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2024 - élo - usmle rx qbank > cardio > Flashcards

cardio Flashcards

(101 cards)

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1
Q

subacute vs acute endocarditis

A

acute —s taph aureus and quick onset

subacute —- prosthetic vavles strept virdian

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2
Q

his patient presents with decreased distal pulses, dry gangrene, and ulceration over the digits. Together, these findings indicate a diagnosis of

A

buerger disease

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3
Q

history of sharp pain at rest but not while exercising

A

prinzmetal

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4
Q

pt has essential hyp and prizmetal angina plus wants to become pregnant
whats the best medicaiton

A

hydrochlorothiazide

amlodipine

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5
Q

bblocker overdose txt

and the cellualr signalling pathway

A

glucagon

activate Gs adenyl cyclase

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6
Q

which vasculitis has a . Granulomatous infiltrate

A

giant cell arteritis

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7
Q

cystic hygroma

A

cystic hygroma is a congenital malformation resulting in lymph accumulation in jugular lymphatic sacs; it is caused by congestion of the lymphatic system in the neck.
in turners or down

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8
Q

which pattern of inheritence is demonstrated by AD conditions likes BRCA 1

A

incomeplete penetrance

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9
Q

Loss of hetrozygosity

A

oss of heterozygosity is a phenomenon in which an individual who previously lost an allele (usually congenitally) loses the last and final allele due to an additional insult. This occurrence is well represented by the two-hit hypothesis in which loss of two alleles is required to activate a proto-oncogene. Retinoblastoma (Rb) gene is a well known example in which Rb mutations can either be sporadic or inherited.

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10
Q

pt works in a factory with high exposure to nitrates

what can this condition be

A

mondays disease
Monday disease, reflex tachycardia, dizziness, hypotension, flushing, and headache occur on Monday with re-exposure to nitrates
most severe consequence occurs when compensatory vasoconstriction is unopposed in critical areas such as the coronary vessels, leading to nonatherosclerotic-related cardiac ischemia.

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11
Q

digeorge pharyngeal arch or pouch

A

POUCH 3 4

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12
Q

treatment of septic shock and the receptors this drug works on

A

norepi

alpha1>2> beta1

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13
Q

short term SVT txt

A

diltiazem

negative dromotropic effect

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14
Q

which antiarrythmic drug can cause torsade pointes

A

sotalol

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15
Q

what drug is given to treat vent fibrillation

A

amiodarone

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16
Q

centrally acting hypertension medication

can cause

A

clonidine

presynaptic alpha 2 agonism …. decrease sympathetic outflow

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17
Q

virus causing pericarditis

A

small non enveloped single stranded RNA virus

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18
Q

the only two double stranded RNA virus

A

colti virus

rotavirus

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19
Q

what would increase prevalance but not incidence

A

better healthcare quality

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20
Q

sacubitril mechanims

A

inhibits neprilysin

which is responsible for deactivating ANP BNP … which help reduce BP

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21
Q

he compensatory neurohumoral mechanisms of CHF include

A

The activation of the RAASproduces an increase in the level of angiotensin II and aldosterone, which both function to increase sodium reabsorption in the kidneys.

Increased sympathetic output by the central nervous system
Increased activation of the RAAS
Increased secretion of ADH

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22
Q

acute SVT first second third line therapy

A

vagal manneuver
adenosine
BB

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23
Q

HCM treatment

A

BB or nondehydropyridine ca channel blocker

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24
Q

describe murmur in HCM

A

when heart it full murmur decreases (squatting)

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25
atient presented with unexplained palpitations, tachycardia, and shortness of breath. These signs indicate that she should be evaluated for an
arrythmia | possibly SVT
26
treatment given to a patient iwth SVT causes sudden drop in pressure and flushing name of drug
adenosine denosine is a very short-acting drug that is useful in terminating certain forms of supraventricular tachycardia by hyperpolarizing the cell and decreasing atrioventricular (AV) node conduction. Adverse effects include flushing, hypotension, chest pain, bronchospasm, and a sense of impending doom. 
27
34-year-old man comes to the physician due to difficulties speaking and swallowing due to mitral stenosis why is he having such symptoms
The left recurrent laryngeal nerve loops beneath the aortic arch leaving it vulnerable to compression from an enlarging left atrium in rare cases. Such an obstruction can also compress surrounding structures such as the esophagus, resulting in hoarseness and aphonia (loss of voice). In extremely severe cases, the enlargement of the left atrium may cause difficulty swallowing. 
28
pt is on simvastatin developds community acq pneumonia txt is given and he expereiences muscle aches WHY
Macrolides also inhibit the cytochrome P-450 enzyme, CYP3A4, which metabolizes simvastatin. Increased serum concentration of simvastatin results in simvastatin-associated muscle pain that may evolve to rhabdomyolysis.
29
Inherited defects of myocyte ion channels cause what condition
long QT syndrom
30
heart condition assoc to marfan
MVP aortic regurg mitral regurg
31
adenosine mechanism
Adenosine is an antidysrhythmic that hyperpolarizes the cell via potassium channels and inhibits L-type calcium channels. It will not significantly affect the calcium flow.
32
in order to reach the IVC ... an umbilical vein catheter must pass thru which ductus
ductus venosus!!
33
nitroglycerin physiological impact
reduces PRELOAD | reduces oxygen demand by heart muscle
34
SLE endocarditis vegetations
SMALLLLLLLLL verrucous
35
fibrates mechanims
upregulate lipoprotein lipase | and activate PPR
36
umbilical vessels
``` one vein (oxygenated) two arteries ```
37
what is coronary dominance
which artery supplies the PDA
38
treatment of choice for type IIa and IIb familial hyperlipidemia.
high dose statin | and ezetemib
39
statin with cholestyramine
NO | it will decrease absp of statin toooo
40
normal essential HTN drugs
thiazaide CCB ACEi
41
in blacks treatmnt for HTN
thiazide and long acting ACEi
42
necrotizing granulomas are seen in whcih type of vasculitis
polyangitis granulomatos
43
necrotizing vasculitis with eosinophilia
churg straus
44
igA complex deposition
henoch schonlen
45
segmental thrombosing vasculitis
beurger
46
drug x is given which causes increase in systolic diastolic and MAP after the affect is worn off another drug Y is given before drugX is given again ... now the BP DECREASES
drug x epinephrine (a b receptors) drug y phenoxybenzamine phenoxy blocks the a1 affects of epi ..... means only b1 and b2 rec are activated
47
patient presents with severe chest pain, a history of hypertension and type 2 diabetes mellitus, and asymmetric pulses in the upper extremities
aortic dissection | cardiac tamponade complication
48
define kawasaki disease
``` Kawasaki disease is an acute necrotizing vasculitis of medium to small muscular arteries. CRASH conjunctival injection Rash adenopathy strawberry tongue fever ```
49
digoxin effects on heart
increase EF | decrease HR
50
reperfusion injury histology
Contraction bands on histology following MI are caused by massive calcium influx, and result in hypercontraction of the sarcomeres
51
inhibition of hormone senstive lipase
niacin increases HDL also decreases triglyceride
52
what is a serious side effect of hydralazine
reflex tachy | use labetolol
53
when is flecainide used
it is also used for intractable supraventricular tachycardia.
54
lidocaine use
lass Ib antiarrhythmic, is used in the treatment of acute ventricular arrhythmias such as postmyocardial infarction arrhythmias.
55
PDA in a baby can be caused by which infection
rubella fever lymphadenopathy arthralgia rash from face down
56
many of the adverse effects are related to central nervous system (CNS) depression fatigue drowsiness
clonidine | centrally acting
57
internal jugular vein anatomy
within the carotid sheath lateral to the common carotid artery and anterior to the vagus nerve.
58
stenosis/regurgitation vs endocarditis/RHF
stenosis in RHF | regurg in endocarditis
59
post MI fibrillation
1b lidocaine ... decrease AP ARP
60
cardiac remodelling with sarcomeres added in parallel
concentric hyprtrphy | diastolic dysf
61
long qt syndrome with sensorineural deafness | which ion chanel involved
Jervell and Lange-Nielsen syndrome is an autosomal-= recessive condition caused by mutated voltage-gated potassium channels. Individuals commonly present with sensorineural deafness, a family history of sudden death, and a prolonged QT interval on ECG (>420 ms).
62
L-type Ca2+ channels mutation causes
malignant hyperthermia
63
ostium primum wall defect
. Ostium primum septal defect is seen in the lower portion of the septum at the level of the tricuspid and mitral valves. It is also known as endocardial cushion defect. It is associated with mitral and tricuspid valve defects as well as Down syndrome. 
64
2 days post MI | pt has pleuritic chest pain ... widespread ST elevations ... and friction rub
fibrinous pericarditis
65
ventricullar wall ruptture post MI occurs after
2-8 days
66
troponin levels
after 6 hours can peak by 24 down in 2 weeks
67
CKMB
peak by 24 and down by 72 | used to check for reinfarction
68
buproprion mechanism in smoking cessation
blocks reuptake of norepi and dopamine
69
what factors predispose digoxin toxicity
amiodarone verapamil quinidine hypokalemia
70
brugada
Brugada syndrome is an inherited sodium channel abnormality that leads to arrhythmias in young men.
71
The Gαq subunit
The Gαq subunit is part of a G-protein pathway that activates phospholipase C (PLC) after exchanging guanosine diphosphate (GDP) for guanosine triphosphate (GTP). As a result, PLC splits phosphatidylinositol bisphosphate (PIP2) into diacylglycerol (DAG) and inositol trisphosphate (IP3). As a result, protein kinase C is activated and calcium levels increase intracellularly resulting in muscle contraction.
72
amiodarone mechanism
prolonging the repolarization phase via potassium channel blockade.
73
how to improve HDL
aerobic exercise and weigh tloss
74
how can an epidural hematoma present (what type of herniation)
causes increased ICP transtentorial herniation CN III palsy
75
acute kidney injury can lead to what electrolyte imbalance
hyperkalemia
76
which BB acts by decreasign phase 4 of pacemaker cells
The β-blocker metoprolol is the only cardioselective β-blocker among the options listed. It acts by decreasing the slope of phase 4 in cardiac pacemaker cells.
77
old pt has P.HTN i chose BMP2 is the cause
Patients with hereditary pulmonary arterial hypertension typically present at a younger age and do not have pulmonary crackles.
78
reinke crystals
Reinke crystals are found in Leydig cell tumors of the testis. They are plump, rod-like cytoplasmic inclusions. Cytoplasmic inclusionLeydig cell tumor Bottom Line:
79
mechanism of fibrates
Fibrates activate peroxisome proliferator-activated receptor α to decrease expression of 7-α-hydroxylase, which catalyzes the rate-limiting step of bile acid synthesis.
80
risk factor for AAA
smoking atherosclerosis HTN is more for thoracic AA
81
pressures of heart
The right atrium has a normal mean pressure range of 1-8 mm Hg. The right ventricle has a normal pressure range of 1-30 mm Hg. The mean pulmonary artery wedge pressure is normally 4-12 mm Hg and identical to that of the pulmonary artery diastolic pressure. The left ventricle would normally have a dramatically higher peak systolic pressure (>90 mm Hg).
82
causes of dialated cardiomyopathy
Dilated cardiomyopathy has several causes, including chronic alcohol abuse, beriberi, coxsackie B myocarditis, chronic cocaine use, Chagas disease, and doxorubicin toxicity.
83
causes of dialated cardiomyopathy
Dilated cardiomyopathy has several causes, including chronic alcohol abuse, beriberi, coxsackie B myocarditis, chronic cocaine use, Chagas disease, and doxorubicin toxicity.
84
granulomatous inflammation with mononuclear and giant cells
giant cell arteritis
85
mitarzapine
Mirtazapine is a selective α2-receptor antagonist used in the management of depression.
86
granulomatous inflamamtion of cardiac myocytes is a sign of
Granulomatous inflammation of cardiac myocytes is characteristic of infiltrative diseases such as sarcoidosis.
87
dialated CM after viral infectino
autoimmune attack on cardiomyocytes
88
incidence formula
new cases / population at RISK | so subtract ppl that already have diseas
89
amiodarone works on which phases of action potential
phase 2 3
90
how does norepi effect heart rate
it decreases heart rate | a1 causes vasoconstricton which increases blod flow bak to heart... this increases SV ... and lowers hr
91
which heart tumor is assoc with Tuberous sclerosis
rhabdomyoma
92
seizures, intellectual disability, and facial angiofibromas
TS
93
turner has a specific typoe of coarctation of aorta
The most common is coarctation of the aorta, a congenital narrowing of the descending aorta, usually just distal to the origin of the left subclavian artery and opposite the ductus arteriosus (and so termed "juxtaductal"). If the left subclavian artery is involved, juxtaductal coarctation of the aorta can result in a small left arm because of compromised blood flow.
94
central line technique
lateral to commmon carotid artery
95
MVP murmur increased by
valsalva | low flow brings the mid systolic click closer to S1
96
s1q3t3 found in
P embolism
97
which antiarrythmic can cause tosade pointes
``` class I a and III ibutilide ```
98
tyoes of amyloidosis
AL amyloidosis, also known as primary amyloidosis, which is due to immunoglobulin light chain deposition arising from bone marrow antibody production (most common type) AA amyloidosis, also known as secondary amyloidosis, which occurs as a consequence of chronic inflammation β2-microglobulin amyloidosis, which is related to long-term dialysis in patients with renal failure Familal/senile ATTR amyloidosis, which is either inherited or acquired in old age
99
wpw treatment
procainamide 1A
100
hydralazine most imp side effect
sudden vasodialataion ... activate baroreflex | can cause angina
101
increase her cardiac contractility and decrease her peripheral vascular resistance.
milrinone | pde5 inhibitors

2024 - élo - usmle rx qbank (29 decks)

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