cardio p 296 - 300

Question 1

what path is associated with systolic regurgitation murmur, balloon appearance of heart on CXR?

Answer 1

dilated cardiomyopahty

Question 2

what is the path that is associated with hypertrophic cardiomyopathy, muscle weakness, loss of DTR, vibratory sense, and proprioception?

Answer 2

Friedreich ataxia

Question 3

define kussmaul sign

Answer 3

inc JVP on inspiration instead of a normal dec

Question 4

explain the mech of kussmaul sign

Answer 4

during inspiration –> negative intrathoracic pressure is not transmitted to the heart –> impaired filling of the Rt. ventricle –> blood backs up into vena cava and inc JVD during inspriation

Question 5

name 3 paths associated with kusmmaul sign

Answer 5

1. constrictive pericarditis
2. restrictive cardiomyopathies
3. Rt atrial/ventricular tumors

Question 6

what is the most common cardiac tumor in child?

Answer 6

rhabdomyomas (associated with tuberous sclerosis)

Question 7

what path is associated with “multiple tumor plop” sound?

Answer 7

myxomas

Question 8

90% of the myxoma takes place in

Answer 8

Lt. atrium

Question 9

what kind of obstruction is seen in myxoma?

Answer 9

ball valve obstruction (pedunculated mass) in the Lt. atrium

Question 10

what is the most common heart tumor?

Answer 10

metastasis

Question 11

what particular structure is disrupted in 3’ syphilis?

Answer 11

vasa vasorum

Question 12

what mutation is associated with hypertrophic cardiomyopathy?

Answer 12

beta myosin heavy-chain mutation

Question 13

what is the main cause of death in hypertrophic cardiomyopathy?

Answer 13

ventricular arrhythmia

Question 14

in hypertrophic cardiomyopathy, what leads to the outflow obstruction?

Answer 14

asymmetric septal hypertrophy and systolic motion of mitral valve

Question 15

symptoms of hypertrophic cardiomyopathy?

Answer 15

syncope, dyspnea

Question 16

what type of hypertrophy do you see in dilated cardiomyopathy?

Answer 16

eccentric

Question 17

name all the etiologies for dilated cardiomyopathy?

Answer 17

alcohol
wet beriberi
coxsackie B virus myocarditis
cocaine
chagas
doxorubicin
hemochromatosis
sarcoidosis
peripartum cardiomyopathy

Question 18

what is the name of the path associated with endomyocardial fibrosis with a prominent eosinophilic infiltrate in restrictive cardiomyopathy?

Answer 18

Loffler syndrome

Question 19

what is the characteristic of ECG for restrictive/infiltrative cardiomyopathy?

Answer 19

low voltage ECG despite thick myocardium

Question 20

name 4 causes for restrictive/infiltrative cardiomyopathy

Answer 20

1. sarcoidosis
2. amyloidosis
3. postradiation fibrosis
4. endocardial fibroelastosis (thick fibroelastic tissue in endocardium of young children)

Question 21

what treatment of HF improves both symptoms and mortality?

Answer 21

hydralazine with nitrate

Question 22

what treatment of HF is used for symptomatic relief?

Answer 22

thiazide/loop diuretics

Question 23

the diff btw systolic vs diastolic dysfunction?

Answer 23

EF is reduced in sysotlic (normal is diastolic)

EDV is inc in systolic (normal in diastolic)

Question 24

what is the 1st sign of shock?

Answer 24

tachycardia

Question 25

symptoms of systemic inflammatory response syndrome?

Answer 25

fever/hypothermia, tachycardia, tachypnea, leukocytosis/leukopenia

Question 26

most likely culture neg bacterial endocarditis?

Answer 26

Coxiella burnetii, Bartonella spp and HACEK

Question 27

name examples of nonbacterial endocarditis

Answer 27

marantic/thrombotic secondary to malignancy, hypercoagulable state, lupus

Question 28

what is the early/late lesion of rheumatic fever?

Answer 28

early: mitral valve regurge late: mitral stenosis

Question 29

treatment/prophylaxis for rheumatic fever?

Answer 29

penicillin

Question 30

explain anitschkow cells

Answer 30

"activated histiocyte" enlarged macrophages with ovoid, wavy, rod-like nucleus

Question 31

what is the order of the most affected valve to the least affected valve in rheumatic fever?

Answer 31

mitral > aortic >> tricuspid (high pressure valve is affected most)

Question 32

what are the ECG changes in acute pericarditis?

Answer 32

widespread ST segment, T wave inversion, ST elevation, PR depression

Question 33

name all the causes for acute pericarditis?

Answer 33

1. idiopathic (most common, presumed viral) 2. confirmed infection (coxsackievirus) 3. neoplasia 4. autoimmune (SLE, rheumatoid arthritis) 5. uremia 6. cardiovascular (acute STEMI, Dressler) 7. radiation therapy

Question 34

what is the characteristics of pain in acute pericarditis?

Answer 34

sharp pain, aggravated by inspiration, relieved by sitting up