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Step 1 > Cardio > Flashcards

Cardio Flashcards

1
Q

S3

A

“Kentucky”
Rapid ventricular filling - MR, CHF
Normal in kids and preggers

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2
Q

S4

A

“Tennessee/atrial kick”

High atrial pressure d/t VH

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3
Q

Normal S2 splitting

A

Inspiration –> Pulmonic closes after aortic

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4
Q

Wide S2 splitting

A

Pulmonic stenosis & RBBB –> Delay in RV emptying

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5
Q

Fixed S2 splitting

A

ASD –> L-R shunt delays pulmonic closure

  • secundum = #1
  • primum = DOWN SYNDROME
  • paradoxical emboli
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6
Q

Paradoxical S2 splitting

A

Aortic stenosis & LBBB —> delays LV emptying

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7
Q

Hand grip

A

Inc MR, VSD

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8
Q

Valsalva

A

Most DEC

Inc MVP, hypertrophic

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9
Q

Squatting

A

Dec MVP, hypertrophic

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10
Q

Mitral/Tricuspid regurg

A

Holosystolic, high pitched “blowing”

Rheumatic fever

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11
Q

Radiates to axilla

A

MR

- Complication of MVP, LV dilation, endocarditis, Rheumatic, papillary muscle rupture

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12
Q

Ejection click –> Crescendo-decrescendo

A 
Aortic stenosis
- Radiates to carotids
- Pulsus et tardus - weak pulses
- Wear and tear, bicuspid valve, or chronic RF
-
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13
Q

Angine, syncope w/ exercise, radiates to carotids

A

Aortic stenosis

  • “Fish mouth” commisure
  • -> LVH, anemia
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14
Q

Weak pulses compared to heart sounds

A

Pulsus et tardus - Aortic stenosis

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15
Q

Holosystolic, harsh murmur at left sternal border

A

VSD

  • Most common
  • FETAL ALCOHOL
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16
Q

Mid-systolic click with late systolic crescendo

A

MVP

  • Can predispose to endocarditis
  • Caused by RF, chordae rupture, Marfan, ED syndrome
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17
Q

High-pitched, blowing diastolic murmur

A

AR

  • Widened pulse pressure, bounding pulses, head bobbing
  • Heard over LEFT sternal border (pulmonic area)
  • INC when leaning forward w/ held expiration
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18
Q

Widened pulse pressure, bounding pulses, head bobbing, pistol shot bruit over femoral pulsating uvula

A

AR

  • aortic root dilation - syphiltic aneurysm, dissection, endocarditis
  • LV dilation w/ ECCENTRIC hypertrophy
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19
Q

Opening snap with diastolic rumble in LLD position

A

Mitral stenosis (same as tricuspid)

  • D/T RF…endocarditis, SLE, amyloid, carcinoid
  • -> LA dilation –> pul congestion/HTN –> RHF
  • -> A-fib –> mural thrombi
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20
Q

Continuous machine-like murmur

A

PDA

  • RUBELLA
  • Prematurity
  • LE cyanosis
  • Tx = indomethacin
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21
Q

Pressure formula

A

P = flow x resistance

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22
Q

Resistance formula

A

R = 8(viscosity) x length / pi(radius)^4

Inc viscosity –> inc TPR –> inc work

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23
Q

MAP

A

MAP = 2/3 DBP x 1/3SBP

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24
Q

High-pitched, blowing, holosystolic murmur at the apex

A

MR

Rupture of papillary muscle –> flash pulmonary edema

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25
Q

Day 1-4 post-MI complication

A

Fatal arrhythmia, pericardial friction rub

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26
Q

Day 5-10 or 4-7 post-MI complication

A

Rupture of papillary muscle, IV septum, Ventricular free wall

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27
Q

Months to years post-MI complication

A

Ventricular aneurysm

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28
Q

Peaked T-waves

A

HyperK –> Torsades –> asystole

Tx = calcium gluconate

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29
Q

Causes of hyperK

A 
Burns, tumor lysis, rhabdo
BBs, ACEs, ARBs, Digitalis, K+ sparing
Renal failure
Acidosis
Low insulin
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30
Q

U-waves

A

HypOK+

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31
Q

Opening snap with high-pitched diastolic rumble, inc with inspiration

A

Tricuspid stenosis

Mitral is the same but inc w/ Expiration

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32
Q

4-24 hours post-MI

A

Hypereosinophilia

No nuclei

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33
Q

1-3d post-MI

A

Lots of neutrophils –> coagulative necrosis

Pericardial friction rub

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34
Q

New murmur 1 week post-MI

A

IV septum rupture

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35
Q

ST elevation in V1-6, I, aVL

A

Left Main coronary artery

36
Q

ST elevation in V1-2

A

Proximal LAD - septal

37
Q

ST elevation in V3-4

A

LAD - anterior

38
Q

ST elevation in V5-6

A

LAD - Apical

39
Q

ST elevation in V1-4

A

LAD - anteroseptal

40
Q

ST elevation in I, aVL

A

Left circumflex

41
Q

ST elevation in II, III, aVF

A

RCA/PD - inferior

- supplies LV papillary muscle

42
Q

Pericardial friction rub with ST elevation in all 12 leads

A
  • Acute pericarditis*
  • SLE, Scleroderma, Post-MI Dressler syndrome
  • Diffuse ST elevation & PR depression
43
Q

Viral pericarditis

A

Coxsackie B

44
Q

Chest pain relieved by sitting forward

A

Pericarditis

45
Q

ST depressions in II, III, aVF + cardiac enzymes

A

Inferior wall NSTEMI = SUBendocardium

unstable angina can have ST depression but no enzymes

46
Q

Causes of 3rd degree AV block

A

Lyme, Chagas, endocarditis, Syphilis, Auto-immune

47
Q

Silent MIs

A

Diabetics and Women - looks for Q waves

48
Q

Q-waves

A

> 25% of R wave or wide

Indicates an OLD MI

49
Q

High TAGs assoc w/?

A

Pancreatitis

50
Q

QRS >3 boxes, rSR in V1, 2, slurred S waves in I and V6

A

RBBB

51
Q

HA, lower extremity claudication, UE/LE BP differences

A

Coarctation of Aorta

  • Turner syndrome
  • Rib notching, bicuspid aortic valve
  • Distal to L subclavian
  • –> LVH

Infantile form = assoc w/ PDA –> cyanosis

52
Q

Elastic lamina fragmentation

A

Giant cell arteritis

  • Giant cells w/ intimal fibrosis
  • ESR >100
53
Q

Middle ages Asian female w/ weak pulses in extremities

A

Takayasu

- Granulomatous aortic arch

54
Q

Young adult w/ HTN, melena, (+) serum HBsAg, segmental fibrinoid necrosis

A

Polyarteritis nodosa

- “String of pearls”

55
Q

Asian 4 y/o w/ fever, conjunctivitis, rash on palms and soles

A

Kawasaki’s

  • Early MI***
  • Tx = aspirin***
56
Q

30 y/o male smoker w/ claudication and Raynaud’s

A

Buerger Disease

- necrotizing vasculitis of digits –> gangrene, AUTO-AMPUTATION

57
Q

Middle aged male w/ sinusitis, hemoptysis, hematuria

A

Wegener’s

  • c-ANCA, GRANULOMAS
  • Tx = cyclophosphamide

Microscopic polyangitis is similar but NO granulomas

58
Q

Middle aged male w/ asthma, peripheral eosinophilia

A

Churg-Strauss

59
Q

Causes of hyaline arteriolosclerosis/non-enzymatic glycosylation

A

HTN

Diabetes

60
Q

Hyperplastic arteriolosclerosis

A

Hyperplasia of smooth muscles –> onion skinning

D/T Malignant HTN —> fibrinoid necrosis w/ ‘flea-bitten’ appearance

61
Q

Calcification in linear streaks on mammography

A

Monckeberg Medial Calcific Sclerosis

62
Q

‘Tree bark’ aorta thoracic aneurysm

A

Tertiary syphilis –> aortic valve insufficiency

63
Q

65 y/o male smoker w/ pulsatile abdominal mass

A

AAA - BELOW renal arteries

  • atherosclerosis
  • rupture >5cm
64
Q

Chest pain <20min, ST depression d/t subendocardial ischemia

A

Stable angina

- Nitro dilates veins

65
Q

Chest pain at rest, ST depression d/t subendocardial ischemia

A

Unstable angina

  • rupture of plaque
  • nitro dilates veins
66
Q

Prinzmetals agina

A

Coronary vasospasm

  • ST ELEVATION
  • Tx = CCBs
67
Q

1-3 wks post-MI

A

RED border - granulation tissue

68
Q

1 month post-MI

A

Scar/fibrosis

69
Q

Intralveolar hemosiderin-laden MO

A

Left sided HF

Tx = ACE

70
Q

Nutmeg liver

A

Right sided HF –> cirrhosis, pitting edema

71
Q

Boot shaped heart

A

Tetralogy of Fallot

  • Stenosis of RV outflow
  • RVH
  • VSD
  • Overriding aorta
  • -> cyanotic spells –> SQUATTING helps
72
Q

Early cyanosis assoc w/ MATERNAL DIABETES

A

Transposition

- Tx = PGE to maintain PDA

73
Q

Acute RF Jones Criteria

A 
J - joint arthritis
O - MR, aschoff bodies, friction rub
N - Nodules
E - erythema marginatum
S - Syndeham chorea

M-protein MOLECULAR MIMICRY

74
Q

Most common cause of death in acute RF

A

Myocarditis

75
Q

Characteristic cells of myocarditis

A

Anitschkow cell - caterpillar nuclei

76
Q

Chronic RF

A

Stenosis –> “fish mouth” valves
Mitral –> thickened chordae
Aortic –> fusion

77
Q

Bug infecting prosthetic valves

A

S. epi

78
Q

Fever, erythema on palms and soles, painful lesions on finger and toes, splinter hemorrhages in nails

A

Endocarditis

- anemia of chronic disease = INC FERRITIN

79
Q

NBTE

A

Sterile vegetations d/t hypercoagulable state or ADENOCARCINOMA

–> MR

80
Q

Libman-Sacks endocarditis

A

Sterile vegetations on BOTH sides of valve = SLE

–> MR

81
Q

Causes of dilated cardiomyopathy

A 
Genetic
Myocarditis - Coxsackie
Alcohol
Doxorubicin, Cocaine
Pregnancy
82
Q

Mutation in HOCM

A

SARCOMERE PROTEINS

83
Q

Haphazard myofibers

A

HOCM

  • sudden death in athletes
  • syncope w/ exercise
84
Q

Causes of restrictive cardiomyopathy

A 
Amyloid
Sarcoid
Hemochromatosis
Fibroelastosis = KIDS***
Loeffler - fibrosis + eosinophils
85
Q

Low voltage EKG

A

Restrictive cardiomyopathy

86
Q

Most common primary cardiac tumor in kids

A

Rhabdomyoma

  • Assoc w/ tuberous sclerosis*
  • ventricle
87
Q

Metastatic tumors to heart

A

More common than primary

  • breast, lung, melanoma, lymphoma
  • pericardium –> pericardial effusion

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