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53 Cards in this Set

  • Front
  • Back
What is the normal rate of the nodes?
SA 60-100 bpm
AV 40-60 bpm
His-Purkinje 20 bpm
What influences high CO?
high preload, high contractility, low afterload
What is a Frank Starling Curve?
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
What are the major and minor risk factors for atherosclerosis?
smoking, HTn, high cholesterol, DM

obesity, gender, sedentary lifestyle, family history, stress, high TG, hyperhomocystinemia, autoimmune vasculitis
What is intermittent claudication?
reproducible leg pain that is present at rest and worse when lying flat, usually improving w/ letting legs hang down
How does someone develop DVTs?
stasis, endothelial injury, hypercoaguable state
What is Trosseau's sign?
cancer causing hypercoaguable wandering clots in extremities (more superficial than deep)
What are the signs of right sided heart failure?
peripherla pitting edema
JVD
hepatomegaly/hepatojugular reflux
nocturia
What does a chest x-ray of CHf look like? What is visible is both compensated and decompensated CHF?
acute: pleural effusion, prominent interstitial markings, Kerley B lines
chronic: cardiomegaly

cardiomegaly
What is the most common complication of both cardiomyopathy and post-MI?
arrythmias
How do you differentiate between the systolic crescendo-decrescendo murmur from hypertrophic cardiomyopathy and aortic stenosis?
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
What is the murmur and presentation of mitral stenosis?
snap rumble

pulmonary congestion, atrial fib
other: infective endocarditis, dysphagia, hoarseness, hemoptysis
What is the murmur/presentation of mitral regurgitation?
holosystolic high pitched blowing murmur loudest at apex --> radiate to axilla

Acute: pulmonary congestion
Chronic: once compensation fails: dyspnea,/orthopnea, fatigue, Afib, S3
What is the murmur/presentation of aortic stenosis?
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
What is the murmur/presentaiton of aortic regurgitaiton?
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
What is 1st degree AV block?
PR interval > 0.2 s
What is second degree, mobitz type I AV block?
PR prolongs and then QRS drops out
What is second degree, mobitz type II AV block?
PR stays the same and then QRS randomly drops
What is third degree AV block?
no association between atrial impulses and ventricular beats
How do you tell the difference between ventriculr tachycardia and SVT?
ventricular has wide QRS due to lack of AV conduction and
What is used to diagnose re-infarct?
CK-MB
What are the timeline for complications of MI?
1-4 d arrythmia
3-5 d fibrinous pericarditits
3-10 d rupture
3-7 wks ventricular aneurysm
6-8 wks Dressler's
What is the presentation of pericardial tamponade?
Beck's triad: hypotenison, JVD, distant heart sounds
pulsus paradoxus
kussmaul's sign: JVD rises with inspiration
What is the presentation of constrictive pericarditis?
JVD, Kussmaul's diastolic pericardial knock
low voltage ECG
What is the presentation of VSD?
harsh holosystolic murmur ( does not radiate to axiall like mitral regurg)
What gives you a fixed split S2?
ASD
What gives a continous machine like murmur, loudest at S2?
PDA
What is the test to look for cyst and hydronephrosis?
ultrasound
How does CIN occur?
decreased blow flow
direct toxicity
free radicals

use less contrast, hydration, and N-acetylcysteine
What causes unilateral versus bilateral obstruction?
Unilateral: tumor, stone, or cancer obstruction in kidney or ureter

Bilateral: BPH
What causes hypernatremia?
GI loss (low Na fluid)
renal loss (osmotic diuresis- DKA)

diabetes insipidus

Iatrogenic, drowning, hyperaldosteronism
What is the anion gap?
AG= [Na] - [Cl-] - [HCO3]
What are the causes of increased anion gap metabolic acidosis?
methanol, uremia, DKA, paraldehyde, INH, lactic acidosis, ethylene glycol, salicylate
Crush injury --> hyperkalemia What should the urine pH be?
high to aid in secretion and to allow cells to take in K+ via K/H shift
What are cuases of hypokalemia?
K+ wasting diuretics
Mg deficiency
hyperaldosternoism, vomitting, diarrhea
What is the presentation of ATN?
oliguria, diuretic, recovery
What are the causes of ATN?
ischemia and toxic
What type of vasculitis has organ damage and PALPABLE purpura?
small vessel
What is the etiology of prerenal failure?
hypovolemia, CHF, peripheral vasodilation (sepsis), renal artery stenosis, cirrhosis, hepatorenal failure
What is hte etiology of renal failure?
tubular, glomerular, vascular, interstitum
Is epidydmitis associated with renal stones?
No
What is associated with renal obstruction?
flank pain, groin pain, hematuria
hydronephrosis
all of the above?
hypertensive emergency
all of the above
What is elevated in renal HTN
renenin and aldosterone
renal artery stenosis
all of the above
When do you treat with lifestyle in Hypertension? One drug?
120/80-139/89
140/90- 159/99
What do chronic renal failure kidneys look like?
small and scarred
What is the most common cause of CKD?
DM
What happens to fluids, electrolytes, VitD, PTH, and EPO in CKD?
hyperkalemia, hypermagnesia, hyperphosphatemia, metabolic acidosis, decreased Vit D, increased PTH, decreased EPO
What is the difference between nephrotic and nephritic syndrome?
nephrotic >3.5g/day, hyperlipidemia, anasarca, hypogammaglobulinemia, hypercoaguability

nephritic- <3.5g/day, hematuria, ARF, HTN, periorbital edema
What is minimal change disease?
fusion of podocytes, loss of charge in BM --> albumin leakage
MC childhood nephrotic
associated with lymphomas
responds to steroid therapy
What is focal segmental glomerulosclerosis?
segmental sclerosis, halinosis, non-confluent

associated w/ HIV, IV drug users
poor prognosis- majority progress to ESRD, and can recur after transplant