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USMLE Step 1 Random Facts > Cardio > Flashcards

Flashcards in Cardio Deck (106):
1

cardiac tissue conduction velocity

purkinje system --> atrial muscle --> ventricular muscle --> AV node

"Park AT VENTura AVenue"

2

P-wave

atrial depolarization

3

PR interval

conduction delay thru AV node (<200 ms)

4

QRS complex

ventricular depolarization (<120 ms)

5

QT interval

mechanical contraction of ventricles (depol + repol)

6

T-wave

ventricular repolarization

7

T-wave inversion indicates?

recent MI

8

ST segment

ventricles depolarized

9

U-wave caused be?

hypokalemia, bradycardia

10

preference for Pacemaker activity?

SA > AV > bundle of His/Purkinje/ventricles

11

conduction pathway of heart?

SA node --> atria --> AV node --> common bundle --> bundle branch --> Purkinje fibers --> ventricles

12

AV node delay?

100 ms --> allow for ventricular filling

13

how do ventricles depolarize?

from apex to base and endocardium to epicardium

14

ST elevation indicates?

transmural MI

15

QRS interval prolongation indicates?

ventricular dyssynchrony or slowed intraventricular impulse conduction

16

prolonged QT interval

torsades de pointes

17

no discrete P-waves

Afib

18

"sawtooth" appearance of waves

atrial flutter

19

no identifiable waves

Vfib

20

common cause of Vfib in <30 y.o pt

hypertrophic cardiomyopathy

21

PR interval prolonged

1st degree AV block

22

P-wave not followed by QRS complex

2nd degree AV block = Mobitz type I = Wenckebach

23

distinguishing feature of Wenckebach

progressive lengthening of PR interval until beat "dropped"

24

2 or more P-waves to 1 QRS complex

Mobitz type II

25

distinguishing feature of Mobitz type II

not preceded by lengthening of PR intervals

26

narrow QRS complex

3rd degree AV block (complete)

27

atria and ventricles beat independently of each other (P waves have no relation to QRS complex)

3rd degree AV block (complete)

atrial rate faster (SA node) than ventricular rate (AV node)

28

uses accessory pathway (bundle of Kent)

WPW synd

29

early ventricular depolarization w/ delta waves at beginning of QRS complex

WPW synd

30

where does ANP work?

medullary collecting tubule

31

what presents w/ sharp chest that is worsened by inspiration and relieved by sitting up/leaning forward?

acute pericarditis

32

striking physical finding of acute pericarditis

friction rub

33

kussmaul's sign description + seen in?

INC in JVP on INSPIRATION instead of NORMAL DEC

constrictive pericarditis
restrictive cardiomyopathies
RA/ventricular tumors
right-sided HF
tricuspid stenosis

34

pulsus paradoxus description + seen in?

dec in amplitude of systolic BP by >= 10 mmHg during INSPIRATION

severe cardiac tamponade
asthma
obstructive sleep apnea
pericarditis
croup

35

bifurcation of abd aorta @ what level?

L4

36

IVC courses through what?

abdomen and inferior thorax in location ANTERIOR to the right half of the vertebral bodies

37

renal veins join IVC @ what level?

L1/L2

38

common iliac veins merge to become IVC @ level

L4

39

fibrinous pericarditis caused by?

Dressler's synd
uremia
radiation

40

serous pericarditis caused by?

viral pericarditis
SLE, RA, etc. (noninfectious inflamm dz)

41

suppurative/purulent pericarditis caused by?

bacterial infections

42

cardiac tamponade triad?

hypotension
increased venous pressure (JVD)
muffled heart sounds

43

"tree-bark" appearance of aorta

tertiary syphilis (disrupts vasa vasorum)

44

cardiac myxomas are ass w/?

multiple syncopal episodes

45

V1-V4 leads w/ Q waves implies infarct in?

anterior wall (LAD)

46

V1-V2 leads w/ Q waves implies infarct in?

anteroseptal (LAD)

47

V4-V6 leads w/ Q waves implies infarct in?

anterolateral (LCX)

48

I, aVL leads w/ Q waves implies infarct in?

lateral wall (LCX)

49

II, III, aVF leads w/ Q waves implies infarct in?

inferior wall (RCA)

50

Cardiac Output (CO) = ?

HR x SV

51

Fick principle?

CO = rate of O2 consumption/(arterial - venous O2)

52

PT for? PTT for?

PT = extrinsic
PTT = intrinsic

"my PET uPITT caused me to BLEED"
PET = PT extrinsic (PT less letter, less factors)
PITT = PTT intrinsic (PTT more letters, more factors)

53

reduced LV compliance indicates what?

diastolic dysfunction ("stiff ventricle")

54

predom mechanism of HF in restrictive cardiomyopathy

diastolic dysfunction ("stiffer ventricle")

55

predom mechanism of HF in dilated cardiomyopathy

systolic dysfunction

56

what can lead to dilated cardiomyopathy?

viral myocarditis
alcohol toxicity
diphtheric myocarditis
doxorubicin/danorubicin tx

57

S1 =

mitral/tricuspid closure
loudest @ mitral area

58

S2 =

aortic/pulmonary valve closure
loudest @ left sternal border

59

S3 =

EARLY diastole
rapid ventricular filling phase
ass w/ increased filling pressures (mitral regurg, CHF) + common in dilated ventricles
normal in children + pregnant women

60

S4 =

"atrial kick"
LATE diastole
ass w/ ventricular hypertrophy
high atrial pressure (LA must push against stiff LV wall)

61

truncus arteriosus forms?

ascending aorta + pulm trunk

62

bulbis cordis forms?

SMOOTH parts of left/right ventricles (outflow tract)

63

primitive ventricle forms?

TRABECULATED left/right ventricles

64

primitive atria forms?

TRABECULATED left/right atria

65

left horn of sinus venosus forms?

coronary sinus

66

right horn of sinus venosus forms?

SMOOTH part of RA (sinus venarum)

67

SVC formed from?

right common cardinal vein and right anterior cardinal vein

68

mean arterial output =

CO x TPR

69

pulse pressure is proportional to?

stroke volume

70

factors that increase SV

increased PRELOAD
decreased AFTERLOAD
increased CONTRACTILITY

71

contractility and SV increased by

catecholamines
increased INTRAcell Ca
decreased EXTRAcell Na
Digitalis (blocks Na/K pump)

72

contractility and SV decreased by

beta blockade
HF
acidosis
hypoxia/hypercapnia
non-dihydropyridine CCB

73

afterload =

MAP

74

histo in temporal (giant cell) arteritis?

focal granulomatous inflamm (branches of carotid a.)

75

histo in Takayasu's arteritis

granulomatous thickening (of media of aortic arch @ branch pts)

76

histo in polyarteritis nodosa (PAN)

transmural inflamm of arterial wall w/ fibrinoid necrosis (except in lungs)

77

weird tx in Kawasaki dz

aspirin (bc never given to children)

78

histo in Buerger's dz (thromboangiitis obliterans)

segmental thrombosing vasculitis (necrotizing vasculitis involving digits) - often of tibial/radial a.

79

histo in microscopic polyangiitis

segmental fibrinoid necrosis (can be caused by AB use - penicillins)
NO granulomas

80

histo in Wegeners granulomatosis (granulomatosis w/ polyangiitis)

focal necrotizing vasculitis
necrotizing granulomas in lung
necrotizing glomerulonephritis

81

histo in Churgg-Strauss synd

granulomatous necrotizing vasculitis w/ eosinophilia (diff from MP)

82

histo in Henoch-Schonlein purpura

vasculitis 2ndary to IgA complex depositions

83

ECG changes in V1-V4, V5

LAD (anterior wall)

84

ECG changes in V1-V2

LAD (anteroseptal)

85

ECG changes in I, aVL

LCX (lateral wall)

86

ECG changes in V4-V6

LCX (anterolateral)

87

ECG changes in II, III, aVF

RCA (inferior wall)

88

common cause of death BEFORE reaching hospital in MI pts

arrhythmia (Vfib)

89

common cause of death in pt hospitalized for MI

cardiogenic shock (esp if large infarct)

90

cardiac tamponade in post-MI pt

ventricular wall rupture (up to 14 days after)

91

severe mitral regurg in post-MI pt

papillary muscle rupture

92

new VSD in post-MI pt

interventricular septum rupture

93

embolus from mural thrombus in post-MI pt

ventricular aneurysm formation (common 1 wk after)

94

friction rub 1-3 days after MI

fibrinous pericarditis

95

pulmonary wedge pressure is pretty equivalent to?

LA pressure

96

murmurs heard @ right 2nd ICS adjacent to sternum (aortic area)

SYSTOLIC MURMURS!
aortic stenosis (radiates to neck [carotids])
flow murmur
aortic valve sclerosis

97

murmurs heard @ left sternal border

systolic murmurs:
hypertrophic cardiomyopathy

diastolic murmurs:
aortic regurg (if caused by aortic root dilation, heard best @ RIGHT sternal border)
pulmonic regurg

98

murmurs heard @ left 2nd ICS adjacent to sternum (pulmonic area)

systolic ejection murmurs!
pulmonic stenosis
flow murmur (ex. ASD [mid-systolic ejection murmur])

99

murmurs heard @ left 4th ICS adjacent to sternum (aka "left lower sternal border" or the tricuspid area)

pansystolic murmurs:
tricuspid regurg (radiates to right sternal border)
VSD

diastolic murmur:
tricuspid stenosis
ASD

100

murmurs heard @ left 5th ICS at midclavicular line (apex of heart) (mitral area)

systolic murmur:
mitral regurg (radiates toward axilla)
MVP (late systolic crescendo w/ midsystolic click; loudest @ S2)

diastolic murmur:
mitral stenosis

101

murmur heard @ left infraclavicular region

PDA

102

valsalva increases intensity of what murmurs

MVP, hypertrophic cardiomyopathy

103

rapid squatting decreases the intensity of what murmurs

MVP, hypertrophic cardiomyopathy

104

in pacemaker action potential, what phase determines HR and how

slope of phase 4 (Na channels)

105

increasing afferent baroreceptor firing does what to HR?

decreases HR

106

Cushing reaction triad

HTN
resp depression
BRADYcardia! (due to reflex baroreceptor-induced)