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107 Cards in this Set

  • Front
  • Back
5 dilations of the heart tube?
sinus venosus, prim atrium, prim vent., bulbus cordis, truncus arteriosus
what forms the smooth part of the right atrium?
sinus venosus
most common positional abnormality of the heart?
dextrocardia (mirror image flip)
critical first step in development of 4-heart chamber?
endocardial cushions
Most common congenital heart defect?
(membranous) VSD
Most common form of ASD?
patent foramen ovale
4 clinically significant types of ASD's?
ostium secundum defect, endocardial cushion defect w/ ostium primum defect, sinus venosus defect, common atrium.... easy! ... what are those? it doesn't matter!
vitelline veins eventually become what?
hepatic sinusoids, hepatic veins (.... in the liver, duh), and a part of the IVC. and some other stuff
Umbilical vein forms what eventually?
left umbilical vein forms the venous shunt known as ductus venosus (umbilical vein to IVC)... remnant called ductus venosus
What forms the SVC?
right anterior and common cardinal veins
equal division of truncus arteriosus w/ incomplete fusion of bulbar ridges distally leads to what?
eisenmenger's syndrome
4 criteria for tetralogy of fallot?
pulmonary stenosis (RV outflow), VSD, overriding aorta, RVH
What primitive aortic arch forms the real aortic arch?
IV
What forms the ductus arteriosus?
the left VI aortic arch
coronary arteries form from what?
epicardium (mesodermal primordium)
mom brings in a baby saying "they have labored breathing while they are feeding!" what you think?
double aortic arch
95% of coarctation of aorta cases are...?
postductal
What are the two types of futility?
medical and physiological
What are the 5 stages of death and dying?
1. denial and isolation
2. anger
3. bargaining
4. depression
5. acceptance
What are the two types of depression in death and dying?
reactive (to news of imminent death w/ regrets about goals), and preparatory (to imminent death)
What is the minimum infectious dose for TB?
10 cells
What is the doubling time of M. tuberculosis?
18 hours
How does TB remain viable and replicate?
infect and replicated intracellularly in alveolar macrophages
What three areas is M. tuberculosis found in infected but asymptomatic individuals?
primary lesions, lesion-free areas of the lung, and lymph nodes
What is the major virulence factor of M. tuberculosis?
Cell wall
What is produced by virulent strains of TB?
cord factor (mycolic acids connected by disaccharide trehalose)
Two important cytokines in activation of macrophages?
TNF-alpha and INF-gamma
What cause weight loss in chronic TB infection?
TNF-alpha toxicity
How long can TB survive in fine aerosol particles?
8 months
What type of hypersensitivity response is characteristic of TB skin test?
type IV
Multiple discrete nodules throughout the lung = what cancer type?
Metastatic carcinoma
Are bronchial carcinoid tumors low-grade or aggressive?
low grade cancer
Bronchial carcinoid tumor arises from where?
duh! a bronchus
primary respiratory carcinoma least likely to find where?
trachea
lung carcinoma, hyperpcalcemia, think what?
squamous cell
what lung tumor arises from small peripheral airways?
adenocarcinoma
pulmonary tumor that is non-operable and baaad prognosis?
small cell carcinoma
what is bronchial carcinoid tumor growth like?
intraluminal growth around site of origin
most common endocrine site of metastasis from bronchiogenic carcinoma?
adrenals
Pts. w/ bronchiogenic carcinoma frequently present with (3 things)?
bronchial obstruction, atelectasis, and pneumonia
Where does squamous cell carcinoma normally originate?
near the hilum
What cell does small cell carcinoma come from?
K-cells
well-established risk factors for lung cancer?
smoking, radiation, asbestos, certain metals (nickel), coal tar, etc.
most common bronchiogenic carcinoma?
all equally common
squamous cell carcinoma commonly produces what substance?
PTHrP
most adenocarcinomas arise where?
in the periphery beneath or near the pleura
adenocarcinomas can arise near what causing "yokoo tumors"?
scars
what malignant tumor grows along alveolar septal framework?
bronchio-alveolar carcinoma
All major lung cancers usually stain for erbB except?
small cell
2 most commonly secreted substances of oat cell carcinoma?
ACTH and hADH
Eaton-lambert syndrome is associated with what lung tumor?
oat cell
What mesenchymal marker is famous in mesothelioma?
vimentin
Amplitude of P wave should not exceed what height and length?
height: 2 or 3 mm in any lead
length: <0.11 sec
What things should you look for in a p wave (in various leads)?
inversion, increased amplitude, increased width, diphasicity, notching, peaking, absence
What are the 7 features to inspect for the QRS complex?
duration, amplitude, absence of q wave, axis, transition zone, intrinsicoid depletion, slurring or notching
QRS should not exceed what duration?
duration: 0.12 sec or > indicates problem
A Q wave, if present, should not exceed what depth and duration?
height: 1 or 2 mm fine.
duration: shoudn't be more than 0.03 sec
What is the exception to the isoelectric ST segment rule?
young, healthy black men (due to early repol.)
Displacement of ST segment is hallmark of what?
MI or myocardial injury
ST depression in precordial leads =?
ST elevation = ?
dep= subendocardial
elevation= subepicardial injury or ischemia
Sharply pointed and symmetrical t wave. suspect ?
MI
T wave heights should not exceed ?
std leads: 5 mm; chest leads: 10 mm
What is the most common cause of LVH?
hypertension
What do you use the Ronhilt-Este's scoring system for?
diagnosing LVH; 4 points = probable LVH, 5 points= LVH
What are some causes of RVH?
COPD, mitral stenosis, tricuspid regurg, something congenital
What is a major thing to examine for determing RVH?
R:S ratio greater than 1 in V1
What are two good leads for determining atrial enlargement?
V1 and LII
p-pulmonale peaked p wave w/ 3 mm amplitude in lead II. think ?
RAE
Key causes of LAE?
MS & MR
p-mitrale w/ p wave suration of .11 sec. think ?
LAE
Septum is depolarized in what direction?
L to R
What is intrinsicoid deflection? What is normal?
1. time lapse from beg of QRS to the peak of the R wave = time when impulse reaches the epicardial surface of the ventricle
2. V1- .02 sec. V6- .04 sec
2 common features of BBB?
1. wide QRS (> .12 sec)
2. ST seg: T wave slopes off in opposite direction to QRS
RsR' in V1 = ?
RBBB
QS (rS) in V1, monophasic R . think?
LBBB
T wave polarity is opposite QRS direction. think ?
BBB
3 features of LAH?
LAD, normal QRS duration, Q1S3
3 features of LPH?
RAD (120+), Q3R1, normal QRS duration
fixed PR interval > .2 sec. no dropped beats. diagnosis?
first degree block
#1 etiology of first degree block?
ischemic heart disease
progressivel prolonged PR-interval w/ dropped beats.... could be "grouped beats"... what is it?
second degree block: Mobitz 1
most common cause of mobitz I?
inferior MI
uniform PR interval w/ dropped beats. what is it?
second degree block: mobitz II
Where does a mobitz II block occur?
bundle of HIS or below
common cause of mobitz II?
LAD ischemia
AV dissociation. QRS occurs as either junctional or ventricular rhythm. what is it?
third degree block
rate <60/min = ?
bradycardia
Where is the SA node located?
junction of SVC & RA
inferior wall MI leads to brady or tachy?
brady (usually)
anterior wall MI leads to brady or tachy?
tachy (usually)
2 drugs and 1 electrolyte imbalance associated w/ bradycardia?
digitalis, quinidine, hyperkalemia..... also beta blockers
DOC for bradycardia? if that doesn't work?
atropine.... then pacemaker
3 classifications of SVT?
paroxysmal, sustained (> 30sec), and repetitive
DOC for sinus tach?
treat the underlying cause!
combination of A-fib and RAD = ?
mitral stenosis
irregular rhythym irregular baseline... what is it?
a-fib
Saw tooth pattern on baseline, normal QRS in 8:1 - 2:1 ratio... what is it?
atrial flutter
flutter waves occur at what rate range?
250-350 /min
irregular rhythm, P-R interval varies, 3 or more P wave morphologies. what is it?
multifocal atrial tach
MAT is associated w/ what?
lung disease! (and theophylline, catecholamines. etc)
DOC for MAT?
magnesium sulfate
What often follows a PVC?
full compensatory pause
What is it called when a PVC occurs w/ no pause in between beats?
interpolated
at least 3 consecutive bizarre QRS complexes rate at 120-200. what is it?
v-tach
ventricular arrhythmia associated w/ prolonged QT?
torsades de pointes
How do you treat torsade de pointes?
magnesium sulfate
no evidence of p waves. extremely wide and bizarre QRS w/ a rate at 75. what is it (likely)?
accelerated idioventricular rhythm. LEAVE IT ALONE (seen post-thrombolysis tx)