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Step 1 > Cardio > Flashcards

Cardio Flashcards

1
Q

What gives rise to the ascending aorta and pulmonary trunk

A

Trucus arteriosus

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2
Q

What gives rise to the smooth parts (outflow tract) of left and right ventricles?

A

Bulbus cordis

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3
Q

What gives rise to the trabeculated part of the left and right atria?

A

primitive atria

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4
Q

What gives rise to the trabeculated part of left and right ventricles?

A

primitive ventricle

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5
Q

What gives rise to the smooth part of the left atrium?

A

primitive pulmonary vein

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6
Q

What gives rise to the coronary sinus?

A

Left horn of sinus venosus

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7
Q

What gives rise to the SVC?

A

right common cardinal vein and right anterior cardinal vein

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8
Q

When does the heart start to beat?

A

week 4

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9
Q

What causes a patent foramen ovale (PDA)?

A

septum primum and septum secundum failure to fuse after birth. Can lead to paradoxical emboli

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10
Q

What is the most common location of a VSD?

A

membranous septum

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11
Q

Where does coronary artery occlusion most likely occurs?

A

in the LAD (left anterior descending artery)

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12
Q

What drug treats subarachnoid hemorrhage by preventing cerebral vasospasm?

A

nimodipine-dihydropyridine CCB

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13
Q

What is fenoldopam?

A

D1 receptor agonist that vasodilates almost everything. Decreases BP and increases natriuresis.

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14
Q

What hypertensive emergency med can be used in patients with renal insufficiency?

A

fenoldopam, since it increases renal perfusion.

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15
Q

What antiarrhythmics control rate?

A

Class II (B-blockers) and Class IV (CCB)– pacemaker potential will be shown on a test question

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16
Q

What antiarrhythmics control rhythm?

A

Class I (Na channel blockers) and Class III (K+ channel blockers)–will show myocyte AP on test question

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17
Q

What is it called when there is narrowing of the small arterioles?

A

Arteriolosclerosis

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18
Q

What are the 2 type of arteriolosclerosis?

A

hyaline and hyperplastic

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19
Q

What are the main cuases of hyaline arteriolosclerosis?

A

benign HTN and diabetes

High BP pushes proteins into the vessel wall; non-enzymatic glycosylation of basement membrane makes the wall leaky so proteins can leak in

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20
Q

What is the pathogenesis of hyaline arteriolosclerosis?

A

proteins leak into the vessle wall producing vascular thickening. Porteins seen as pink hyaline on microscopy

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21
Q

What are the consequences of hyaline arteriolosclerosis?

A

Can causes glomerular scarring and lead to chronic renal failure

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22
Q

What is the pathogenesis of hyperplastic arteriolosclerosis?

A

thickening of the vessel wall via hyperplasia of smooth muscle leading to an onion skin appearance, not as pink as hyaline

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23
Q

What is the major causes of hyperplastic arteriolosclerosis?

A

malignant HTN

smooth muscle tries to multiply to try and contain the super high BP

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24
Q

When do you seen fibrinoid necrosis?

A
  1. Malignant HTN
  2. Vasculitis
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25
Q

What are the main consequences of hyperplastic arteriolosclerosis?

A

acute renal fialure with flea bitten appearance

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26
Q

What is thickening of the medium/large vessels in the intima called?

A

Atherosclerosis

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27
Q

What are the 2 requirements for formation of an aortic dissection?

A

needs to occur in a high stress region (first 10cm of the aorta) and with preexisting weakness of the media

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28
Q

What is the most common cause of aortic dissection?

A

HTN. Leads to arteriolosclerosis of vasa vasorum, which lessens the blood flow to the CT of the media causes atrophy of the media.

29
Q

What is the most common causes of death associated with an aortic dissection?

A

pericardial tamponade

30
Q

What is the classic cause of thoracic aneurysm?

A

ertiary syphilis due to endarteritis of vasa vasorum wwhich leads to atrophy of the vessel wall, tree bark appearance of vessel wall

31
Q

What type of aneurysm are Marfan’s patients likely to experience?

A

thoracic aortic aneurysm

32
Q

What is the pathogenesis of AAA?

A

AA doesn’t have a vaso vasorum, so if pt develops atherosclerosis in the AA, then the wall gets less O2 and leads to atrophy and predisposes to an aneurysm.

33
Q

What triad is associated with AAA?

A

Hypotension, pulsatile abdominal mass, and flank pain

34
Q

What percentage of an artery needs to be stenosed for there to be symptoms?

A

70%

35
Q

With subendocardial ischemia, will you see ST depression or elevation?

A

ST depression

36
Q

Which coronary artery supplies the papillary muscles?

A

RCA

37
Q

What congenital heart disorder is associated with fetal alcohol syndrome?

A

Ventricular septal defect

38
Q

What congenital heart disease is associated with Down’s Syndrome?

A

ASD of ostium primum

39
Q

What congenital heart disease is associated with congenital rubella?

A

PDA

40
Q

What congenital heart disease is associated with TUrner Syndrome?

A

Coarctation of the aorta, infantil type

41
Q

What congenital heart disease is assocaited with maternal diabetes?

A

Transposition of the great vessels

42
Q

How is digoxin cleared?

A

Renal clearance

43
Q

How should treatment with digoxin be modified in elderly patients?

A

Need reduced levels of digoxin since their renal function decreases. (Even if normal creatinine levels, still give reduced levels of digoxin)

44
Q

Statins combined with which drugs have increased risk of rhabdomyolysis?

A

fibrates and niacin (fenofibrate causes myopathy and gemfibrozil just increases the concentration of statins in the blood, increasing risk of myopathy)

45
Q

Combination of which two lipid lowering agents increases the risk of cholesterol gallstones?

A

fibrinic acid derivatives and bile-acid binding resins

46
Q

What is the best drug for lowering TG levels?

A

Fibrates

47
Q

Which vasculitis have granulomatous inflammation?

A

Wegeners (granulomatosis with polyangiitis), Temporal Giant cell, Takayasu, Churg-Strauss

48
Q

Which vasculitis are necrotizing?

A

polyarteritis nodosa, Buerger (thromboangiitis obliterans), Microscopic polyangiitis, Churg-Strauss, Kawasaki

49
Q

What arteries are affected in Takayasu?

A

aortic arch at branching points

50
Q

What is the classic Takayasu patient?

A

young asian woman with abset pulse in upper extremity, visual and neurologic sxs. Elevated ESR

51
Q

High yield facts about Polyarteritis Nodosa?

A

Lungs spared, HBsAg association, fibrinoid necrosis, string of pearls appearance, tx corticosteroids.

52
Q

High yield facts about Kawasaki?

A

asian children, nonspecific viral sxs, rash of palms and soles, coronary artery involvement (MI in child, think Kawasaki), Tx aspirin and IVIG

53
Q

High yield association of Brueger’s?

A

necrotizing vasculitis due to heavy smoking, gangrene and autoamputation of fingers and toes

54
Q

How do you treat wegeners?

A

cyclophosphamide

55
Q

How is Microscopic Polyangiitis different from Wegeners?

A

Microscopic polyangiitis- no nasopharyngeal involvement and no granulomas. p-ANKA + (tx same as wegeners, cyclophosphamide)

56
Q

High yield facts aout Churg-Strauss Syndrome?

A

necrotizing granulomatous inflammtion with eosinophils. Associated with asthma and peripheral eosinophilia. p-ANKA +

57
Q

High yield facts about Henoch-Schonlein Purpura?

A

IgA immune complex deposition, most common vasculitis in children. Palpable purpura on butt and legs, GI pain and bleeding, and hematuria (IgA nephropathy). Follows URI.

58
Q

Common cause of secondary HTN?

A

Renal artery stenosis

59
Q

What causes renal artery stenosis? (2)

A

atherosclerosis in elderly males

fibromuscular dysplasia in young females

60
Q

What are the most common locations for atheroscledrosis?

A

AA>coronary artery>popliteal>internal carotid artery

61
Q

Modifiable risk factors for atherosclerosis?

A

HTN, hypercholesterolemia, smoking, diabetes

62
Q

Nonmodifiable risk factors of atherosclerosis?

A

age, gender (male, postmenopausal female), genetics

63
Q

What are the complications of atherosclerosis?

A

peripheral vascular disease, angina, and ischemic bowel disease

64
Q

What is a major complication of thoracic aneurysm?

A

aortic valvue insufficiency

65
Q

What cancer is caused by polyvinyl chloride?

A

liver angiosarcoma

66
Q

How can you tell the difference between hemangioma and kaposi sarcoma?

A

hemangioma- press and it will blanch

kaposi- press and it will not blanch, blood not in vessels, simply interspersed between endothelial cells

67
Q

Most common cause of death in sudden cardiac death?

A

fatal ventricular arrhythmia

68
Q

What are aschoff bodies and anitschkow cells and what are they associated with?

A

Associated with myocarditis due to acute rheumatic fever. Aschoff bodies are granulomas with giant cells and contain anitschkow cells, enlarged macrophages with wavy nuclei

69
Q

What do the jones criteria describe?

A

Sxs of acute rheumatic fever

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