Cv

Front 1

secundum type ASD

Back 1

most common type of asd
caused by excessive resorption of the septum primum or reduced size of septum secundum or both, causing an opening btwn the L & r atria
defect is in the center of the atrial septum at the foramen ovale
normal av vlaves
abx prophy is not needed

most clinically signifiant ASD
small defect = sx may be delayed as late as age 30

Front 2

foramen ovale

Back 2

fetal communication btwn r & l atria
remains normally patent in 25% of adults but paradoxical emboli may pass through a large patent FO

Front 3

premature FO closure

Back 3

occurs during prenatal life
r heart is hypertrophied while l heart is underdeveloped

Front 4

most common congenital cardiac anomaly

Back 4

vsd

Front 5

l-> r shunt sx

Back 5

excessive fatigue upon exertion
not cyanotic but causes marked proliferation of the tunica intima & media of the pulmonary arteries & arterioles. eventually pulmonary resistance > systemic, & shunt reversal occurs (eisenmenger complex) causing late cyanosis

Front 6

transposition of great vessels

Back 6

AP septum fails to develop in a spiral fashion
aorta on rv & pulmonary trunk on lv
r-> l shunting & cyanosis
infants that are born alive must have other defects that allow mixing of oxygenated & deoxygenated blood

Front 7

tetralogy of fallot

Back 7

most common cyanotic congenital heart dz in older kids & adults
associated w. downs
ap setum doesn't properly align
pulmonary stenosis
overriding aorta
IV septal defect
rvh
r-> l shunting w. early cyanosis that's usually present at birth
most common cyanotic congenital cardiac anomaly

Front 8

persistant truncus arteriosus

Back 8

only partial development of AP setum
only 1 large vessel leaves the heart & gets blood from both the rv & lv
r-> shunting w. cyanosis
always accompanied by membranous ventricular septal defect

Front 9

O2 saturation in fetal circulation

Back 9

highest = umbilical vein
lowest = ductus arteriosus

Front 10

fetal circulation bypass

Back 10

ductus venosus = allows bypass of the liver
FO + ductus arteriosus = bypass of the lungs

Front 11

causes of sustain ductus arteriosus patency

Back 11

PGE
intrauterine/neonatal asphyxia

Front 12

PDA

Back 12

common in preemies & maternal rubella infection
causes l-> r shunting

Front 13

IVC passage through diaphragm

Back 13

caval hiatus @ t8

Front 14

esophageal passage through diaphragm

Back 14

esophageal hiatus @ t10

Front 15

aortic passage through diaphragm

Back 15

aortic hiatus @ t12

Front 16

what does lca supply

Back 16

lv
la
anterior part of the IV septum

Front 17

common systolic valvular defects

Back 17

mitral insufficiency
aortic stenosis

Front 18

common diastolic vavlular defects

Back 18

mitral stenosis
aortic insufficiency

Front 19

valve position during systole

Back 19

mitral closed
aortic open

Front 20

valve position during diastol

Back 20

mitral open
aortic closed

Front 21

artery & nerve damage in humerus surgical neck fracture

Back 21

laceration of posterior humeral circumflex artery
axillary nerve lesion

Front 22

artery & nerve damage in humerus midshaft fracture

Back 22

laceration of profunda brachii artery
radial nerve lesion

Front 23

artery & nerve damage in humerus supracondylar fracture

Back 23

laceration of brachial artery
median nerve lesion

Front 24

artery & nerve damage in medial epicondyle fracture

Back 24

superior ulnar collateral artery
ulnar nerve lesion

Front 25

source of colateral circulation around the axillary artery

Back 25

subscapular artery anastamoses w. suprascapular artery

Front 26

artery & nerve damaged in anterior compartment syndrome of the leg

Back 26

anterior tibial artery
deep fibular nerve

Front 27

artery & nerve damaged in posterior compartment syndrome of the leg

Back 27

posterior tibial artery
tibial nerve

Front 28

areas supplied by deep femoral artery

Back 28

anterior & posterior thigh
shaft of femur

Front 29

major source of blood supply to femur head

Back 29

medial circumflex artery

Front 30

aortic stenosis

Back 30

diff in systolic lv & aortic pressure

Front 31

murmur of aortic stenosis

Back 31

crescendo decrescendo systolic

Front 32

aortic regurgitation

Back 32

diastolic aortic decreases rapidly as blood flows back into ventricle
ventricular diastolic pressure is elevated

Front 33

murmur of aortic regurgitation

Back 33

diastolic

Front 34

mitral stenosis

Back 34

diff in diastolic LV pressure & la pressure during filling

Front 35

murmur of mitral stenosis

Back 35

diastolic

Front 36

mitral regurgitation

Back 36

incompentent valve allows backflow into la during ventricular systole

Front 37

murmur of mitral regurgitation

Back 37

systolic

Front 38

perfusion limited exchange

Back 38

low capillary velocity still allows adequate time for diffusion

Front 39

diffusion limited exchange

Back 39

capillary velocity remains high

Front 40

congenital anomaly of fetal alcohol syndrome

Back 40

vsd

Front 41

congenital anomaly of maternal rubella

Back 41

exposure at 5th-10th wk can cause PDA, ASD & VSD

Front 42

effect of l->r shunt

Back 42

chronic rhf
secondary pulmonary htn

Front 43

effect of r->l shunt

Back 43

bypasses the lungs, producing a cyanosis as early as birth
paradoxical embolism in which dvt causes sytemic infarct

Front 44

6 types of l->r shunts

Back 44

vsd
asd
complete endocardial cushion defect
sinus venosus
patent FO
PDA

Front 45

3 types of r->l shunts

Back 45

tetralogy of fallot
transposition of great vessels
persistent truncus arteriosus

Front 46

complete endocardial cushion defect

Back 46

asd + vsd + a common atrioventricular valve

Front 47

sinus venosus

Back 47

defect in the upper part of the atrial septum
may cause anomalous pulmonary venous return into the svc or ra

Front 48

primum type ASD

Back 48

defect in lower atrial septum above av vlaves
associated w. anomaly of av vlaves
requires abx prophy for invasive procedures

Front 49

preductal/infantile coarctation of the aorta

Back 49

narrowing proximal to the opening of the ductus arteriosus
reversal of flow in intercostal arteries causes rib notching

Front 50

postductal/adult coarctation of the aorta

Back 50

narrowing distal to the opening of the ductus arteriosus
most common type, allows survival into adulthood
diff pressures in UE & LE

Front 51

congenital pulmonic valve stenosis/atresia

Back 51

unequal division of the truncus arteriosus so that the pulmonary trunk has no lumen or opening at the level of the pulmonary valve
may cause cyanosis if severe

Front 52

congenital aortic valve stenosis/atresia

Back 52

complete atresia is incompatible w. life

bicuspid aortic valves are asymptomatic, can lead to infective endocarditis, lv overload or sudden death.
these valves calcify in the 5th/6th decade.
#1 cause of aortic stenosis

Front 53

heart defect associated w. marfan's

Back 53

1/3 have aortic dilation & incompetence, aortic dissection & asd

Front 54

heart defect associated w. down's

Back 54

20% have congenital cv dz

Front 55

heart defect associated w. turner's

Back 55

coarctation of the aorta

Front 56

heart defect associated w. 22q11 (digeorge's)

Back 56

truncus arteriosus
tetralogy of fallot

Front 57

heart defect associated w. congenital rubella

Back 57

septal defects
PDA
pulmonary artery stenosis

Front 58

heart defect associated w. maternal diabetes

Back 58

transposition of great vessels

Front 59

how many days post-mi does wall/papillary muscle rupture occur

Back 59

3-7

Front 60

2 vessels used for coronary artery bypass

Back 60

saphenous vein
internal mammary artery

Front 61

change in myocardium 1hr post MI

Back 61

no gross changes seen
intracellular edema

Front 62

change in myocardium 6-12hr post MI

Back 62

no gross changes seen
wavy myocardial fibers
vacuolar degeneration
contraction band necrosis
beginning of neutrophil infiltration

Front 63

change in myocardium 12-24hr post MI

Back 63

grossly pale, cyanotic & edematous
wavy myocardial fibers
vacuolar degeneration
contraction band necrosis
beginning of neutrophil infiltration

Front 64

change in myocardium 24-48hr post MI

Back 64

area of infarct is well demarcated soft & pale
neutrophil infiltrate
cytoplasmic eosinophilia
coagulative necrosis

Front 65

change in myocardium 3-10days post MI

Back 65

infarct becomes soft, yellow & surrounded by hyperemic rim
monocyte infiltrate predominates at 72hrs

Front 66

change in myocardium 2wks post MI

Back 66

infarct area is surrounded by granulation tissue that's gradually replaced by scar tissue

Front 67

5 major jones criteria

Back 67

migratory polyarthritis
erythema marginatum
sydenham chorea
subcutaneous nodules
carditis

Front 68

rheumatic heart disease

Back 68

repeated bouts of endocarditis & inflammatory insult lead to scarring & thickening of the valve leaflets w. nodules along lines of closure

mitral valve most commonly affected w. fibrosis & deformity causing fish mouth stenosis.

mitral + aortic = #2

LA dilation
mural thrombi
rvh
predisposed to infective endocarditis

Front 69

nutmeg liver occurs in which type of heart failure

Back 69

rhf

Front 70

acute endocarditis

Back 70

high virulence organisms like s. aureus & strep
affects previously normal valves
tricuspid often involved in iv drug users
vegetation may form myocardial abscesses, septic emboli or cause valve destruction which results in insufficiency
high fever w. chills

Front 71

subacute bacterial endocarditis

Back 71

low virulence organisms, strep viridans, s. epidermidis, g(-) bacilli
candida is associated w. indwelling vascular catheters
affects previously abnormal valves
more insidious onset
(+) blood bulture
fatigue, lowe grade fever w.o chills, splinter hemorrhages

Front 72

nonbacterial thrombotic endocarditis

Back 72

associated w. chronic illness
mitral valve most commonly affective
sterile small vegetations are loosely adhered along the lines of closure
may embolize & provide a nidus for infective endocarditis

Front 73

libman sacks endocarditis

Back 73

nonbacterial verrucous endocarditis
mitral & tricuspid valvulitis in pt w. SLE
small warty vegetations are found on both sides of valve leaflets
doesn't embolize

Front 74

myocarditis

Back 74

dilation & hypertrophy of all 4 chambers
diffuse patchy hemorrhage
peripheral edema

Front 75

cellular infiltrate in bacterial myocarditis

Back 75

neutrophil

Front 76

cellular infiltrate in viral myocarditis

Back 76

mononuclear

Front 77

cellular infiltrate in fiedler myocarditis

Back 77

eosinophils