Vonholten 09-11-07 Cardiology

Front 1

Category I cardiovascular risk factors

(remove for definite reduction of risk)

Back 1

HTN,
Smoking,
LDL > 100,
LVH (not very treatable)
Thrombogenic factors

Front 2

Category II cardiovascular risk factors

(removal likely reduces risk)

Back 2

DM
Low HDL (try to get it >60)
Obesity
Physical inactivity

Front 3

Category III cardiovascular risk factors

(removal might reduce risk)

Back 3

High triglycerides
Lipoprotein (a)
Oxidative stress
Alcohol (too much) (try to have m:2/f:1 glasses per day)
Psychosocial stress factors
CRP

Front 4

Category IV cardiovascular risk factors

(pt cannot change these things)

Back 4

Family history
Age
-Men >45, Women >55
Gender
-Men (all)
-Women (postmenopausal)

Front 5

Congenital abnormalities that are cardiovascular risk factors

Back 5

Marfan’s syndrome – AR, aorotic dilitaion
Down’s syndrome – endocardial cushion defects
Interuterine alcohol exposure – VSD
Pseudoxanthoma elasticum – PAD, CAD
Tuberous sclerosis – cardiomyopathy
Ehlers-Danlos - MR, atrial dilitation
Acromegaly – cardiomyopathy, valvular disease

Front 6

Best place to see Pseudoxanthoma elasticum

Back 6

neck and axilla

Front 7

Ash Leaf on abdomen

Back 7

Tuberous Sclerosis

Front 8

central/south America, valvular heart disease

Back 8

Chaga’s disease

Front 9

cause of PDA invitro

Back 9

rubella

Front 10

insect that passes T. Cruzii that causes Chagas disease

Back 10

Reduvit bug (kissing beetle)

Front 11

When looking at chest x-ray, think ABCD. What's that?

Back 11

Airway - look for esophagus
Bones
Cardiac shadow
Diaphragm

Front 12

subtle ischemic symptoms:
(red flag during history)

Back 12

DOE - dyspnea on exertion
claudication (angina of the legs)
ED - erectile dysfunction

Front 13

Class 1 thru 4 of cardiological symptoms

Back 13

Class I – no symptoms with normal activity
Class II – symptoms with normal to heavy activity
Class III - severe symptoms with normal activity, but resolves at rest
Class IV – severe limitations even at rest

Front 14

Frank's sign?

Back 14

horizontal/oblique crease in the Ear lobe

Front 15

Keith-Wagner Classification directly correlate with ________ arterial disease

Back 15

peripheral (???--this scale is for grading hypertensive retinopathy-mm)

Front 16

Normal Keith-Wagner Classification

Back 16

Artery is fine yellow line No AV crossing defects

Front 17

Class I
Keith-Wagner Classification

Back 17

Broad yellow line Mild depression of vein

Front 18

“Copper wire” Depression or “humping”of vein

Back 18

Class II
Keith-Wagner Classification

Front 19

“Silver wire”, Exudates, Tapering, right angle derivation (should be deviation-mm)

Back 19

Class III
Keith-Wagner Classification

Front 20

Class IV
Keith-Wagner Classification

Back 20

Fibrous cords, exudates, papilledema Same as Class III

Front 21

Hepato-jugular reflex?

Back 21

push on liver bed and get jugular venous distension

Front 22

What do you palpate in cardiovascular exam?

Back 22

pulses
HJR
heaves/thrills
PMI

Front 23

Pulse with 2 peaks

Back 23

Bisiferens pulse

Front 24

What does Bisiferens pulse suggest?

Back 24

Aortic regurg

Front 25

regular alteration of pulse pressure

Back 25

Pulsus Alterans

Front 26

what does pulsus alterans suggest?

Back 26

decreased LV function

Front 27

What does Parvus et Tardus (long and late) suggest?

Back 27

aortic stenosis

Front 28

What does Pulsus Paradoxus (decreased pulse with inspiration, or gone altogether) suggest?

Back 28

cardiac tamponade

Front 29

What CVP height diagnosis JVD

Back 29

> 3cm above sternal notch (in any position)

Front 30

Cannon A wave?

Back 30

Cannon A wave – TS; JVP goes up and down in Jugular Vein

Front 31

Kussmal’s sign?

Back 31

Kussmal’s sign – increased CVP with inspiration secondary to right sided CHF

Front 32

cause of cannon a waves

Back 32

caused by atrial contractions against a closed tricuspid valve and observed in the jugular venous pulse

Front 33

What conditions cause a constant splitting of S2?

Back 33

"fixed split” with MR,VSD,or constrictive paricarditis

Front 34

S3 suggests what heart problem?

Back 34

CHF

Front 35

S4 is a ______ problem

(bad question, I know)

Back 35

compliance

Front 36

classes of soft and loud murmurs

Back 36

2 and 3

Front 37

class of murmur with thrill

Back 37

4

Front 38

class of murmur hear without bell on the chest

Back 38

6

Front 39

heart problems with holosystolic murmurs

Back 39

MR, TR, VSD

Front 40

heart problems with Midsystolic (crescendo-decrescendo) murmurs

Back 40

PS, AS, MR, HSS

Front 41

Which have decreased hand grips?
AS
MR
HSS

Back 41

AS and HSS

Front 42

Which is "brought out" with Valsalva?
AS
MR
HSS

Back 42

HSS

Front 43

Which Radiates to axilla?
AS
MR
HSS

Back 43

MR

Front 44

Which is heard in the Right 2nd intercostal and radiates to neck?
AS
MR
HSS

Back 44

AS