Sileramram Usmle Cardio Flashcards

Front 1

ergonovine

Back 1

test for prinztmal's angina
- alpha and sertotonin agonist --> vasoconstriction, vasospasm

Front 2

Exercise- what happens systemically

Back 2

- venous system contracts to increase preload
- Increase CO
- local dilation in muscles so TOTAL Systemic resistance decreases

Front 3

coronary steal- vasodilation of what vessels

Back 3

microvessels of heart- collateral circulation between ischemic and non-ischemic areas

Front 4

causes of pulsus paradoxus

Back 4

- pericarditis
- Cardiac tamponade
- asthma attack

Front 5

S3

Back 5

dilated LV!

Front 6

Jervell and Lange-Nielson

Back 6

- long QT
- neurosensory deafness
- autosomal recessive
- sudden death from torsades de pointes
- defect in cardiac sodium and potassium channels

Front 7

wide splitting

Back 7

pulmonic stenosis
RBBB
- delayed RV emptying

Front 8

Fixed splitting

Back 8

ASD
- increased flow through pulmonic valve- closure always delayed

Front 9

Paradoxical splitting

Back 9

aortic stenosis
LBBB
- delay LV emptying

Front 10

Progression of ASD murmur

Back 10

1. No murmur because no pressure gradient
2. Once pulmonic artery is dilated --> diastolic murmur from pulmonic regurg
- flow murmur because increased flow across triscuspid

Front 11

pacemaker cells- difference in conduction

Back 11

No fast acting Na channels- delays transmission
- initiates with Calcium channels (preceded by slow Na depolarization)

Front 12

ST segment refers to

Back 12

ventricles depolarizing

Front 13

PR interval

Back 13

AV delay

Front 14

Treatment for A fib

Back 14

Calcium channel blocker
Beta blocker

Front 15

sawtooth on ECG

Back 15

atrial flutter

Tx: class IA, IC or III

Front 16

Prolonged PR interval

Back 16

> 200 msec
AV block - 1st degree
- looks like WPW delta waves

Front 17

Lyme disease --> heart condition?

Back 17

3rd degree heart block (complete)
- p waves are not associated with QRS

Front 18

aortic arch receptor

Back 18

responds to increased BP --> vagal stimulation

Front 19

carotid sinus

Back 19

responds to increase AND decrease in BP --> CN IX (glossopharyngeal nerve --> solitary nucleus)

Front 20

hypotension and baroreceptors

Back 20

decreased firing --> increased sympathetic firing and decreased parasym

*hemorrhage response

Front 21

carotid massage

Back 21

increases baroreceptor firing --> decreased heart rate

Front 22

peripheral chemoreceptors

Back 22

-carotid and aortic bodies
- respond to decreased PO2, increased PCO2, and decreased pH

Front 23

Central chemoreceptors

Back 23

respond to pH and PCO2 changes of brain interstitial fluid
-

Front 24

Cushing reaction

Back 24

Increased cranial pressure --> arterioles constrict --> cerebra ischemia --> reflex bradycardia

- hypertension, bradycardia, respiratory depression

Front 25

TAPVR

Back 25

pulmonary veins drain in RA

Front 26

Tetralogy of Fallot

Back 26

PROVe
Pulmonary stenosis
RVH
Overriding aorta
VSD

- R-->L shunt from increased pressure from stenotic pulmonic valve

Front 27

patient learns to squat

Back 27

Tetralogy of Fallot
- increased pressure on femoral arteries --> decreased R-->L shunt --> more blood to lungs

Front 28

What is different from French entryways and American entryways in apartment buildings?

Back 28

French "immeuble" entryways often have mailboxes.

Front 29

Monckeberg arteriosclerosis

Back 29

calicification of media of arteries
- benign
- ulnar and radial
- no blood flow obstruction

Front 30

onion skinning of artieries

Back 30

malignant hypertension
- small arteries

Front 31

hyaline thickening in small arteries

Back 31

essential hypertension in DM

Front 32

cystic medial necrosis

Back 32

Marfan's
- aortic dissection

Front 33

ST depression

Back 33

Stable and unstable angina

Front 34

Which cardiac enzyme first detects an MI?

Back 34

troponin- up after 4 hours, up for 7-10 days

Front 35

ST depression MI

Back 35

subendo

Front 36

Dressler's syndrome

Back 36

autoimmune fibrous pericarditis
- weeks after MI

Front 37

Causes of dilated cardiomyopathy

Back 37

ABC3D
Alcohol abuse
Beri beri (wet)
Coxsackie B
Cocaine
Chagas
Doxorubicin

hemochromatosis
peripartum cardiomyopathy

Front 38

Why did Jeanne d'Arc go to war?

Back 38

In 1429, when France was at war with England, Joan of Arc decided to go into battle to liberate her country. She took the head of an army and liberated the city of Orleans from the English.

Front 39

Tx for hypertrophic cardiomyopathy

Back 39

Beta blocker
verapamil

Front 40

hemochromatosis cardiac manifestation

Back 40

dilated cardiomyopathy
restrictive cardiomyopathy

Front 41

Loffler's syndrome

Back 41

endomyocardial fibrosis with a prominent eosinophilic infiltrate

Causes:
- ascaris lumbricoides
- strongyloides stercoralis
- Ancylostoma duodenale, Necator Americanus

Front 42

Extracardiac symptoms of bacterial endocarditis

Back 42

Roth's spots- white spots in eyes
Osler's nodes- finger pads, OW
Janeway- palm and sole
splinter hem- nail beds

Front 43

endocarditis in children

Back 43

HACEK organism
H- haemophilus
etc
- slow growing, gram neg

Front 44

early and late lesions of rheumatic fever?

Back 44

early- mitral valve prolapse
late- mitral stenosis

Front 45

non MI cause of ST elevation

Back 45

pericarditis

Front 46

uremia- heart manifestation?

Back 46

pericarditis

Front 47

causes of hemorrhagic pericarditis

Back 47

TB, malignancy

Front 48

Tertiary syphilis manifestations

Back 48

- disrupts vasa vasorum of aorta
- dilation of aorta and valve ring
"tree bark" appearance of aorta

--> aneurysms of ascending aorta, aortic valve incompetence

Front 49

Most common cardiac tumor in adults

Back 49

Myxoma
- LA mostly
"ball-valve" obstruction
- multiple syncopal episodes

Front 50

Most frequent cardiac tumors in children

Back 50

Rhabdomyoma
- associated with tuberous sclerosis

Front 51

Most common heart tumor overall?

Back 51

mets
- rest are primary tumors

Front 52

Hereditary hemorrhagic telangectasias- Osler-Weber- Rendu

Back 52

- AD
- recurrent epistaxis
- skin discoloration
- mucosal telangiectasia
- GI bleeds

Front 53

varicose veins

Back 53

dilated, tortuous
- from chronic increased venous pressure

Front 54

Churg-Strauss

Back 54

granulomatous vasculitis
- eosinophilia
- pANCA
- asthma, sinusitis, skin lesions, peripheral neuropathy (foot drop)
- heart, GI, kidneys

Front 55

Sturge-Weber

Back 55

- port-wine stain
- small vessels
- ipsilateral leptomeningeal angiomatosis
- seizures
- early-onset glaucoma

Front 56

Heavy smokers vasculitis

Back 56

Buerger's
- thromboangitis obliterans
- segmental thrombosing vasculitis
- small and medium vessels

Sx:
- intermittent claudication
- Raynaud's
- gangrene
- autoamputation of digits

Front 57

"strawberry tongue" and desquamative skin rash

Back 57

Kawasaki disease
- necrotising vasculitis in children
- self limiting
- Asian ethnicity
- coronary aneurysms may develop
- fever, conjunctivities

Tx: IVIg, aspirin

Front 58

Hep B associated vasculitis

Back 58

Polyarteritis nodosa
- IC mediated
- fibrinoid necrosis
- aneurysms
- small and medium vessels
- renal not pulmonary

Front 59

Pulseless disease

Back 59

Takayusu's arteritis
- granulomatous thickening of aortic arch
- increase ESR
- young asian females
- medium and large arteries

Sx:
Fever
Arthritis
Night sweats
Myalgia
Skin nodules
Ocular disturbances
Weak pulses in upper extremities

*can lead to mesenteric artery ischemia

Front 60

associated with temporal arteritis

Back 60

polymyalgia rheumatica

Front 61

pyogenic granuloma

Back 61

- polypoid capillary hemangioma
- can ulcerate and bleed
- trauma, pregnancy

Front 62

Cystic hygroma

Back 62

lymphangioma of neck
- Turner's

Front 63

Glomus tumor

Back 63

benign, painful, red-blue tumor under fingernails
- modified smooth muscle of glomus body

Front 64

Bacillary angiomatosis

Back 64

- caused by bartonella henselae in AIDS patients
- mistaken for Kaposi's

Front 65

Angiosarcoma

Back 65

lethal malignancy of liver
- vinyl chloride, arsenic
- thorotrast exposure (xray)

Front 66

Lymphangiosarcoma

Back 66

lymphatic malignancy --> persisitent lymphedema
- post masectomy

Front 67

ST elevation , II, III, avF

Back 67

RCA

Front 68

ST elevation V1-V4

Back 68

LAD

Front 69

ST elevation V4-V6

Back 69

circumflex

Front 70

bacteria endocarditis leads to what kidney problems

Back 70

Diffuse Proliferative glomerulonephritis - nephritic
- subenco ICs

Front 71

IV drug user, endocarditis, lung problem?

Back 71

pulmonary embolism- looks hemorrhagic because of collateral blood supply

Front 72

Plaque occluding < 75% of lumen

Back 72

asymptomatic

Front 73

bounding pulses and head bobbing

Back 73

Aortic regurgitation
"de Musset sign"
- water hammer pulses

Front 74

aortic outflow obstruction

Back 74

Hypertrophic Cardiomyopathy
- hypertrophied ventricular wall
- anterior leaflet of mitral valve leaflet pushed in the way

Front 75

pathogenesis of janeway lesions

Back 75

microemboli from bacterial endocarditis

Front 76

pathogenesis of osler's nodes

Back 76

IC deposition from bacterial endocarditis

Front 77

new onset regurgitant murmur

Back 77

bacterial endocarditis

Front 78

splinter hemorrhages pathogenesis

Back 78

- microemboli from bacterial endocarditis

Front 79

valsalva maneuver effect on murmurs

Back 79

decreased preload

Front 80

valsalva release and squatting effect on preload

Back 80

increasing preload

Front 81

opening snap in MS occurs when?

Back 81

When LV pressure equals LA pressure - early diastole

Front 82

non bacterial endocarditis pathogenesis in cancer?

Back 82

hypercoaguable
- like trousseau's sign

Front 83

amyloid in heart- senile cardiac

Back 83

ANP, tranthyretin
AF

Front 84

Maneuvers that increase murmur of hypertrophic cardiomyopathy

Back 84

decrease preload --> louder outflow obstruction murmur

valsalva
Abrupt standing

Front 85

mutated gene in dilated cardiomyopathy

Back 85

dystrophin

Front 86

mutated gene in hypertrophic cardiomyopathy

Back 86

beta myosin

Front 87

cardio effects of long time phenphen use?

Back 87

secondary pulmonary hypertension --> cor pulmonale

Front 88

organ that can stand the most infarcts?

Back 88

liver- collateral circulation

Front 89

Mechanism of digoxin

Back 89

Inhibits Na+/K+ ATPase--> indirect inhibition of Na+/Ca+ exchanger --> increased calcium in cell --> ionotropic
- Use in CHF

- stimulates vagus nerve (use in A fib)

Front 90

Digoxin toxicity on ECG

Back 90

Increased PR
Decreased QT
Scooping
T wave inversion
Arrhythmia

Front 91

digoxin causes what electrolyte abnormality?

Back 91

hyperkalemia
- block pump that puts K in cells

Front 92

digoxin clearance?

Back 92

kidney

Front 93

digoxin toxicity worsened by...

Back 93

renal failure
quinidine- decreased clearance
hypokalemia

Front 94

signs of digoxin toxicity

Back 94

cholinergic
- nausea, vomiting, diarrhea, blurry yellow vision
- Arrhythmias

Front 95

beta blocker site of action

Back 95

L type calcium channels or sarcomere

Front 96

Beta blocker use

Back 96

V-tach
SVT
slowing ventricular rate during atrial fibrillating and atrial flutter

Front 97

overdose of Beta blockers treatment

Back 97

glucagon

Front 98

Why does amiodarone have class I, II, III and IV effects?

Back 98

alters lipid membrane

Front 99

side effects of amiodarone

Back 99

pulmonary fibrosis
hepatotoxicity
hypothyroidism/hyperthyroidism

Front 100

Which two classes have the same effect on AP, ERP and QT

Back 100

IA and III
Increased AP
Increased ERP
Increased QT

*III used when IA fails

Front 101

Adenosine mechanism

Back 101

K+ out of cell --> hyperpolarized cell
- SVT

Front 102

Magnesium use

Back 102

Torsades de pointes
Digoxin toxicity

Front 103

hyradalzine

Back 103

dilates arterioles>veins
increases cGMP --> smooth muscle relaxant
- decreased afterload

Give with methyldopa in pregnancy

-

Front 104

minoxidil

Back 104

K+ channel opener
- hyperpolarizes, relaxes smooth muscle

toxicity: hypertrichosis (increased hair), pericardial effusion

Front 105

Calcium channel blocker best for hypertension

Back 105

nifedipine
- relaxes vascular smooth muscle

Front 106

side effects of Ca channel blockers

Back 106

AV block
- edema, flushing, dizziness, constipation

Front 107

nitroprusside

Back 107

Increases cGMP, direct release of NO
- CN toxicity
- short acting

Front 108

Fenoldopam

Back 108

D1 receptor agonist- relaxes vascular smooth muscle

Front 109

Diazoxide

Back 109

K+ channel opener
- can cause hyperglycema-- from reduced insulin release

Front 110

Nefedipine is like

Back 110

nitrates

Front 111

fetal gestational diabetes cardiac?

Back 111

hypertrophic cardiomyopathy

Front 112

Epstein abnormality

Back 112

apically displaced triscupid leaflets etc...

- Associated with Li use in mother

Front 113

phenylephrine

Back 113

alpha 1> alpha 2

Front 114

dobutamine

Back 114

Beta 1> Beta 2

Front 115

renal effects of selective beta blockers?

Back 115

B1 on JGA cells
--> decreased renin release

Front 116

Side effect = reversible SLE syndrome

Back 116

procainamide
hydralazine

Front 117

increased cGMP leads to

Back 117

decreased intracellular Ca --> dephosphorylation of myosin --> muscle relaxation

Front 118

prolongs QT but doesn't predispose to torsades do pointes

Back 118

amiodarone
- IA- prolongs QT AND predisposes to torsades de pointes

Front 119

beta blocker effect on EKG?

Back 119

increased PR interval because slows AV node (phase 4 or pacemaker graph)

Front 120

Enlarged LA -->

Back 120

hoarsness- impinges recurrent laryngeal nerve

Front 121

myocardium swelling in in MI

Back 121

switch to anaerobic metabolism --> decreased ATP
- Na+/K+ ATPase doesn't work well --> increase Na+ in cell
- Ca+ pump doesn't work well --> increase intracellular Ca+

Increased solutes draw water in

Front 122

cyanosis of lower body only

Back 122

infantile coarcation of aorta- before DA

PDA