Cardio

Question 1

What gives rise to the ascending aorta and pulmonary trunk

Answer 1

Trucus arteriosus

Question 2

What gives rise to the smooth parts (outflow tract) of left and right ventricles?

Answer 2

Bulbus cordis

Question 3

What gives rise to the trabeculated part of the left and right atria?

Answer 3

primitive atria

Question 4

What gives rise to the trabeculated part of left and right ventricles?

Answer 4

primitive ventricle

Question 5

What gives rise to the smooth part of the left atrium?

Answer 5

primitive pulmonary vein

Question 6

What gives rise to the coronary sinus?

Answer 6

Left horn of sinus venosus

Question 7

What gives rise to the SVC?

Answer 7

right common cardinal vein and right anterior cardinal vein

Question 8

When does the heart start to beat?

Answer 8

week 4

Question 9

What causes a patent foramen ovale (PDA)?

Answer 9

septum primum and septum secundum failure to fuse after birth. Can lead to paradoxical emboli

Question 10

What is the most common location of a VSD?

Answer 10

membranous septum

Question 11

Where does coronary artery occlusion most likely occurs?

Answer 11

in the LAD (left anterior descending artery)

Question 12

What drug treats subarachnoid hemorrhage by preventing cerebral vasospasm?

Answer 12

nimodipine-dihydropyridine CCB

Question 13

What is fenoldopam?

Answer 13

D1 receptor agonist that vasodilates almost everything. Decreases BP and increases natriuresis.

Question 14

What hypertensive emergency med can be used in patients with renal insufficiency?

Answer 14

fenoldopam, since it increases renal perfusion.

Question 15

What antiarrhythmics control rate?

Answer 15

Class II (B-blockers) and Class IV (CCB)– pacemaker potential will be shown on a test question

Question 16

What antiarrhythmics control rhythm?

Answer 16

Class I (Na channel blockers) and Class III (K+ channel blockers)–will show myocyte AP on test question

Question 17

What is it called when there is narrowing of the small arterioles?

Answer 17

Arteriolosclerosis

Question 18

What are the 2 type of arteriolosclerosis?

Answer 18

hyaline and hyperplastic

Question 19

What are the main cuases of hyaline arteriolosclerosis?

Answer 19

benign HTN and diabetes

High BP pushes proteins into the vessel wall; non-enzymatic glycosylation of basement membrane makes the wall leaky so proteins can leak in

Question 20

What is the pathogenesis of hyaline arteriolosclerosis?

Answer 20

proteins leak into the vessle wall producing vascular thickening. Porteins seen as pink hyaline on microscopy

Question 21

What are the consequences of hyaline arteriolosclerosis?

Answer 21

Can causes glomerular scarring and lead to chronic renal failure

Question 22

What is the pathogenesis of hyperplastic arteriolosclerosis?

Answer 22

thickening of the vessel wall via hyperplasia of smooth muscle leading to an onion skin appearance, not as pink as hyaline

Question 23

What is the major causes of hyperplastic arteriolosclerosis?

Answer 23

malignant HTN

smooth muscle tries to multiply to try and contain the super high BP

Question 24

When do you seen fibrinoid necrosis?

Answer 24

1. Malignant HTN
2. Vasculitis

Question 25

What are the main consequences of hyperplastic arteriolosclerosis?

Answer 25

acute renal fialure with **flea bitten** appearance

Question 26

What is thickening of the medium/large vessels in the intima called?

Answer 26

Atherosclerosis

Question 27

What are the 2 requirements for formation of an aortic dissection?

Answer 27

needs to occur in a high stress region (first 10cm of the aorta) and with preexisting weakness of the media

Question 28

What is the most common cause of aortic dissection?

Answer 28

**HTN**. Leads to arteriolosclerosis of vasa vasorum, which lessens the blood flow to the CT of the media causes atrophy of the media.

Question 29

What is the most common causes of death associated with an aortic dissection?

Answer 29

pericardial tamponade

Question 30

What is the classic cause of thoracic aneurysm?

Answer 30

ertiary syphilis due to endarteritis of vasa vasorum wwhich leads to atrophy of the vessel wall, **tree bark appearance of vessel wall**

Question 31

What type of aneurysm are Marfan's patients likely to experience?

Answer 31

thoracic aortic aneurysm

Question 32

What is the pathogenesis of AAA?

Answer 32

AA doesn't have a vaso vasorum, so if pt develops atherosclerosis in the AA, then the wall gets less O2 and leads to atrophy and predisposes to an aneurysm.

Question 33

What triad is associated with AAA?

Answer 33

Hypotension, pulsatile abdominal mass, and flank pain

Question 34

What percentage of an artery needs to be stenosed for there to be symptoms?

Answer 34

70%

Question 35

With subendocardial ischemia, will you see ST depression or elevation?

Answer 35

ST depression

Question 36

Which coronary artery supplies the papillary muscles?

Answer 36

RCA

Question 37

What congenital heart disorder is associated with fetal alcohol syndrome?

Answer 37

Ventricular septal defect

Question 38

What congenital heart disease is associated with Down's Syndrome?

Answer 38

ASD of ostium primum

Question 39

What congenital heart disease is associated with congenital rubella?

Answer 39

PDA

Question 40

What congenital heart disease is associated with TUrner Syndrome?

Answer 40

Coarctation of the aorta, infantil type

Question 41

What congenital heart disease is assocaited with maternal diabetes?

Answer 41

Transposition of the great vessels

Question 42

How is digoxin cleared?

Answer 42

Renal clearance

Question 43

How should treatment with digoxin be modified in elderly patients?

Answer 43

Need reduced levels of digoxin since their renal function decreases. (Even if normal creatinine levels, still give reduced levels of digoxin)

Question 44

Statins combined with which drugs have increased risk of rhabdomyolysis?

Answer 44

fibrates and niacin (fenofibrate causes myopathy and gemfibrozil just increases the concentration of statins in the blood, increasing risk of myopathy)

Question 45

Combination of which two lipid lowering agents increases the risk of cholesterol gallstones?

Answer 45

fibrinic acid derivatives and bile-acid binding resins

Question 46

What is the best drug for lowering TG levels?

Answer 46

Fibrates

Question 47

Which vasculitis have granulomatous inflammation?

Answer 47

Wegeners (granulomatosis with polyangiitis), Temporal Giant cell, Takayasu, Churg-Strauss

Question 48

Which vasculitis are necrotizing?

Answer 48

polyarteritis nodosa, Buerger (thromboangiitis obliterans), Microscopic polyangiitis, Churg-Strauss, Kawasaki

Question 49

What arteries are affected in Takayasu?

Answer 49

aortic arch at branching points

Question 50

What is the classic Takayasu patient?

Answer 50

young asian woman with abset pulse in upper extremity, visual and neurologic sxs. Elevated ESR

Question 51

High yield facts about Polyarteritis Nodosa?

Answer 51

Lungs spared, HBsAg association, fibrinoid necrosis, string of pearls appearance, tx corticosteroids.

Question 52

High yield facts about Kawasaki?

Answer 52

asian children, nonspecific viral sxs, rash of palms and soles, coronary artery involvement (MI in child, think Kawasaki), Tx aspirin and IVIG

Question 53

High yield association of Brueger's?

Answer 53

necrotizing vasculitis due to heavy smoking, gangrene and autoamputation of fingers and toes

Question 54

How do you treat wegeners?

Answer 54

cyclophosphamide

Question 55

How is Microscopic Polyangiitis different from Wegeners?

Answer 55

Microscopic polyangiitis- no nasopharyngeal involvement and no granulomas. p-ANKA + (tx same as wegeners, cyclophosphamide)

Question 56

High yield facts aout Churg-Strauss Syndrome?

Answer 56

necrotizing granulomatous inflammtion with eosinophils. Associated with **asthma and peripheral eosinophilia**. p-ANKA +

Question 57

High yield facts about Henoch-Schonlein Purpura?

Answer 57

IgA immune complex deposition, most common vasculitis in children. **Palpable purpura** on butt and legs, GI pain and bleeding, and hematuria (IgA nephropathy). Follows URI.

Question 58

Common cause of secondary HTN?

Answer 58

Renal artery stenosis

Question 59

What causes renal artery stenosis? (2)

Answer 59

atherosclerosis in elderly males fibromuscular dysplasia in young females

Question 60

What are the most common locations for atheroscledrosis?

Answer 60

AA\>coronary artery\>popliteal\>internal carotid artery

Question 61

Modifiable risk factors for atherosclerosis?

Answer 61

HTN, hypercholesterolemia, smoking, diabetes

Question 62

Nonmodifiable risk factors of atherosclerosis?

Answer 62

age, gender (male, postmenopausal female), genetics

Question 63

What are the complications of atherosclerosis?

Answer 63

peripheral vascular disease, angina, and ischemic bowel disease

Question 64

What is a major complication of thoracic aneurysm?

Answer 64

aortic valvue insufficiency

Question 65

What cancer is caused by polyvinyl chloride?

Answer 65

liver angiosarcoma

Question 66

How can you tell the difference between hemangioma and kaposi sarcoma?

Answer 66

hemangioma- press and it will blanch kaposi- press and it will not blanch, blood not in vessels, simply interspersed between endothelial cells

Question 67

Most common cause of death in sudden cardiac death?

Answer 67

fatal ventricular arrhythmia

Question 68

What are aschoff bodies and anitschkow cells and what are they associated with?

Answer 68

Associated with myocarditis due to acute rheumatic fever. Aschoff bodies are granulomas with giant cells and contain anitschkow cells, enlarged macrophages with wavy nuclei

Question 69

What do the jones criteria describe?

Answer 69

Sxs of acute rheumatic fever