF |
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Hepatomegaly + jvd + peripheral edema |
RHF |
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HF cells |
hemosiderin laden macrophages in lungs LHF |
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cold clammy skin , very low pcwp |
hypovolemic shock |
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cause of hypovolemic shock |
Hemorrhage Dehydration Burns |
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TX of HS |
IV fluids |
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Cold clammy skin , very low co |
Cardiogenic/obstructive shock |
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Cardiogenic shock cause |
Acute mi HF vdysfunction arrhythmia |
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Tx of cgenic shock |
Ionotropes diuresis |
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Obstructive shock causes |
Cardiac tamponade PE Tension pneumothorax |
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Tx of obst shock |
Removed obstruction |
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Warm hypotensive |
Sepsis anaphylaxis |
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Dry skin hypotensive |
CNS injury |
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What is pulsus paradoxus |
Dec in amplitude of systolic bp by >10mmhg during inspiration |
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Causes of pulsus paradoxus |
COPD Croup OSA Asthma Temponade Pericarditis (constrictive) |
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Electric alternans |
Cardiac temponade |
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Beck triad? |
Hypotension Distended neck vein Distant hear sound |
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What is cardiac temponade |
Equilibration of diastolic bp in all 4 chambers of heart |
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Fever , new murmur , painful lesions on fingers and toes , painless lesions on palms and soles , splinter hemorrhage on nail beds |
Endocarditis |
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Sequela of dental procedure + new murmur |
Subacute endocarditis May be with h/o congenital abnormality or diseased valve |
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Previously OK valve + new murmur |
Acute endocarditis |
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Vagitations on both sides of valve , h/o SLE |
Libman sack endocarditis (nonbacterial) |
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Symptoms of bacterial endocarditis |
FROM JANE Fever Roth spots (retina white spots) Osler nodes(immune complex dep) Murmur(new onset) Janeway lesions(palm sole) Anemia Nailbed hemorrhage Emboli |
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Culture negative bacterial endocarditis |
Most likely due to coxiella burnetii or bartonella spp. |
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Endocarditis+colon cancer |
S. Bovis |
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Prosthetic valve+endocarditis |
S. Epidermidis |
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Mitral valve+endocarditis |
S. Aureus Viridans streptococci |
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Non bacterial endocarditis causes ? |
SLS Malignancy Hypercoagulable state |
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Native valve endocarditis cause may be? |
HACEK
Haemophillus Actinobacillus/aggregatibacter Cardiobecterium Eikenella Kingella |
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Tricuspid valve+endocatditis |
IV drug abuse S. aureus Pseudomonas |
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Sore throat history , migratory joint pain , carditis , subcutaneous nodules , rash with ring margins involuntery muscle movements |
Rheumatic fever J🖤NES joint (migratory polyarthrits) 🖤carditis Ndoules on skin Erythema marginatum sydenham chorea |
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what is mechanism of injury to heart ? |
molecular mimicry |
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Aschoff bodies |
granuloma with giant cells |
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anitshkow cells |
enlarged macrophages with ovoid wavy rod like nucleus |
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what is pancarditis , what are separate lesions ? |
inflamtion of all heart layers endocarditis (valve involvement) myocarditis(Ashoff+anitshkow) pericarditis(friction rub and chest pain) |
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tx/prophylaxis of RF |
penicillin |
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mcc of death in RF |
Myocarditis |
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type of hypersensitivity RF is ? |
2 |
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HLA type ? |
B51 |
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Early leision of RF |
MR |
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other tx |
nsaids glucocorticoides colchicine |
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watery diarrhea+flushing+right valvular involvement |
carcinoid tumor syndrome due to 5HIAA |
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fever , weight loss , sycopal episodes , early diastolic sound |
myxoma |
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Ride sided valvular involvement D/D |
IV drug abuse Carcinoid tumor |
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sharp chest pain , inc by inspiration , pt. leaning forward , cannot lay down |
acute Pericarditis |
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causes of acute pericarditis |
idiopathic (assume viral) infection (coxackievirus B) Neoplasia autoimmune(SLE, RA) uremia CVS(STEMI/Dressler s) radiation therapy |
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tree bark aorta |
syphillic heart disease |
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tx if due to uremia |
dialysis |
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children+cardiac tumor+histology shows hemartomatous growth |
rhabdomyoma |
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rhabdomyoma ass e |
tuberous sclerosis |
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red blanching leisions on skin and mucous membrane , recurrent epistaxis hematuria hematchezia |
hereditary hemorrhagic telengiectasia (Osler weber rendy syndrome) |
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GCA leads to ? |
blondness due to ophthalmic a. occlusion |
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HHT heritable as ? |
AD |
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65 years female , unilateral headache , ocular disturbances , jaw claudication , general joints pain , inc ESR |
GC(T)A |
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Mc location of myxoma |
LA |
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histology of myxoma? |
gelatinous material myxoma cells immeresed in GAGs |
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heavy smoker , <40 years male , superficial painful induration with erythema , Raynaud phen+ |
Berger disease(thromboangiitis obliterans) |
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what is thromboangiitis obliterans |
segmental thrombosing vasculitis with vein and nerve involvement |
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tx of tao |
smoking cessation |
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Tx of Kawasaki dx |
IV IG and aspirin |
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why raynaud synd occurs |
peripheral nerve ischemia |
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<4 year old children , red conjuctiva , desequamating rash , enlarged crvical LN , fever , red tongue |
kawasaki disease (mucocutaneous lymph node syndrome) CRASH Conjuctival injection ting polymorphous) Rash(desequamating polymorphous)Adenopathy(cervical) Strawberry tongue(oral mucositis) Adenopathy(cervical)Strawberry tongue(oral mucositis)Hand feet changes(edema,erythema)Fever Hand feet changes(edema,erythema) Fever |
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GCA ass e? |
polymyalgia rheumatica |
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tx of GCA ? |
corticosteroids |
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Tx of takayasu |
Corticosteroids |
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Mid age man , ±h/o htn / neurologic dysfunc / cutaneous eruptions / renal damage , hepatitis b seropositivity , melena |
Polyarteritis nodosa |
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PAN spares? |
Lungs |
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PAN involves ? |
Renal and visceral vessels |
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Reason of name PAN |
Different stages of transmural inflammation (beads on string appearance of artery) |
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PAN tx? |
Corticosteroid Cyclophosphamide |
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<40 years old manocular disturbance skin nodules night sweats fever weak extremity pulse high esr |
Takayasu arteritis |
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TA involves ? |
Aortic arch and proximal great vessels |
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Late leision of RF |
MS |
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Palpable purpura with drug h/o penicillin or cephalosporin or phenytoin or allopurinol 7-10 days later |
Cutaneous small vessel vasculitis or IC mediated leukoclastic vasculitis |
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Palpable purpura + HCV/HIV |
CSVV |
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Hematuria , cough with blood , cANCA+ , CXR showing large nodular densities |
Granulomatosis e polyangiitis (wegener) |
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Painful nodes on shin , rucurr oral mucosal ulcers , HLA? |
Bechet syndrome (ic vasculitis)
*uveitis , genital ulcers B51 |
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Children , Palpable purpura buttocks/legs , joint pains , abdominal pain , H/O URI |
IgA vasculitis(henoch schönlein purpura) |
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IgA V ass e? |
Intussusception IgA nephropathy (berger disease) |
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Tx of IgA V |
Supportive care possibly cortivosteroids |
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Tx of Wegener |
Cyclophosphamide , corticosteroid |
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No granuloma , pANCA+ |
Microscopic polyangiitis |
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Palpable purpura weakness arthralgia HCV , what deposits ? |
Mixed cryoglobulinemia IgG and IgM |
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pAnCA + , inc IgE levels , asthma , purpura , neuropathy |
Churg Strauss syndrome |
