5/7 Flashcards by Karin Lavie

congenital long QT syndrome

disorder of myocardial repolarization (ion channel defects)

risk of sudden cardiac death from torsades

two types

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two types of long QT syndromes

Romano-Ward: aut dom- cardiac problems only- mutation of Ca or Na channels

Jervell and Lange-Nielsen syndrome- aut rec- cardiac and sensorineural deafness- mutation of K channels

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Brugada syndrome

aut dom- asian males

pseudo RBBB and ST elevation in V1-V3

risk of ventricular tachyarrythmias and SCD

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Wolff-Parkinson-White syndrome

ventricular pre-excitation syndrome that can lead to supraventricular tachycardia

cause: abnormally fast bundle of Kent bypasses AV node and prematurely depolarizes ventricles

EKG: delta wave, wide QRS, short PR

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things that cause wide splitting

delay RV emptying!

pulmonic stenosis, RBBB

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things that cause fixed splitting

ASD (left to right shunt)

regardless of breath!

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things that cause paradoxical splitting

delay aortic valve closure so get rid of split on inspiration!

aortic stenosis
LBBB

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continuous machine-like murmur

PDA

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pathway of fetal blood flow

umbilical vein –> liver (ductus venosus bypass) –> IVC –> heart

then either enters pulmonary circuit or crosses from RA to LA via foramen ovale

some blood from pulmonary enters aorta via ductus arteriosus and then supplies all tissues

transfers deoxygenated blood back to placenta via umbilical arteries

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amyloid angiopathy

spontaneous lobar hemorrhage- particularly parietal (contra hemisensory loss) and occipital (vision changes), sometimes frontal (contra hemiparesis)

beta amyloid deposits in small and medium sized arteries

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telomerases

reverse transcriptase (RNA-dep DNA pol) that lengthens telomeres by adding TTAGGG to 3’ end.

composed of TERT (rev transcriptase) and TERC (RNA template)

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which type of cells have long telomeres and high telomerase activity?

stem cells (eg. skin)

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thiazides effect on Ca

increase Ca absorption in distal tubule

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loop diuretics effect on Ca

hypocalemia- Ca excretion

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Cori disease feature

unbranched glycogen with short outer chains (limit dextrins)

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where are actin filaments bound to in the sarcomere?

structural proteins at the z line (the non-myosin part)

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Babesiosis symptoms and signs

flu-like

anemia, thrombocytopenia, elevated LFTs

intraerythrocytic pleomorphic rings (maltese crosses sometimes)

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how does squatting help relieve tet spells

increase SVR, preventing right to left shunts

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factor Xa inhibitors effect

prolong PT and PTT (at the junction of extrinsic and intrinsic pathways)

no effect on Thrombin time

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types of drug reactions

predictable- what’s expected

exaggerated- what’s expected but occurs at low unexpected dose

idiosyncratic- unpredictable reaction in certain patients

immunologic- unpredictable immunologic reaction

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uncal herniation symptoms

oculomotor nerve palsy with fixed dilated pupil

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SGLT2 inhibitor Tx and contra

urinary tract and genital mycotic infections (from glucosuria)

symptomatic hypotension

avoid in patients with mod-severe renal impairment (check BUN and Cr)

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deep inguinal ring vs superficial inguinal ring

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deep- transversalis fascia

superficial- external oblique muscle aponeurosis - then from there testis enters scrotum

adenosine tx

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RAPID (half life of ten seconds)

flushing
bronchospasm (chest burn)
hypotension
AV block

which is based on prevalence? sens/specficity or pos/neg predictive value?

Positive and negative predictive value

Hartnup disease

impaired transport of neutral amino acids in small intestine and PT of kidney particularly tryptophan affected, which is a precursor for niacin, serotonin, and melatonin pellagra and ataxia

myocardial hibernation

chronic myocardial iscemia LV systolic dysfunction due to redued coronary blood flow reversed by coronary revascularization

filtration fraction

portion of renal plasma flow that is filtered through Bowmans space GFR: RPF

what composes of most of the right side of cardiac silhouette?

right atrium

carotid sinus massage

reflex parasympathetic stimulation of SA, AV and atrial myocytes--> decrease HR and CO

murmur in VSD

holosystolic murmur low pitched heard best at left sternal border accentuates with handgrip maneuver (increase afterload)

what is needed to make nitrous oxide

nitrous oxide synthetase arginine NADPH O2

fixed splitting heard in...

ASD --> pulm hypertension

where is the placement of cannulation of femoral vein

medial to femoral artery (midinguinal) 1 cm below inguinal ligament

when does RF make mitral regurgitation and when mitral stenosis

regurg- first few decades- holosystolic murmur stenosis-mid-age

after MI, when does pericarditis begin and when would dressler begin?

pericarditis- 2-4 days dressler- one week to few months

when and where is aortic regurgitation best heard?

after second heart sound (aorta valve closes) left sternal border, in 3-4th intercostal space

when is mitral regurgitation best heard

after first heart sound (mitral valve closes)

when is aortic stenosis best heard

mid systole (crescendo-decrescendo)

when is mitral stenosis best heard

mid diastole

polyarteritis nodosa histo and association

hep B association transmural inflamm of mid-sized arteries fibrinoid necrosis- amorphous, eosin staining

varicella zoster histo

multinucleated giant cells with intranuclear inclusions

cells that have raquet shaped granules

langherans cells

Kozak consensus sequence

sequence on euk mRNA that helps initiate translation before AUG start codon gccrcc r is either a or g

NADPH functions

- antioxidant- regnerate glutathione - phagosomes resp burst - biosynthesis in liver and adrenal- fatty acids, steroids, cholesterol - cyt p450 metabolism

how many calories of protein, carb, and fat per 1 gram?

protein and carb- 4 cal/g fat- 9 cal/g

where do internal hemorrhoids drain to?

middle and superior rectal veins--> internal iliac and inferior mesenteric veins

how can you reduce recurrence of genital herpes

daily treatment of oral valcyclovir, acyclovir, or famcyclovir

pathology of Reyes syndrome

hepatic dysfunction- microvesicular steatosis encephalopathy- hyperammonemia --> cerebral edema

when do you screen for group b strep in pregnant women?

35-37 weeks gestation

hCG has similar structure to

FSH, LH, TSH

bacteria most common of secondary pneumonia

strep pneumo, staph aureus, hemophilus

incomplete fusion of the urethral folds results in

hypospadias

primary cause of death in acute rheumatic fever

pancarditis

how many days after MI does free wall rupture happen?

5-14 days

5/7 Flashcards

(55 cards)