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Flashcards in Cardio Deck (98)
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61

What are the locations & corresponding leads...inferior? anterior?

inferior => II, III, aVF

anterior=> V1-V6

62

What does the PR interval depend on? tachycardia?

depends on conduction velocity through AV node & HR;
shortens

63

Differentiate Mobitz type I vs type II AV blocks

PR interval in type I lengthens until beat is dropped;

PR interval remains constant before dropped beat in type II

64

What is a mural thrombus? what is a risk factor for LA mural thrombus?

adheres to wall of heart or artery;

mitral stenosis is risk factor for LA mural thrombus

65

What is MCC of atrial fib in US?

HTN

66

What is the initial DOC for Tx of primary HTN?

thiazides

67

How do ACE-inhibitors lower mortality & morbidity in diabetic HTN?

decrease renal HTN by decreasing efferent arteriolar vasoconstriction to decrease intraglomerular pressure to lessen proteinuria

68

Define primary aldosteronism

HTN, hypokalemia, metabolic acidosis (increased aldosterone, decreased renin)

69

Medial calcification of radial, ulnar, tibial, uterine or femoral arteries have what Sx?

benign medial calcification of medium sized arteries does NOT INVOLVE the intima so does NOT obstruct arterial flow

70

Define arteriolosclerosis. When is it most often seen?

affects intima of small arterioles & arteries;
seen in elderly, diabetics, metabolic syndrome, HTN

71

Differentiate the 2 types of arteriolosclerosis

hyaline => protein deposits in arterial wall to narrow lumen => seen in diabetics due to NEG;
=>in HTN pt from pressure forcing proteins into wall causing increased muscle & elastic tissue

hyperplastic => malignant HTN => increased smooth muscle proliferation & BM duplication to onion skinning

72

Where are aneurysm's typically found? why?

below level of renal arteries due to fewer vasa vasorum in the media of these vessels leading to increased risk & damage of ischemia

73

What is the MC etiology of myocarditis?

viral => coxsackie B, rubella, CMV => lymphocytic infiltrates

74

When is bacterial myocarditis seen? what are usual bugs?

immundodeficiency/suppression =>
S aureus; Corynebacterium diphtheriae, Haemophilus influenzae

75

Other than bacteria, pt w/ HIV get myocarditis how?

toxoplasmosis or Kaposi's sarcoma

76

What are diseases & Rx that can cause myocarditis?

Chagas, Lyme, acute renal failure, rheumatic fever, lupus, doxorubicin

77

How does myocarditis present?

muffled S1; S3; MR murmur

diffuse T wave inversion & ST elevations => Bx is best Dx

78

Bacterial cause of endocarditis assoc w/ prosthetic device

Staph epidermis w/in first 6 months;

after 6 mo then S. aureus & viridans

79

Bacterial cause of endocarditis assoc w/ colon cancer

Strept bovis

80

Bacterial cause of endocarditis assoc w/ dental procedure

Stept viridans

81

Bacterial cause of endocarditis assoc w/ GI surgery

enterococcus

82

Bacterial cause of endocarditis assoc w/ total parenteral nutrition

fungal

83

Bacterial cause of endocarditis assoc w/ alcoholics or homeless

Bartonella henselae

84

Bacterial cause of endocarditis assoc w/ fastidious & culture negative

HACEK organisms => Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella

85

Nutmeg liver on histology

congestion of centrilobular veins surrounded by paler region

86

What are the treatments for acute decompensated CHF?

LMNOP
Lasix (furosemide);
Morphine
Nitrates;
O2;
Position upright

87

Murmur of MVP is seen in who? what makes it worse?

Marfan's & young women; SLE; mucopolysaccharidoses (hurler & hunter); hypothyroidism; Ehlers-Danlos
Valsalva makes it worse

88

What does S3 in older adult mean?

occurs in early diastole & implies volume overload

89

What does TR murmur increase w/ inspiration?

blowing holosystolic murmur at L LSB due to increase in venous return to R side of heart

90

What are the ONLY 2 murmurs that do not increase intensity w/ squatting & decrease in intensity w/ valsalva?

MVP & hypertrophic cardiomyopathy