Cardio Flashcards
(108 cards)
0
Q
Palpitation and nighttime
Head pounding with exertion
A
Widened Pulse pressure
Palpitation result from forceful ventricular contraction ejecting large stroke volume.
Head pounding can be due to unusually high amplitude pulsation of intracranial artery with each heartbeat
Head bobbing can be a sign
Widened Pulse pressure +large LV stroke volume and a heart murmur is aortic regurgitation
1
Q
has a presystolic sound on cardio that immediately precede the first heart sound and is best hurt when the patient turns to His left side.
A
S4
2
Q
AV shunt increases?
A
Preload by increasing the rate and volume of blood flow back to the heart
Results in elongation of diastolic filling
And a higher end-diastolic volume
A decrease total peripheral resistance
Thus also decrease the afterload
3
Q
Truncus arteriosus give rise to?
A
Ascending aorta
Pulmonary trunk
4
Q
Bulbus Cordis give rise to?
A
Smooth part of left and right ventricles
Outflow tract
5
Q
Primitive ventricle give rise to?
A
Trabeculated Left and right ventricle
6
Q
Primitive atria and rise to?
A
Trabeculated left and right atria
7
Q
Left horn of sinus Venosus give rise to?
A
Coronary sinus
8
Q
Right horn of SV give rise to?
A
Smooth part of right atrium
9
Q
Right common cardinal vein and right anterior cardinal vein give rise to?
A
SVC
10
Q
Fetal Erythropoiesis
3-10wk
A
Yolk sac
11
Q
Fetal Erythropoiesis
6 wk-birth
A
Liver
12
Q
Fetal Erythropoiesis
15-30wk
A
Spleen
13
Q
Fetal Erythropoiesis
22wk-adult
A
Bone Marrow
14
Q
Fetal hemoglobin
A
Alpha2
Gamma2
15
Q
Adult hemoglobin
A
Alpha2 beta2
16
Q
Umbilical vein
A
Ligamentum tere hepatis
17
Q
Umbilical artery
A
Ligamentum arteriosum
18
Q
Ductus venosus
A
ligamentum venosum
19
Q
Foramen ovale
A
Fossa ovalis
20
Q
Allantosis
A
urachus-median umbilical ligament
21
Q
Notochord
A
Nucleus pulposus of intervertebral disc
22
Q
right dominate artery
A
right coronary artery
LCA
23
Q
Left dominant artery
A
Left circumflex artery
LCX
24
coronary artery occlusion most likely which artery?
Left anterior descending artery
| LAD
25
coronay artery fills in which phase
diastole phase
| 在收缩期的时候主动脉瓣打开会关闭冠脉，所以无法有血充盈
26
stroke volume is affected by?
Contractility
After load
Preload
27
Venodilator
nitroglycerin
| decrease preload
28
Vasodilator
Hydrazine
| decrease afterload
29
EF normal
>55%
30
what accounts for most of the total peripheral resistance?
Arteriole. the largest gap
| Aorta(100)->Great arteries(95)->small arteries(80-90)->arterioles(45-55) ->cappillary(20-30)-->venoles(10)->RA(0)
31
Velosity difference
Aorta>vena cava>large vein>small arteries>arterioles>small veins>venules>capillary
32
cardiac and vascular function curve, venous return and EDV intersection represents?
mean systemic filling pressure
33
S1
mitral and tricuspid valve closure
| Loudest as mitral area
34
S2
aortic and pulmonary vlave closure
| Loudest at left sternal border
35
S3
in early diastole during rapid filling phase.
associated with increase filling pressures, and dilated ventricle
CHF,mitral regurgitation
normal in children and pregnant women
36
normal splitting
Inspiration
drop in intrathoracic pressure->increase venous return to the RV-->increase RV stroke volume--> increase RV ejection time-->delayed P2
37
Wide splitting
delayed RV emptying:
pulmonic stenosis, right bundle brach block
delayed pulmonic sound
38
fixed splitting
ASD
| left to right shunt->increase RA and RV volume-->increase flow through pulmonic valve such that regardless of breath
39
paradoxical splitting
seen in condition that delay LV emptying
aorta sternosis, Left bundle branch block
P2 before A2
40
heart sound in inspiration
increase intensity of R heart sound
41
heart sound in expiration
increase intensity of L heart sounds
42
heart sound in hand grip
increase systemic vascular resistance
increase intensity of MR, AR, VSD, MVP murmur
decrease intensity of AS, hypertrophic cardiomyopathy
43
Valsalva
decrease intensity of most murmur
increase intensity of MVP, hypertrophic cardiomyopathy
decrease venous return
44
heart sound in rapid squatting
increase venous return, preload, afterload in prelonged
| decrease intensity of MVP, hypertrophic cardiomyopathy
45
Holosystolic, high-pitched"blowing murmur"
MR:apex
TR:tricuspid area
46
crescendo-decrescendo systolic ejection murmur following ejection click
```
AS
EC:abrupt halting of valve leaflets
pulsus parvus et tardus: pulse weak with a delayed peak
Syncope, Angina, Dyspnea
age related or bicuspid.
```
47
Late systolic crescendo murmur with a midstolic click
MVP
MC: due to sudden tensing of chordae tendineae
best heard over apex, loudest at S2
caused by myxomatous degeneration, rheumatic feverchordae rupture
enhanced by maneuver that decrease venous return
48
Immediate high pitched"blowing" diastolic decrescendo murmur.
AR
Wide pulse pressure when chronic;
caused by aortic root dilation, bicuspid aortic valae, endocartidis, rheumatic fever, increase murmur with hand grip, vasodilator decrease intensity of murmur
49
Follows opening snap,delayed rumbling late diastolic murmur
MS
OS:due to abrupt halt in leaflet motion in diastoleafter rapid opening due to fusion at leaflet tips.
LA>>LV pressure during diastole.LA dliation
cuz: rheumatic fever
enhanced by maneuver that increase LA return(expiration)
50
Continuous machine like murmur
PDA
loudest at S2, best heard at left intraclavicular area
congenital rubella, prematurity
51
cardiac myocyte are coupled with each other by?
gap junction
52
speed of conduction:
| Purkinje, AV, A,V
P>A>V>AV
53
torsade de pointe
present?
cuz?
treat?
ventricular tachy
anything that prolong QT
Mg sulfate
54
congenital long QT
defects in cardiac sodium or potassium channelssensorineural deafness
Jervell and Lange-Nielsen syndrome.
55
pulmonary capillary wedge pressure
left atrial pressure
| swan-ganz catheter
56
coarctation of the aorta-infantile type
stenosis proximal to insertion of ductus arteriosus
57
coarctation of the aorta
| adult type
```
stenosis is distal to ligamentum arteriosum
notching of rib
hypertension in upper extremity
weak pulse in the lower extremity
associated with bicuspid aorta valve
```
58
bicuspid valve will result in?
aorta stenosis in the 60s
| normally happen in the 70s and 80s if it is age related.
59
late cyanosis in the lower extremity?
uncorrected PDA
60
22q11 syndrome result in?
Truncus arteriosus
| tetralogy of fallot
61
Down syndrome
ASD, VSD, AV septal defect
62
Congenital rubella
septal defect
PDA
pulmonary artery stenosis
63
Turner syndrome
coarctation of aorta,preductal
64
Marfan's syndrome
Aortic insufficiency and dissection
late complication
valve prolapse
65
Infant of DM mom
Tranposition of great vessels
66
Atheromas
plaques in blood vessels
67
Xanthomas
plaques or nodules composed of lipid laden histiocytes in the skin,especially the eye lids
68
Tendinous xanthoma
lipid deposition in tendon, especially Achilles
69
Corneal arcus
lipid deposit in cornea
nonspecific
arcus senilis
70
Monckeberg arteriosclerosis
Calcification in the media, intima not invovled
radial or ulnar
pipestem artery
do not obstruct blood flow
71
Arteriolosclerosis
hyaline: hypertension or DM
| hyperplastic(onion skin): malignant hypertension
72
Atherosclerosis
Fibrous plaques and atheromas form in intima of arteries
elastic artery and large,media size artery
SMOKING!!!!!!POSTMENOPAUSAL WOMEN!!!!!!!
endo dysfunction->Macro and LDL accumulation-->foam cell->fatty streaks-->smooth muscle migration(PDGF, FGF), ECM deposition ->fibrous plaque
73
Atherosclerosis most common happen in?
Abdominal aorta
74
abdominal aneurysm is associated with?
atherosclerosis
| HTN male>50yrs
75
thoracic aneurysm is associated with
hypertension
cycpstic media necrosis: Marfan Syndrome
historically 3 syphilis
76
aortic dissection is associated with?
| BMCH
HTN
bicuspid aortic valve
cystic medial necrosis: marfan
connective tissue disorder
77
aortic dissection CXR presentation
mediastinal widening
78
cystic medial necrosis is 2ndary to?
Marfan in young ppl
HTN in old ppl
small cleft like seperation between elastic and fibromuscular element
79
ST depression angina
Stable and unstable angina due to AS
ischemic necrosis of <50% of ventricle wall
subendocardium
80
ST elevation angina
```
Prinzmetal's variant
2nd to coronary spasm
increase necrosis
affects entire wall
have Q wave
```
81
coronary steal syndrome
vasodilator aggravate ischemia by shunting blood from area of ischemia to place with higher perfusion
82
sudden cardial death is due to?
lethal arrhythmia and CAD
83
ECG can be used for diagnosis within?
6hours
| gold standard
84
troponin I can be used for diagnosis within?
after 4hours and 7-10days
85
CK-MB and be used for diagnosis with in?
48hrs, not helpful after 3 days
| can also be found in skeleton muscle damage
86
infarction of anterior wall
LAD
| V1-4
87
infarction of the anteroseptal wall
LAD
| V1-V2
88
infarction of anterolateral wall
LCX
| v4-V6
89
infarction of the lateral wall
LCX
| I, aVL
90
infarction of Inferior wall
RCA
| II, III, aVF
91
Dressler's syndrome
autoimmune resulting in fibrinous pericarditis
| several weeks post MI
92
cartid bruit
Amanurosis fugax
| AS of cartid vessels
93
heart sound in cardiomyopathy
dilated: S3
hypertrophic: S4
94
Loffler syndrome
endomyocardinal fibrosis with a prominent eosinophil infiltration
95
beta-myosin heavy chain mutation is found in?
hypertrophic cardiomyopathy
AD
associated with Fredreich's ataxia
96
cause of death in young atheles? sudden
hypertrophic cardiomyopathy
97
Roth's spot
round white spots on retina surrounded by hemorrhage
| bacterial endocarditis
98
Osler's nodes
tender raised lesion on finger or toe pads
| bacterial endocarditis
99
Janeway lesions
small, painless, erythematous lesions on palm or sole
| bacterial endocarditis
100
tricuspid endocarditis is freq associated with?
iv drug abuse
S. aureus
Pseudomonas
Candida
101
pulsus paradoxus
decrease amplitude of systolic blood pressure>10mmHg during inspiration.
seen in severe cardiac tamponade, asthma, obstructive sleep apnea pericarditis and croup.
102
kussmaul sign
increase systemic venous pressure with inspiration,JVP increase
normal: decrease
cause: negative intrathoracic pressure or transmitted to heart
103
tree bark appearance of the aorta
syphilitic heart disease
calcification of the aortic arch.
disrupts vasa vasorum of aorta with atrophy of vessel wall and dilation of the aorta and valve ring
104
multiple syncopal episode
myxomas
| ball valve obstruction in the left atrium
105
1 freq tumor of cardiac in children
Rhabdomyomas
| tuberous sclerosis
106
pain aggravated by inspiration and relieved by sitting up and lean forward, friction rub.
acute pericarditis
| ST elevation and PR depression.
107
Raynaud disease and syndrome
primary and 2nd
| finger turn white with decrease temp, due to vasospasm
