cardio p 296 - 300 Flashcards

1
Q

what path is associated with systolic regurgitation murmur, balloon appearance of heart on CXR?

A

dilated cardiomyopahty

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2
Q

what is the path that is associated with hypertrophic cardiomyopathy, muscle weakness, loss of DTR, vibratory sense, and proprioception?

A

Friedreich ataxia

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3
Q

define kussmaul sign

A

inc JVP on inspiration instead of a normal dec

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4
Q

explain the mech of kussmaul sign

A

during inspiration –> negative intrathoracic pressure is not transmitted to the heart –> impaired filling of the Rt. ventricle –> blood backs up into vena cava and inc JVD during inspriation

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5
Q

name 3 paths associated with kusmmaul sign

A
  1. constrictive pericarditis
  2. restrictive cardiomyopathies
  3. Rt atrial/ventricular tumors
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6
Q

what is the most common cardiac tumor in child?

A

rhabdomyomas (associated with tuberous sclerosis)

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7
Q

what path is associated with “multiple tumor plop” sound?

A

myxomas

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8
Q

90% of the myxoma takes place in

A

Lt. atrium

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9
Q

what kind of obstruction is seen in myxoma?

A

ball valve obstruction (pedunculated mass) in the Lt. atrium

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10
Q

what is the most common heart tumor?

A

metastasis

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11
Q

what particular structure is disrupted in 3’ syphilis?

A

vasa vasorum

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12
Q

what mutation is associated with hypertrophic cardiomyopathy?

A

beta myosin heavy-chain mutation

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13
Q

what is the main cause of death in hypertrophic cardiomyopathy?

A

ventricular arrhythmia

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14
Q

in hypertrophic cardiomyopathy, what leads to the outflow obstruction?

A

asymmetric septal hypertrophy and systolic motion of mitral valve

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15
Q

symptoms of hypertrophic cardiomyopathy?

A

syncope, dyspnea

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16
Q

what type of hypertrophy do you see in dilated cardiomyopathy?

A

eccentric

17
Q

name all the etiologies for dilated cardiomyopathy?

A
alcohol
wet beriberi
coxsackie B virus myocarditis
cocaine
chagas
doxorubicin
hemochromatosis
sarcoidosis
peripartum cardiomyopathy
18
Q

what is the name of the path associated with endomyocardial fibrosis with a prominent eosinophilic infiltrate in restrictive cardiomyopathy?

A

Loffler syndrome

19
Q

what is the characteristic of ECG for restrictive/infiltrative cardiomyopathy?

A

low voltage ECG despite thick myocardium

20
Q

name 4 causes for restrictive/infiltrative cardiomyopathy

A
  1. sarcoidosis
  2. amyloidosis
  3. postradiation fibrosis
  4. endocardial fibroelastosis (thick fibroelastic tissue in endocardium of young children)
21
Q

what treatment of HF improves both symptoms and mortality?

A

hydralazine with nitrate

22
Q

what treatment of HF is used for symptomatic relief?

A

thiazide/loop diuretics

23
Q

the diff btw systolic vs diastolic dysfunction?

A

EF is reduced in sysotlic (normal is diastolic)

EDV is inc in systolic (normal in diastolic)

24
Q

what is the 1st sign of shock?

A

tachycardia

25
Q

symptoms of systemic inflammatory response syndrome?

A

fever/hypothermia, tachycardia, tachypnea, leukocytosis/leukopenia

26
Q

most likely culture neg bacterial endocarditis?

A

Coxiella burnetii, Bartonella spp and HACEK

27
Q

name examples of nonbacterial endocarditis

A

marantic/thrombotic secondary to malignancy, hypercoagulable state, lupus

28
Q

what is the early/late lesion of rheumatic fever?

A

early: mitral valve regurge
late: mitral stenosis

29
Q

treatment/prophylaxis for rheumatic fever?

A

penicillin

30
Q

explain anitschkow cells

A

“activated histiocyte” enlarged macrophages with ovoid, wavy, rod-like nucleus

31
Q

what is the order of the most affected valve to the least affected valve in rheumatic fever?

A

mitral > aortic&raquo_space; tricuspid (high pressure valve is affected most)

32
Q

what are the ECG changes in acute pericarditis?

A

widespread ST segment, T wave inversion, ST elevation, PR depression

33
Q

name all the causes for acute pericarditis?

A
  1. idiopathic (most common, presumed viral)
  2. confirmed infection (coxsackievirus)
  3. neoplasia
  4. autoimmune (SLE, rheumatoid arthritis)
  5. uremia
  6. cardiovascular (acute STEMI, Dressler)
  7. radiation therapy
34
Q

what is the characteristics of pain in acute pericarditis?

A

sharp pain, aggravated by inspiration, relieved by sitting up