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53 Cards in this Set
- Front
- Back
What is the normal rate of the nodes?
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SA 60-100 bpm
AV 40-60 bpm His-Purkinje 20 bpm |
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What influences high CO?
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high preload, high contractility, low afterload
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What is a Frank Starling Curve?
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Y axis: CO, Contractility, or SV
X axis: EDV, EDP, or preload ability of the heart to change its force of contraction and therefore stroke volume in response to changes in venous return |
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What are the major and minor risk factors for atherosclerosis?
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smoking, HTn, high cholesterol, DM
obesity, gender, sedentary lifestyle, family history, stress, high TG, hyperhomocystinemia, autoimmune vasculitis |
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What is intermittent claudication?
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reproducible leg pain that is present at rest and worse when lying flat, usually improving w/ letting legs hang down
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How does someone develop DVTs?
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stasis, endothelial injury, hypercoaguable state
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What is Trosseau's sign?
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cancer causing hypercoaguable wandering clots in extremities (more superficial than deep)
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What are the signs of right sided heart failure?
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peripherla pitting edema
JVD hepatomegaly/hepatojugular reflux nocturia |
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What does a chest x-ray of CHf look like? What is visible is both compensated and decompensated CHF?
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acute: pleural effusion, prominent interstitial markings, Kerley B lines
chronic: cardiomegaly cardiomegaly |
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What is the most common complication of both cardiomyopathy and post-MI?
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arrythmias
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How do you differentiate between the systolic crescendo-decrescendo murmur from hypertrophic cardiomyopathy and aortic stenosis?
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Valsalva decreases preload
-increases obstruction and murmur in hypertrophic cardiomyopathy -decreases blood flow and murmur in aortic stenosis Handgrip increases afterload -pushes obstruction aside and causes a softer murmur in hypertrophic cardiomyopathy -sends blood increases murmur in aortic stenosis |
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What is the murmur and presentation of mitral stenosis?
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snap rumble
pulmonary congestion, atrial fib other: infective endocarditis, dysphagia, hoarseness, hemoptysis |
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What is the murmur/presentation of mitral regurgitation?
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holosystolic high pitched blowing murmur loudest at apex --> radiate to axilla
Acute: pulmonary congestion Chronic: once compensation fails: dyspnea,/orthopnea, fatigue, Afib, S3 |
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What is the murmur/presentation of aortic stenosis?
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systolic ejection crescendo-decrescendo murmur best heard at R base, radiating to carotids
murmurs decrease w/ valsalva and increase w/ hand grip Presentation SAD syncope upon exertion, angina, dyspnea pulsus parvus et tardus |
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What is the murmur/presentaiton of aortic regurgitaiton?
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soft sstolic murmur --> high pitched blowing diastolic murumur --> Austin flint murmur
fatigue, left sided heart failure, angina Wide pulse pressure Corrigan's water hammer pulse deMuset;s sign |
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What is 1st degree AV block?
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PR interval > 0.2 s
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What is second degree, mobitz type I AV block?
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PR prolongs and then QRS drops out
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What is second degree, mobitz type II AV block?
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PR stays the same and then QRS randomly drops
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What is third degree AV block?
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no association between atrial impulses and ventricular beats
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How do you tell the difference between ventriculr tachycardia and SVT?
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ventricular has wide QRS due to lack of AV conduction and
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What is used to diagnose re-infarct?
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CK-MB
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What are the timeline for complications of MI?
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1-4 d arrythmia
3-5 d fibrinous pericarditits 3-10 d rupture 3-7 wks ventricular aneurysm 6-8 wks Dressler's |
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What is the presentation of pericardial tamponade?
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Beck's triad: hypotenison, JVD, distant heart sounds
pulsus paradoxus kussmaul's sign: JVD rises with inspiration |
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What is the presentation of constrictive pericarditis?
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JVD, Kussmaul's diastolic pericardial knock
low voltage ECG |
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What is the presentation of VSD?
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harsh holosystolic murmur ( does not radiate to axiall like mitral regurg)
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What gives you a fixed split S2?
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ASD
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What gives a continous machine like murmur, loudest at S2?
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PDA
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What is the test to look for cyst and hydronephrosis?
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ultrasound
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How does CIN occur?
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decreased blow flow
direct toxicity free radicals use less contrast, hydration, and N-acetylcysteine |
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What causes unilateral versus bilateral obstruction?
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Unilateral: tumor, stone, or cancer obstruction in kidney or ureter
Bilateral: BPH |
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What causes hypernatremia?
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GI loss (low Na fluid)
renal loss (osmotic diuresis- DKA) diabetes insipidus Iatrogenic, drowning, hyperaldosteronism |
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What is the anion gap?
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AG= [Na] - [Cl-] - [HCO3]
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What are the causes of increased anion gap metabolic acidosis?
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methanol, uremia, DKA, paraldehyde, INH, lactic acidosis, ethylene glycol, salicylate
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Crush injury --> hyperkalemia What should the urine pH be?
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high to aid in secretion and to allow cells to take in K+ via K/H shift
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What are cuases of hypokalemia?
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K+ wasting diuretics
Mg deficiency hyperaldosternoism, vomitting, diarrhea |
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What is the presentation of ATN?
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oliguria, diuretic, recovery
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What are the causes of ATN?
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ischemia and toxic
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What type of vasculitis has organ damage and PALPABLE purpura?
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small vessel
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What is the etiology of prerenal failure?
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hypovolemia, CHF, peripheral vasodilation (sepsis), renal artery stenosis, cirrhosis, hepatorenal failure
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What is hte etiology of renal failure?
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tubular, glomerular, vascular, interstitum
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Is epidydmitis associated with renal stones?
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No
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What is associated with renal obstruction?
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flank pain, groin pain, hematuria
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hydronephrosis
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all of the above?
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hypertensive emergency
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all of the above
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What is elevated in renal HTN
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renenin and aldosterone
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renal artery stenosis
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all of the above
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When do you treat with lifestyle in Hypertension? One drug?
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120/80-139/89
140/90- 159/99 |
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What do chronic renal failure kidneys look like?
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small and scarred
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What is the most common cause of CKD?
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DM
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What happens to fluids, electrolytes, VitD, PTH, and EPO in CKD?
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hyperkalemia, hypermagnesia, hyperphosphatemia, metabolic acidosis, decreased Vit D, increased PTH, decreased EPO
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What is the difference between nephrotic and nephritic syndrome?
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nephrotic >3.5g/day, hyperlipidemia, anasarca, hypogammaglobulinemia, hypercoaguability
nephritic- <3.5g/day, hematuria, ARF, HTN, periorbital edema |
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What is minimal change disease?
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fusion of podocytes, loss of charge in BM --> albumin leakage
MC childhood nephrotic associated with lymphomas responds to steroid therapy |
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What is focal segmental glomerulosclerosis?
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segmental sclerosis, halinosis, non-confluent
associated w/ HIV, IV drug users poor prognosis- majority progress to ESRD, and can recur after transplant |