Pathoma: Cardiac

Front 1

How can you tell someone is having stable angina?

Back 1

Can not meet o2 demand with increase exertion or emotional stress.
reversible injury to myocytes
Coronary arteries are > 70% stenosis.

Think fatty struggling to get up stairs. (note to self- do more cardio)

Front 2

How can you tell someone is having Unstable angina?

Back 2

chest pain at rest!
incomplete occlusion of coronary aa. (KNOW THIS)
ST depression on EKG
reversible, give nitroglycerin

Front 3

Prinzmetal angina is what?

Back 3

Coronary aa. vasospams.
chest pain at rest.
reversible,
Will have ST elevation on EKG

Front 4

A patient has an occlusion to his LAD, what will this cause, besides a widow?
(see what I did there)

Back 4

infarction of anterior wall and anterior septum of the Left ventricle.

Front 5

What aa. is associated with posterior wall, posterior septum and papillary msucle of LV necrosis.

Back 5

Right Coronary A.
2nd most common for MI after LAD

Front 6

When will see infarction of the lateral wall of the LV?

Back 6

occlusion of the left circumflex a.

Front 7

MI lab test... what enzymes are you looking for and what do they tell you?

Back 7

Troponin I- gold marker,
seen 2 hours after and lasts for a weekish

Ck-MB rises 5hrs after and is normal in 72 hours. (good for recent MI)

Front 8

What do you have to worry about if you try to treat an MI with angioplasty (opens blocked vessels)

Back 8

Reperfusion Injury!

Ca++ influx leads to hypercontraction of myofibrils.

Front 9

General Rule of thumb for time table after MI?

3 steps

Back 9

Necrosis- 1 day
Inflammation- 1 week
Scar- 1 month

Front 10

At what time after an MI are you at greatest risk for Fibrinous pericarditis?

Back 10

1-3 days afer due to neutrophils

Will have yellow pallor look

Front 11

What time after an MI are you at the greatest risk for a rupture of the ventricle?

Back 11

4-7 days after.

Macrophages be eating all the garbage in the walls like you were eating all that Mcdonalds

Front 12

Dressler Syndrome

Back 12

Autoimmune disease where inflammation in the pericardium causes antibodies to attack the pericardium.

6-8wks after an MI

Front 13

Sudden Cardiac Death associations?

Back 13

fatal ventricular arrhytmias
hypertrophic cardiomyopathy
Cocaine (Glenn Bias)
Italians (seriously look at their soccer players)

Front 14

Hemosiderin-laden macrophages
are seem where?

Back 14

with left sided heart failure

They are called "heart-failure cells"

Front 15

What time period do most cardiac abnormalities happen during development

Back 15

3-8 weeks

8=h
3=c

heart cabnormalities

Front 16

Eisenmenger syndrome is what?

(hint; its related to shunts)

Back 16

When you have a reversal of a shunt

most likely due to pulmonary hypertension developing

Front 17

Ventricular Septal Defect

Back 17

Most common in the membrane of the septum
Most common congenital heart defect
Associated with fetal alcohol syndrome

Front 18

You're looking at a peds chest x-ray and you see a "boot shaped heart"

What does this child have?

Back 18

Tetralogy of Fallout

If you said a love for Italy (half points)

Front 19

Whats the most common type of Atrial Septal Defect?

What syndrome is associated with the second most common type?

Back 19

Most common type is ostium secundum.

Down Syndrome is associated with ostium primum (its upset its not in first)

Front 20

What kind of auscultation finding will you have with an ASD

Back 20

split s2 sound due to increase in blood in the right heart causes delay in pulmonary valve closing.

Front 21

Patent Ductus Arteriosus

You know you're in long distance relationship when you hear PDA and don't think of this.

Back 21

Associated with congenital rubella
Machine like murmur is the give away.
may cause lower body cyanosis if pul HTN develops

Front 22

How would one close a PDA

Back 22

Close with indomethacin (NSAIDS)

Front 23

You hear a machine like murmur and you have lower body cynosis

What's going on?

Back 23

PDA

may cause lower body cyanosis if pul HTN develops

Front 24

What are the four things associated with Tetralogy of Fallot

What does the patient learn to do to help?

Back 24

stenosis of RV outflow, RVH, VSD, aorta overrides.

They squat allowing more blood to reach the lungs.

Front 25

Mom is a fatty and has diabetes.

What heart disease are you expecting her unborn child to have?

Back 25

Transportation of the great arteries.

And you hope they have a shunt as well in order to survive after birth.

Front 26

A child is born with Transportation of the great arteries and they are fine for the first few days. Then things go wrong, what happened?

Back 26

PDA closed, no more shunt, should have given prostaglandins to keep it open.

Front 27

What signs will you see with Truncus Arteriosus?

Back 27

One large vessel leaving the heart so you get mixing of the blood and results in cyanosis

Front 28

If you see notching of the ribs on a chest x-ray in a 5 year old girl, what else should you check for?

Back 28

Turner syndrome is associated with Coarctation of the Aorta

You know its C of the A because the rib notching results in hypertrophy of the aa on the ribs.

Front 29

You find bounding pulses in the upper extremities and pretty much nothing in lower... First thought?

Back 29

Coarctation of the Aorta

Front 30

What pathogen is most likely to cause Rheumatic Fever

Back 30

Streph A. due to molecular mimicry (M proteins resemble human tissue proteins)

Front 31

You suspect rheumatic fever in a patient (bc you're awesome and know everything) What are you basing this on?

Back 31

Jone's Criteria
J- joint arthritis
O- heart issues (yea I know)
N- nodules
E- erythema marginatum
S- sydenham chorea (twitching)

Mitral valve issues also a good indication

Front 32

Aschoff bodies are seen with what pathology

Back 32

Rheumatic Fever

Will see Myocarditis with aschoff bodies

Front 33

If you have aortic stenosis in a patient under the age of 60, what is most likely the cause?

Back 33

Bicuspid valve instead of Tricuspid.

Wear and tear quicker

Front 34

Aortic Stenosis S&S

Back 34

systolic ejection click with <> murmur
LVH
Angina or syncope with Exercise
Can damage RBC when they cross the calcified valve

Front 35

Aortic Regurgitation S&S

Back 35

diastolic murmur of the blowing type
Huge pulse pressure due to back flow of blood decreasing diastole and increasing systole

Front 36

Ecentric Hypertrophy (enlargement of one area) in the LV is caused by what?

Back 36

Aortic Regurgitation

More blood in= volume overload

Front 37

You notice classmate draws a larger then normal C wave on Dr. Browns cardiac thing... They quickly gunner you by pointing out its due to a?

Back 37

Mitral valve prolapse

Front 38

You hear a mid systolic click followed by a regurgitation murmur over the left MCL. What you got?

Back 38

Mitral valve prolapse

Front 39

Mitral valve regurgitation will sound like what?

Back 39

Holosystolic blowing murmur that gets louder with squatting

Front 40

If you get Mitral valve stenosis from rheumatic fever, what else are you expecting to follow?

Back 40

Volume overload-> LAH
LAH-> pul congestion
Pul congestion-> CHF right side
Right side CHF-> umm yea

Front 41

What is the most common cause of endocarditis overall?

Back 41

Strept V.

note: low-virulence so most be previous valve damage

Front 42

Acute Endocarditis is accused by what organism and what valve is it most likely to infect?

Back 42

Homosapien via IV drug use (didnt see that one coming)

also: Staph A. infects normal valves, most likely Tricuspid

Front 43

If you find someone has endocarditis due to Strep bovis, what must you absolutely check for?

Back 43

Colorectal carcinoma

to make sure "ITS NOT A TUMOR"

Front 44

Patients with what problems are you most likely to see with non bacterial thrombotic endocarditis?

Back 44

hypercoagulable state

maybe adenocarcinoma

Front 45

Libman-Sacks endocarditis is associated with?

Back 45

Systemic Lupus

Will see vegetation on both sides of mitral valve

Front 46

What are 5 possible causes of Dilated Cardiomyopathy other then the most popular one: Unknown

Back 46

1. genetic mutation
2. myocarditis due to coxsackie
3. Alcohol abuse
4. Drugs
5. Preggers

Front 47

With a dilated cardiomyopathy what S&S are you expecting to see?

Back 47

systolic dysfunction leads to CHF
arrhythmias
all four chambers dilated

Front 48

You have a genetic mutation in the sarcomere proteins of the heart, name that myopathy...

Back 48

Hypertrophic

Will see diastolic dysfunction (tight ventricle cant fill)

Most hypertrophy in the LV septum!

Front 49

A patient comes in and has diminished QRS amplitude on their EKG, what myopathy causes this?

Back 49

Restrictive

Front 50

Name 3 causes of Restrictive cardiomyopathy?

Back 50

Endocardial fibroelastosis- full of fibrosis in children

Loffler syndrome- eosinophilic infiltrate

amyloidosis- gets in between myocardial fibers.

Front 51

Myxoma fun facts... Go!

Back 51

most common primary cardiac tumor in adults.
usually found in left atrium and causes syncope
abundant ground substance on histology

Front 52

What is the most common cardiac tumor in children?

Back 52

Rhabdomyoma

associated with tuberous sclerosis!!!!!!!

Front 53

Are Mets common in the heart?

Back 53

Why yes they are, think of all that blood supply.