Cardiac Flashcards
(194 cards)
1
Q
What causes Printzmetal Angina? What drug is used to Dx Prinzmetal’s Angina?
A
coronary artery vasospasm
Ergonovine
2
Q
Would Printzmetal Angina cause ST elevation or ST depression?
A
ST elevation
3
Q
Which protein is the gold standard for MI?
A
Troponin I
4
Q
How long does it take for Troponin I levels to rise?
A
2-4 hours
5
Q
How long does it take for Troponin I to peak?
A
24 hours
6
Q
Which protein is the transient marker for MI?
A
CK-MB
7
Q
How long is the myocardium dark following M.I.?
A
4-24 hours
8
Q
What is the microscopic change one day post-MI?
A
coagulative necrosis
9
Q
What is the microscopic change one week post-MI?
A
invasion of neutrophils and then macrophages
10
Q
What vessel feeds the papillary muscle?
A
RCA
11
Q
What is the complication of neutrophils invading the myocardium post-MI?
A
fibrinous pericarditis
12
Q
How does fibrinous pericarditis present?
A
friction rub
13
Q
What is the complication of macrophages invading the myocardium post-MI?
A
wall rupture
14
Q
What type of tissue invades one month post-MI?
A
granulation tissue
15
Q
What is the gross change months after an MI?
A
white scar
16
Q
What is the complication of a white scar in the myocardium?
A
Aneurysm
17
Q
What mediates Dressler syndrome? How many weeks post-MI does it take for this to occur?
A
autoimmune reaction to PERICARDIAL membrane
6-8 weeks
18
Q
How is Dressler Syndrome treated?
A
colchicine
19
Q
What are VSDs associated with?
A
fetal alcohol
20
Q
What is Eisenmenger Syndrome?
A
VSD–> L to R –> Pulm. HTN–> R to L
21
Q
What type of speciific heart defect is associated with Downs Syndrome?
A
Ostium Primum ASD
22
Q
Why does an ASD produce a split S2?
A
more blood in left heart delays closure
23
Q
What is the important and potentially fatal complication of an ostium primum?
A
paradoxical emboli
24
Q
What is the most common cause of a PDA?
A
congenital rubella
25
Does a PDA result in a right-to-left or a left-to-right shunt?
left to right
26
What is the treatment of a PDA? Why?
indomethacin
decreases PGE synthesis
27
What are the four characteristics of Tetralogy of Fallot?
Persistent PDA
RVH
Over-riding aorta
VSD
28
Does tetralogy of fallot cause a right-to-left or a left-to-right?
right-to-left
29
What is Transposition of the Great Arteries associated with?
maternal diabetes
30
What maintains a PDA?
PGE
31
What is a Truncus Arteriosus?
single vessel arising from both ventricles
32
Tricuspid atresia results in the development of what structure?
ASD
33
Where does an infantile Aortic Coarctation often present?
distal to aortic arch
proximal to PDA
34
What disease is Coarctation of the Aorta associated with?
Turner Syndrome
35
How does adult Coarctation of the Aorta present?
strong UE pulses and low LE pulses
36
What is the finding of Coarctation of the Aorta on Imaging? What causes this?
notched ribs
development of collateral circulation
37
What valvular issue does Adult Coarctation of the Aorta present with?
bicuspid aortic valve
38
What group of Strep cause rheumatic fever?
Group A
39
What is the hemolysis pattern of Strep that causes Rheumatic Fever ?
β-hemolytic
40
How long after an infection can Rheumatic Fever present?
2-3 weeks
41
What is the constituent of Strep that causes Rheumatic Fever molecular mimmicry?
M-protein
42
What are the two titers that may be present if a patient has been previously diagnosed with Group A β-hemolytic Strep?
anti-ASO
anti-DNase B
43
What criteria are used to Dx Group B β-hemolytic Strep infection?
Jones Criteria
44
What is the J of the JONES criteria?
joints (Migratory polyartiritis)
45
What is the O of the JONES criteria? What specific condition?
O = heart shape = pancarditis
46
What is the N of the JONES criteria?
N = (subcutaneous) Nodules
47
What is the E of the JONES criteria?
Erythema Marginatum
48
What is the S of the JONES criteria?
Syndenham Chorea
49
What is Migratory Polyarteritis?
swelling/pain in one joint that moves to involve another joint
50
What two valves are involved during Rheumatic Fever? Which more often?
aortic and mitral
Mitral = More often
51
What type of abnormality takes place at the mitral valve early during Rheumatic Fever?
mitral regurgitation
52
What is the most common cause of death in the acute phase of Rheumatic Fever?
myocarditis
53
What is the histological finding of Myocarditis during Rheumatic Fever?
Aschoff Bodies
54
What three cells compose the Aschoff Bodies during Rheumatic Fever?
Reactive Histiocytes
Giant cells
fibrinoid material
55
What is Erythema Marginatum?
annular rash with erythematous border
56
What happens to the mitral valve anatomy during chronic rheumatic fever?
thickening of chordae tendinae
57
What happens to the aortic valve during chronic rheumatic fever?
fusion of commissures (bicuspid aortic valve)
58
Ejection Click is a pathological finding of what cardiac abnormality?
Aortic Stenosis
59
What are the three major complications of Aortic Stenosis?
1. LVH
2. Angina/Syncope upon exercise
3. Micropathic Hemolytic Anemia
60
What causes Aortic Regurgitation?
aortic root dilation
61
What is the cause of Mitral Valve Prolapse ?
myxoid degeneration
62
What are the two potential causes of Myxoid Degeneration?
ED or Marfan
63
What is heard on auscultation during Mitral Valve Prolapse?
mid-systolic click
64
Does a Mitral Valve Prolapse become louder or softer during squatting?
softer
65
What is heard on auscultation during Mitral Valve Prolapse?
holosystolic click
66
Does a Mitral Valve Regurgitation become louder or softer during squatting? Why?
louder
squatting causes increased systemic pressure that cause LV to pump more blood through mitral valve
67
What is heard during auscultation during mitral valve stenosis?
opening snap
68
What are the three complications of Mitral Valve Stenosis?
pulmonary congestion
pulmonary HTN
atrial fibrillation
69
What bacteria is the most common cause of endocarditis/?
Strep. viridans
70
Strep. viridans can infect with type of valve? Why?
previously damaged valve
bacteria attach to exposed collagen
71
What is the most common cause of endocarditis in IV drug users?
S. aureus
72
What valve is most commonly infected by S. aureus?
Tricuspid
73
What does S. aureus do to heart valves?
destroy
74
What species of bacteria most often infects prosthetic heart valves?
S. epidermidis
75
What bug strongly hints at Colorectal Carcinoma?
Strep. bovis
76
What group of bacteria is responsible for endocarditis with a negative blood cultures?
HACEK
77
What is H of HACEK?
Haemophilus
78
What is A of HACEK?
Actinobacillus
79
What is C of HACEK?
Cardiobacterium
80
What is E of HACEK?
Eikenella
81
What is K of HACEK?
Kingella
82
What two locations do Janeway lesions manifest? What disease are they indicative of?
palms and soles
endocarditis
83
What two locations do Osler nodes lesions manifest? What disease are they indicative of?
fingers and toes
Endocarditis
84
Where do splinter hemorrhages manifest?
nail-bed
85
Where do Roth Spots manifest? What disease are they indicative of?
Retina
endocarditis
86
What disease can endocarditis precipitate the formation of?
anemia of chronic disease
87
What type of echo is used for endocarditis?
transesophageal echo
88
What two diseases are sterile vegetations indicative of?
hyper-coaguable state
Adenocarcinoma
89
What valve is most commonly infected by sterile vegetations? What is the result?
mitral
mitral regurgitation
90
What endocarditis disease is produce during SLE? Which valve? What does this result in?
Libman-Sachs endocarditis
mitral
regurgitation
91
Does a dilated cardiomyopathy result in systolic or diastolic function?
sytolic
92
What two valves are most often affected during dilated cardiomyopathy? What does this lead to?
mitral and tricuspid
regurgitation
93
What two viruses can cause a dilative cardiomyopathy?
Coxsackie A and B
94
What type of immune cell invades the heart during a coxsackie virus infection? What layer?
Lymphocytes
myocardium
95
What drug can cause a dilative cardiomyopathy?
Doxorubicin
96
What specific disease can hemochromatosis cause in the heart?
dilative cardiomyopathy
97
A mutation in genes for what protein can cause a hypertrophic cardiomyopathy? What is the mode of inheritance?
sarcomere
autosomal dominant
98
What is the mode of inheritance for the most common genetic form of hypertrophic cardiomyopathy?
autosomdal dominant
99
Would a hypertrophic cardiomyopathy lead to a systolic or diastolic dysfunction?
diastolic
100
What type of stenosis can a patient with hypertrophic cardiomyopathy present with? Why?
aortic stenosis
ventricular septum hypertrophy
101
What are the four causes of a restrictive cardiomyopathy?
amyloidosis
sarcoidosis
endocardial fibroelastosis
Loeffler Syndrome
102
What are the three findings of Loeffler Syndrome?
endoMYOcardial fibrosis
Eosinophilic infiltrate
eosinophilia
103
What is the classic finding of restrictive cardiomyopathy?
low-amplitude EKG
104
What is a myxoma? What is the specific location as to where a myxoma often arises?
benign pedunculated mass
usually in left atria
105
What type of tumor is a myxoma?
mesenchymal
106
What valve does a myxoma often occlude?
mitral
107
What is a rhabdomyoma?
benign hamartoma of cardiac muscle
108
What patient population does a myxoma arise?
adult
109
What patient population does a rhabdomyoma arise?
children
110
What other disease is a rhabdomyoma associated with?
tuberous sclerosis
111
Where in the heart does a rhabdomyoma often arise?
ventricle
112
Which four cancer can metastisize to the heart?
breast, lung, lymphoma, melanoma
113
What layer of the heart do metastatic tumors like to lodge? What can this lead to?
pericardium
pericardial effusion
114
Does Temporal Arteritis more commonly effect males or females? Over what age?
females
50
115
What causes Unstable Angina?
rupture of a coronary artery with incomplete occlusion
116
When does unstable angina occur?
at rest
117
Is prinzmetal angina a reversible or irreversible injury?
reversible
118
What does Prinzmetal Angina do on the EKG?
ST elevation
119
What are the two treatments of Prinzmetal Angina?
GTN or CCBs
120
Does GTN relieve the symptoms of myocardial infarction?
no
121
What parts of the heart are often spared during Myocardial Infarction?
RV and both atria
122
How long is Troponin I detectable?
7-10 days
123
Reperfusion of irreversibly damaged myocytes leads to influx of what ion? Causing?
calcium
contraction band necrosis
124
What is the microscopic change of the myocardium months after injury?
fibrosis
125
What is the key complication of the macrophage phase of post-MI immune response?
rupture
126
What must occur for pericarditis to occur post-MI?
transmural infarction
127
How long post-MI does Dressler Syndrome arise?
6-8 weeks
128
What type of collagen would be present in a healed MI?
type one
129
What is the most common cause of right-sided HF?
left-sided HF
130
What are the three manifestations of right-sided HF?
JVD
nutmeg liver
peripheral edema
131
What are the two findings of Eisenmenger syndrome on physical exam and labs?
clubbing of fingers
polycythemia
132
Why does S2 split during an ASD?
delayed closure of pulmonic valve due to increased blood volume
133
Explain the process of why a person with Tetralogy of Fallot squat?
increase pressure on left heart to shunt blood to right heart and improve blood flow to lungs
134
What drug is used to treat TGA? Why?
misoprostol
maintain PDA
135
What is truncus arteriosus ?
single vessel arising from ventricles
136
What are the two forms of Coarctation of the Aorta?
infantile and adult
137
Infantile Coarctation of the Aorta is associated with what other finding?
PDA
138
Where does Adult Coarctation of Aorta occur?
distal to aortic arch
139
How long will each joint be affected during Migratory Polyarthritis?
2-3 days
140
Of the JONES criteria, which is the only symptom that will not resolve with time?
valvular issue
141
What specific cell type is found during myocarditis of rheumatic fever? What type of cell is this?
Anitschkow
reactive histiocyte
142
What process causes the friction of Acute Rheumatic Fever?
pericarditis
143
Repeated exposure to Group A β-hemolytic Strep. can cause what long term heart problem?
mitral stenosis
144
What type of aortic valve has a higher liklihood of developing aortic stenosis?
bicuspid aortic valve
145
What will be heard on auscultation during Aortic Regurgitation ?
early, blowing diastolic murmur
146
What are three common presenting symptoms for a patient with aortic regurgitation?
wide pulse pressure
pulsating nail bed
bobbing head
147
What would be heard during auscultation for mitral valve regurgitation?
holosystolic 'blowing' murmur
148
Would mitral valve regurgitation become louder or softer during expiration? Why?
louder
more blood enters LA and LV to be pumped
149
Below what vessel do the vaso vasorum cease to exist? What can this lead to?
renal arteries
AAA
150
Would a right sided murmur become louder or softer upon inspiration?
louder
151
What is Kussmaul's sign?
rise in JVD upon inspiration
152
Which β-blocker can exacerbate Prinzmetal Angina?
Propranalol
153
What are Janeway Lesions/Osler Nodes/Splinter Hemorrhages composed of?
Septic Embloi
154
Do Janeway lesions hurt?
no
155
Do Osler nodes hurt?
yes
156
Other than a fever and murmur, what disease can all forms of endocarditis produce?
Anemia of Chronic Disease
157
What process occurs during Libman-Sacks Endocrditis?
mitral regurgitation
158
What is the major form of endocarditis that can produce vegetations on the surface and underside of the mitral valve?
Libman Sacks Endocarditis
159
What is the mode of inheritance for a genetic mutation that could lead to dilated cardiomyopathy?
autosomal dominant
160
Other than doxorubicin, what drug is known to cause a dilative cardiomyopathy?
alcohol
161
What heart pathology can pregnancy cause?
dilated cardiomyopathy
162
Myofiber Disarray is indicative of what disease?
hypertrophic cardiomyopathy
163
Endocardial Fibroelastosis primarily effects what age group?
children
164
What is the most common primary cardiac tumor in adults?
Myxoma
165
What is the most common presentation for a myxoma?
syncope
166
What vessel supplies the papillary muscles of the LV?
right coronary artery
167
How long does it take CK-MB to rise after an infarction?
4-6 hours
168
How long does it takes CK-MB to peak after an infarction?
24 hours
169
How long does it takes CK-MB to return to normal levels after an infarction?
72 hours
170
Does a Mitral Valve Regurgitation become louder or softer during inspiration? Why?
louder
more blood enters left atria
171
Which angina show STE? Which angina shows STDs?
STDs = stable or unstable
STEs = prinzmetal
172
What part of the body is cyanotic in a kid with a PDA?
lower extremities
173
What presents with a bounding pulse, aortic stenosis or aortic regurgitation?
regurgitation
174
Does aortic regurgitation result in eccentric or concentric hypertrophy?
eccentric
175
Does aortic stenosis result in eccentric or concentric hypertrophy?
concentric
176
Is stable angina a reversible or irreversible injury?
reversible
177
Would Stable Angina cause ST elevation or ST depression?
depression
178
Would Unstable Angina cause ST elevation or ST depression?
depression
179
What two drugs are used to treat Prinzmetal Angina?
nitro and CCBs
180
What time frame of chest pain differentiate angina from M.I.?
twenty minutes
181
What is removed from the cell during coagulative necrosis?
nuclei
182
For how long following ischemia will no changes be seen in microscopy or gross changes?
four hours
183
What color is the heart on gross examination when neutrophils are present?
yellow
184
What specific days for neutrophil infiltration post-MI?
1-3
185
What specific days for macrophage infiltration post-MI?
4-7
186
What is the most common type of ASD?
ostium secundum
187
Is PDA symptomatic at birth?
no
188
During what kind of heart inflammation do Anitschkow cells arise?
Myocarditis
189
Is mitral regurgitation caused by acute or chronic rheumatic fever?
acute
190
Is mitral stenosis caused by acute or chronic rheumatic fever?
chronic
191
Does S. viridans destroy valves?
no
192
Does S. aureus destroy valves?
yes
193
What type of cardiomyopathy could pregnancy produce?
dilated
194
What is the most common tumor of the heart?
metastasis
