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Internal Medicine > CVS > Flashcards

CVS Flashcards

1
Q

Postural/orthostatic hypotension

A

> 20/10 mmHg

Supine vs. standing position

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2
Q

Active precordium

A

Vascular heart disease
Ischemic heart disease
High output states

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3
Q

Quiet precordium

A

Normal
Dilated cardiomyopathy
Restrictive cardiomyopathy
Constrictive pericarditis

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4
Q

Bulging of chest

A

Chronic condition:
Hypertensive heart disease
Hypertrophic CM

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5
Q

Diffuse PMI

A

> 2.5 cm

LV enlargement

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6
Q

Tapping vs sustained PMI

A

Tapping: normal, dilated CM
Sustained:>2/3 systolic, LVH

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7
Q

Shifted PMI

A

Hypertensive HD
Valvular HD
Dilated CM
Mediastinal shift (pleural effusion, tumor, pneumomediastinum)

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8
Q

LV hypertrophy causes

A 
Hypertension
Athletic
Valvular heart disease
Hypertrophic CM
Congenital heart disease
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9
Q

Ischemic cardiomyopathy

A

Weakening of heart muscle due to blockage of coronary arteries. LV is enlarged, DILATED, and weak.

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10
Q

Jones criteria

A

For Rheumatic fever

Joint 
Carditis
Nodules (subcutaneous, painless)
Erythema marginatum 
Sydenham chorea
Previous rheumatic fever
ECG with PR elevation 
Athralgias
CRP and ESR elevated
Elevated temperature
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11
Q

Non-palpable PMI

A 
Obesity
Muscular chest wall
Pericardial effusion
Dilated cardiomyopathy 
Dextrocardia
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12
Q

Reversible non-palpable PMI

A 
Pregnancy
Alcohol
Thyroid
Cocaine
Chronic uncontrolled tachycardia
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13
Q

Beck’s triad

A

For cardiac tamponade

Raised JVP (distended neck veins)
Absent heart sound
Hypotension

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14
Q

Most common cause of mitral stenosis

A

RHD

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15
Q

RHD leads to (valves)

A

Mitral stenosis, aortic stenosis

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16
Q

Most common cause of aortic regurgitation

A

Aortic root dilatation eg. syphilitic aneurysm

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17
Q

There’s wide pulse pressure with (valvular disease)

A

Aortic regurgitation

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18
Q

Hyper dynamic circulation???

A

Bounding pulse
Pulsating nail bed
Head bobbing

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19
Q

Acute Rheumatic fever etiology

A

Step. pyogene

Group A, beta hemolytic (complete RBC lysis)

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20
Q

Presence of thrill

A

Grade 4+

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21
Q

S1 accentuation in

A 
MS
High output states
Anemia 
Exercise
Hyperthyroidism
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22
Q

S3 normal in

A

Children, adolescents and young adult

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23
Q

S3 in older pts signifies

A

HF

Produced due to volume overload

24
Q

Characterization of murmur

A 
Position 
Quality
Radiation
Timing (systole, diastole)
Pitch 
Grading (1-6)
25
Q

MR ddx

A 
MV prolapse
IE
Papillary muscle rupture
Trauma 
Chordal rupture
Rheumatic fever
Mitral annular calcification 
Dilated cardiomyopathy
IHD
26
Q

MS ddx

A 
Rheumatic fever 
Congenital 
Severe mitral annular calcification 
SLE (Libman Sacks endocarditis) 
RA
27
Q

AR ddx

A 
Congenital (bicuspid)
Endocarditis
Rheumatic fever
Prolapse
Traumatic
Syphilis
Aortic dissection 
Aneurysm
28
Q

Bounding pulse ddx

A 
AR
Anemia
Fever
Thyrotoxicosis
Pregnancy
29
Q

Wide pulse pressure ddx

A 
AR
Thyrotoxicosis 
Fever
PDA
Arteriovenous fistula
30
Q

AS ddx

A

Congenital (bicuspid, unicuspid)
Degenerative calcific
Rheuamtic fever

31
Q

Pulse pressure normal range

A

40-60mmHg

32
Q

Peripheral signs of aortic regurgitation

A 
Demusste’s sign
Traube’s sign
Durozie’s sign 
Quincke’s pulses
Mueller’s sign
Becker’s sign
Hill’s sign
Mayne’s sign
Rosenbach’s sign 
Gerhard’s sign 
Jarring of the entire body 
Corrigan’s/water hammer pulse
33
Q

Risk factors for CVD

A 
Non modifiable:
Age
Sex
Race
Family history 
Modifiable:
Weight (obesity)
Physical activity 
Diet
Salt intake 
Hypertension
DM
Dyslipidemia 
Alcohol
Cigarettes
34
Q

Hypertension complications

A

Cerebrovascular accident (stroke)
Coronary heart disease
Intermittent Claudication (PAD)
CKD

35
Q

Precipitating factors of CVD

A

HEART FAILS

Hypertension 
Infective Endocarditis
Arrhythmia
Rheumatic fever
Thyrotoxicosis
Fever (infection)
Anemia
Myocardial Infarction 
Pulmonary embolism (lung)
Stress
36
Q

Intermittent claudication

A

Muscle pain on mild exertion, classically in the calf muscles, caused by PAD

37
Q

Hypertension definition

A

Pre-HTN: 120-139/80-89 mmHg
Stage 1: 140-159/90-99 mmHg
Stage 2: >=160/100 mmHg

38
Q

DM HTN definition

A

> 130/80 mmHg

39
Q

Ambulatory HTN

A

Awake: >=135/85
Sleeping: >=120/75

40
Q

Ankle-brachial index

A

G

41
Q

Framingham criteria (heart failure)

A

Y

42
Q

DVT ddx

A

Ruptured Baker’s cyst
Cellulitis
Post phlebitic syndrome /venous insufficiency
Lymphedema

43
Q

DVT symptoms

A

Pain
Redness
Superficial venous dilation

44
Q

Risk factors of DVT

A 
Active cancer
Paralysis/limb weakness
Recent cast
Bed ridden
Hx of surgery 
Hx of trauma
Cigarette smoking
OCP
Pregnancy 
COPD
HTN
Anti-phospholipid Ab syndrome 
Long-haul air travel
Family history
45
Q

Complication of DVT

A

Pulmonary embolism
Cerebrovascular accident
Kidney ischemia
Right sided HF

46
Q

Well’s criteria (DVT)

A

Active cancer
Bedridden recently >3 days or major surgery within 12 weeks
Calf swelling >3cm compared to the other leg
Collateral (nonvaricose) superficial veins
Entire leg swollen
Localized tenderness
Pitting edema
Paralysis, paresis or recent plaster immobilization of the lower extremity
Previously documented DVT
Alternative diagnosis to DVT as likely or more likely (-2)

47
Q

DVT investigations

A

D dimer test (>500ng/ml)

Doppler ultrasound

48
Q

Cardiac causes of chest pain

A 
Angina pectoris
MI
Pericarditis
Aortic dissection 
HCM
AS
49
Q

Cardiac causes of SOB

A

HF

Pericardial effusion

50
Q

Cardiac causes of clubbing

A

IE
Cyanotic CHD
PDA with reversal of shunt (in the toes)

51
Q

CXR findings of DVT (pulmonary embolism)

A

Wester Mark’s sign
Hampton’s hump
Palla’s sign

52
Q

Virchow’s triad

A

Hypercoaguability of blood
Vessel wall injury (endothelial damage)
Stasis of blood

53
Q

Rheumatic fever criteria mnemonic

A

JONES CAFE PAL

Major:
Joints
Heart
Nodules 
Erythema marginatun 
Sydenham chorea 
Minor:
CRP elevation
Arthlagia
Fever
ESR elevation

Prolonged PR
Anamesis
Leukocytosis

54
Q

Normal platelet count

A

150,000 - 450,000 per mcl of blood

55
Q

Normal WBC count

A

4,500- 11,000 WBCs/mcl of blood

56
Q

Etiology for culture negative endocarditis (CNE)

A
  • HACEK
  • Coxiella Burnetti
  • Bartonella species
  • Brucella species
  • Tropheryma whipple
  • Corynebacterium species and Propionbacterium acne
  • Legionella
  • Aspergillus species

Internal Medicine (10 decks)

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