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83 Cards in this Set
- Front
- Back
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What is it called when you see redistribution of bloodflow from ischemic areas to vasodilated collateral vessels in coronary vessels?
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Coronary Steal Phenomenon
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Where is the most de-oxygenated blood found in the body?
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Coronary sinus
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What cardiac features can cause dysphagia and hoarseness
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Left atrium enlargement -> compression of esophageal nerve and recurrent laryngeal of vagus nerve
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How is CO maintained in early and late exercise?
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Early - Increase in SV
Late - Increase in HR |
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What results of decreased vessel capacitance as one gets older? What are capacitance vessels?
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Increased pulse pressure; these are veins/ venules that return blood to the heart (high storage capacity, low resistance)
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What effect do venodilators have on the heart and SV/CO?
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The decrease preload
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What is viscosity most dependent on?
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hematocrit
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Do arteries or veins contain the highest proportion of blood in the CV system?
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Veins
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In what conditions do you see decreased aortic elasticity?
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Marfarns, Syphilis ('tree-bark' aorta)
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What happens to the IV septum during inspiration
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IT gets pushed to the left a little bit
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Which murmur decreases intensity with amyl nitrate?
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Aortic regurgitation
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How are cardiac myocytes electrically coupled?
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Via gap junctions
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Chromotropic vs. Dromotropic
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C - HR
Dr - conduction velocity |
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Which of these 4 do not have parasympathetic vagal innervation? SA node, atria, AV node, ventricles
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ventricles
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What effect do B-blockers have on the pacemaker action potential?
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Decrease phase 4 elevation
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T-wave inversion
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recent MI
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U wave
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hypokalemia and bradycardia
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Conduction pathway
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SA node, atria, AV node, common bundle, LAF, bundle branches, Purkinje fibers, ventricles
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Wolff-Parkinson-White ECG
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shortened PR interval
delta wave widened QRS |
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What is SVT?
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bypasses the AV node, uses an accessory node (ie. bundle of Kent)
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Why should you not do cardioversion to rx an A-fib > 48 hours?
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increased risk of dislodging a thrombus that has formed -> transport the clot
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Rx for atrial flutter
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Anti-arrhythmics, B-blocker
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In a 3rd degree AV block, is atrial or ventricular rate faster? what bacteria can cause this?
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atrial rate is faster; Borellia burgdorferi (Lyme Dz)
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Cushing Triad
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Hypertension
Bradycardia Respiratory depression |
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Cushing reaction
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Brought on by baroreceptors. high ICP constricts arterioles -> cerebral ischemia -> hypertension (symp response) -> reflex bradycardia
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What drives respiration in COPD patients?
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high CO2 cannot stimulate central resp center, so low O2 (<60) is major drive on peripheral receptors
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"ring like" calcification in the media of the arteries; where does it most commonly occur?
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Monckeberg (radial and ulnar)
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What are the 2 common causes of "onion skinning"/hyaline thickening of small arteries
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DM and essential HTN (Arteriolosclerosis)
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What are the 2 main mediators of smooth muscle migration in atheroslerosis?
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PDGF and TGF-B
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Rx to decrease slope of BP rise in Aortic dissection
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B-blocker
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How is atherosclerosis related to aortic dissection?
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it is NOT
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During global ischemia, what is the first area damaged?
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Pyramidal cells of Hippocampus (also cerebellum)
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Rx for Prinzmetal's angina?
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CCB - Nifedipine
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Most common cause of sudden cardiac death?
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Arrhythmia (V-fib)
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What causes post MI free wall rupture, tamponande
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macrophages degrade important structural components
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ECG changes seen in MI
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T wave inversion
ST elevation of at least 1mm in 2 contiguous leads Q waves |
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Dressler's syndrome
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Autoimmune fibrinous pericarditis post-MI
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Dilated vs. hypertrophic cardiomyopathy hypertrophy
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Dilated - eccentric; sarcomeres added in series
Hypertrophic - concentric; sarcomeres added in parallel |
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Rx for hypertrophic cardiomyopathy
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B-blockers or non-DHP Ca2+ blocker
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Loffler's syndrome
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a Restrictive Cardiomyopathy; endomyocardial fibrosis with a prominent eosinophilic infiltrate
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These 4 Rx's reduce mortality in CHF
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B-blockers, Ace-I, ARBs, Spironolactone
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What causes persistent truncus arteriosus?
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Abnormal migration of NC cells
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Major cause of D-transposition of great vessels
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Diabetic mother
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Infantile vs. adult coarctation of the aorta
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I - prox to ductus arteriosus
A - distal to ligmentum arteriosus |
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Ebstein's anomaly is most associated with what heart defect?
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ASD
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Atheroma
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plaques in blood vessels
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What are the "heart-failure" cells seen in the lungs?
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Hemosidirin-laden macrophages
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Ortner syndrome
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Dilated LA (maybe from mitral stenosis) -> impingement of L recurrent laryngeal to the point of neuropraxia
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Negative culture endocarditis
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HACEK orgs
Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella |
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Most common bugs of IVDU endocarditis (tricuspid)
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Staph aureus, Pseudomonas, Candida
Rx: Vancomycin |
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Giant cell granuloma in Rheumatic fever
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Aschoff bodies
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Activated histiocytes
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Anitschkow's cells
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Rheumatic fever - what antibodies are found?
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Antibodies to M protein
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ECG of acute pericarditis
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diffuse STEMI, PR depression
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Where do you see pulsus paradoxus (5)
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Cardiac tamponade, asthma, OSA, pericarditis, croup
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Cardiac tamponade ECG
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Electrical alternans - alternation of QRS amplitude or axis between beats
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How does syphilis cause the "tree bark aorta"?
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Disrupts the vaso vasorum of the aorta -> dilation of aorta and valve ring
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What do varicose veins predispose to?
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Poor wound healing, varicose ulcers
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Raynauds Rx:
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DHP CCBs - vasodilators
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Associated with polymyalgia rheumatica
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Temporal arteritis
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Transmural vasculitis with fibrinoid necrosis
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Polyarteritis nodosa
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Rx for Kawasaki
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Ig and aspirin
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Segmental thrombosing vasculitis
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Buerger's disease (thromboangiitis oliterans)
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Nevus flammeus
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Port-wine stain in Sturge-Wever disease (leptomeningeal angiomatosis)
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Rx for HTN in pregnancy
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a-methyldopa, hydralazine
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Malignant HTN rx that release NO -> can cause cyanide toxicity
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Nitroprusside
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Which malignant HTN rx opens up K+ channels
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Diazoxide
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nitrates vs. B-blockers
Nifedipine vs. Verapamil |
Nitrates/Nifedipine affect preload
B-block/Verapamil affect afterload |
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Which lipid-lowering drug can bind C.diff?
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Bile acid resins
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Ezetimibe
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Cholesterol absorption blocker; does not decrease fat-sol vitamin absorption
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How do fibrates act?
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Decrease TG, Upregulate LPL via PPAR-y
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Which CV drug can cause blurry yellow vision?
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Digoxin
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What is the most serious tox of digoxin?
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Arrythmia
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Which drug can decrease digoxin clearance and displace digoxin from tissue-binding sites?
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Quinidine
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Neseritide
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a BNP; increases cGMP and vasodilation
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What competes with digoxin for binding sites?
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K+; so hypokalemia can increase digoxin tox
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What can cause toxicity in all class I antiarrhythmics?
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hyperkalemia
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Which B-blocker can cause dyslipidemia?
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Metoprolol
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What are the Class III antiarrhythmic? (5)
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"K IS BAD"
Ibutilide, Sotalol, Bretylium, Amiodarone, Dofetilide |
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Why does amiodarone have class I,II,III, and IV effects?
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It alters the lipid membrane
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What is unique about amiodarone increasing QT interval?
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Does not increase risk for Torsardes de Pointes
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What is the drug of choice to abolish/diagnose supraventricular tachy?
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Adenosine
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What does adenosine do?
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Increases K+ out of the cells -> hyperpolarizes the cell and decreases Ica
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