Cardio Path

Front 1

True of false: 50% is classified as secondary HTN (usually resulting from renal disease)

Back 1

false. (90% essential/primary, 10% secondary)

Front 2

"read the questioner's mind": HTN predisposes individuals to this disease (the one John Ritter died of)

Back 2

aortic dissection

Front 3

Pathology changes associated with HTN

Back 3

hyaline thickening & atherosclerosis

Front 4

This awful term refers to a stiffening of the arteries that invovles the media. Particularly likely to occur at the radial & ulnar arteries.

Back 4

Monckeberg arteriosclerosis

Front 5

True or false: atherosclerosis is a disease of small sized arteries

Back 5

false. affects elastic, large & medium muscular arteries.

Front 6

Earliest sign of atherosclerotic disease

Back 6

fatty streak

Front 7

most likely location

Back 7

abdominal aorta. (then coronary artery, popliteal artery, and carotid artery)

Front 8

Type of angina resulting from coronary artery spasm

Back 8

Prinzmetal's variant

Front 9

This coronary artery branch is most commonly implicated in myocardial infarction

Back 9

LAD (left anterior descending)

Front 10

most common cause of sudden cardiac death

Back 10

(lethal) arrhythmia

Front 11

Solid tissues like the heart, brain, kidney and spleen have only a single blood supply (not so good collaterals). Therefore infarcts are more likely to be --?

Back 11

pale

Front 12

2 instances where red infarct is likely

Back 12

(1) reperfusion (2) loose tissues with good collaterals - like the lungs or intestine

Front 13

Rank the following vessels from most to least commonly occluded: RCA, LAD, circumflex

Back 13

LAD>RCA>circumflex

Front 14

Histologic changes on day 1 of an MI?

Back 14

pallor of infarcted area; coagulative necrosis

Front 15

days 2-4?

Back 15

dilated vessels (hyperemia); neutrophil invasion; extensive coagulative necrosis

Front 16

days 5-10?

Back 16

yellow-brown softening of infarcted region; macrophages present; granulation tissue begins to grow in

Front 17

after 7 weeks?

Back 17

infarct is gray-white; scar complete

Front 18

True or false: ECG is not diagnostic during the first 6 hours following an MI

Back 18

False; it is the gold standard within this time period

Front 19

What is the test of choice within the first 24 hours?

Back 19

CK-MB

Front 20

This enzyme is elevated from 4 hours up to 10 days after an MI and is the most specific protein marker

Back 20

cardiac troponin I

Front 21

on ecg, transmural infarction causes ______

Back 21

ST elevation, Q wave changes

Front 22

Most common MI complication (90% of patients)

Back 22

arryhthmias, esp. 2 days after infarct

Front 23

automimmune phenomen several weeks post-MI that results in fibrinous pericarditis

Back 23

Dressler's syndrome

Front 24

high risk of mortality

Back 24

cardiogenic shock (large infarcts)

Front 25

seen about a week after the infarction

Back 25

rupture of ventricular wall, septum, or papillary muscle

Front 26

Most common Cardiomyopathies

Back 26

dilated (congestive) cardiomyopathy; heart looks like a ballon on X-ray

Front 27

True or False: substance abuse is a common cause of dilated cardiomyopathy

Back 27

True; cocaine and alcohol especially

Front 28

These two infectious diseases are associated with dilated myopathy

Back 28

coxsackievirus B and Chagas' disease

Front 29

True or false: hypertrophic cardiomyopathy causes systolic dysfunction

Back 29

False; dilated myopathy causes systolic dysfunction, hypertrophic causes diastolic

Front 30

Half of hypertrophic myopathies are inherited as an _________ trait (x-linked, dominant, etc.)

Back 30

autosomal dominant; major cause of sudden death in young athletes

Front 31

On echo in hypertrophic disease, the LV thickens and the chamber looks how?

Back 31

like a banana

Front 32

These "-osis" diseases are major causes of restrictive/obliterative cardiomyopathy

Back 32

sarcoidosis, amyloidosis, hemochromatosis, endocardial fibroelastosis, endomyocardial (Loffler's) fibrosis….also, scleroderma but it's not an -osis

Front 33

Name two causes of holosystolic murmurs

Back 33

1) VSD, 2) mitral regurg, and 3) tricuspid regurg

Front 34

Widened pulse pressure seen with this diastolic murmur

Back 34

aortic regurg

Front 35

Describe the murmur associated with the most common valvular lesion

Back 35

Mitral prolapse; late systolic murmur following mid-systolic click

Front 36

True or false: aortic stenosis causes a decrescendo-crescendo murmur following an ejection click

Back 36

False; ejection click is followed by a crescendo-decrescendo systolic murmur

Front 37

cause of a continuous murmur loudest at time of S2?

Back 37

patent ductus artieriosis

Front 38

opening snap followed by late diastolic rumbling?

Back 38

mitral stenosis

Front 39

most common heart tumor?

Back 39

metastasis

Front 40

primary cardiac tumor in 1) adults and 2) children

Back 40

adults=myxoma (almost always in left atrium); children=rhabdomyoma

Front 41

fun gross pathologic term for changes in liver with CHF?

Back 41

nutmeg

Front 42

what are "heart failure cells"?

Back 42

hemosiderin-laden macrophages in lung

Front 43

dyspnea on exertion, pulmonary edema, and paroxysmal nocturnal dyspnea are symptoms of?

Back 43

left heart failure

Front 44

patient says "I have to sleep upright." the clinical term for this is?

Back 44

orthopnea

Front 45

most pulmonary emboli arise from?

Back 45

DVT

Front 46

True or false: Amniotic fluid can lead to DIC

Back 46

TRUE

Front 47

what are the component of virchow's triad?

Back 47

stasis, hypercoagulability, endothelial damage

Front 48

what is pulsus paradoxus?

Back 48

greater than 10 mmHg drop in systolic on inspiration

Front 49

what is electrical alternans?

Back 49

characteristic of tamponade on ECG in which QRS complex height varies beat-to-beat

Front 50

What valve is usually involved in endocarditis?

Back 50

Mitral

Front 51

What valve indicated drug use if it is involved?

Back 51

Tricuspid

Front 52

Can endocarditis be non-bacterial?

Back 52

Yes. It can be secondary to metastasis, renal failure (maranctic or thrombotic), fungal

Front 53

What type of endocarditis does s. Aureus cause?

Back 53

rapid onset, high virulence, tends to occur secondary to infection elsewhere

Front 54

What do the vegetations look like

Back 54

Large.

Front 55

What type of endocarditis does s. viridians cause?

Back 55

subacute. Tends to have smaller vegetations.

Front 56

What predisposes you to s.viridins endocarditis?

Back 56

tends to occur on previously damaged valves, so rheumatic fever. It is commonly seen after dental work.

Front 57

What are the 8 sings of endocarditis?

Back 57

JR=NO FAME Janeway lesions, Roth's spots, Nail-bed hemorrhages, Osler's nodes, Fever, Anemia, Murmur (new), Emboli

Front 58

What do Janeway Lesions look like?

Back 58

multiple small flat erythematous lesions on palms and soles

Front 59

What are roth spots?

Back 59

round white spots on the retina surrounded by hemorrhage.

Front 60

What are osler's nodes?

Back 60

Tender raised lesions on the fingers and toes.

Front 61

What is the etiology of these lesions?

Back 61

Bacterial vegetations flipping off the heart valve and lodging in the periphery.

Front 62

What type of bacteria causes rheumatic fever?

Back 62

Group A beta-hemolytic strep
(strep pyogenes)

Front 63

when does it occur?

Back 63

Children 5-15 years, four weeks after a bacterial infection

Front 64

Is the bacteria responsible for the symptoms?

Back 64

No. RF is an autoimmune reaction of a cross-reactive protein that is found in the initial bacterial infection.

Front 65

What are the non cardiac clinical signs of rheumatic fever?

Back 65

FEVERSS - Fever, Erythema marginatum, valve damage, Elevated ESR, Red-hot joints (migratory polyarthritis), Subcutaneous nodules, and St. Vitus dance (chorea)

Front 66

What hear valves are effected?

Back 66

Mitral (most frequent), Aortic, Tricuspid (5%) - high pressure valves mainly.

Front 67

What is an Aschoff body?

Back 67

classic histological sign of RF, found in the myocardium, contained fibrinoid material, fragmented collages, surrounded by giant cells.

Front 68

What are the cardiac signs of RF?

Back 68

Verrucious vegetations on the valve, pancarditis, possible pericardial effusions and myocarditis (most common cause of death)

Front 69

Name four causes of serous pericarditis.

Back 69

RAIL - Rheumatic Arthritis, Infection, Lupus, and Uremia

Front 70

What is serous pericarditis?

Back 70

straw colored, protein rich exudates - non-purulent, and acute

Front 71

What are three causes of fibirnous exudates?

Back 71

MI, Rheumatic fever, and Uremia

Front 72

Cloudy pericardial exudates indicated what?

Back 72

Bacterial infection

Front 73

What are two causes of Hemorrhagic pericarditis?

Back 73

malignancy and TB

Front 74

What is hemorrhagic pericarditis?

Back 74

Bloody and inflammatory exudates

Front 75

What are the clinical signs of pericardial exudates?

Back 75

pericardial pain, friction rub, decreased heart sounds, ST elevation throughout, and pulses paradoxes (like cardiac tamponade)

Front 76

What are the long term sequela of pericarditis?

Back 76

chronic adhesive or constrictive pericarditis

Front 77

What is constiricit pericadritis

Back 77

Fibrous scarring in the pericardium obliterates the space and constrict the right side of the heart (because it is less able to withstand the pressure)

Front 78

What types of pericaditis lead to this?

Back 78

TB and pyrogenic staph infections

Front 79

What part of the heart does syphilis damage?

Back 79

The vaso vasorum of the aorta

Front 80

What does this lead to?

Back 80

Dilation of the aorta and valve ring

Front 81

What clinical results does this have?

Back 81

it can cause an aortic aneurysm or valvular incompetence

Front 82

What parts of the aorta are effected

Back 82

ascending and arch

Front 83

What is the appearance or the aorta?

Back 83

Called a "tree-bark" appearance.