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CVS Flashcards

1
Q

Young Liver Synthesizes Blood

A

Yolk sac (3-8wks)

Liver (6wks-birth)

Spleen (10-28wks)

Bone marrow (18wks-adult)

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2
Q

SA and AV node supplied by what blood vessel

A

RCA

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3
Q

CO=

A

SV x HR

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4
Q

Fick principle

CO=

A

Rate of O2 consumption / (arterial O2 content - venous O2 content)

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5
Q

MAP=

A

CO x TPR

2/3 DP + 1/3 SP

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6
Q

SV=

A

EDV-ESV

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7
Q

SV affected by CAP

A
  • Contractility
  • Afterload
  • Preload
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8
Q

Contractility (and SV) increased with (4)

A
  1. Catecholamines: increasing Ca pump activity
  2. Increase intracellular Ca
  3. Decrease extracellular Na
  4. Digitalis
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9
Q

Contractility (and SV) decreased with (5)

A
  1. β-blockers
  2. HF and systolic dysfunction
  3. Acidosis
  4. Hypoxia/hypercapnea
  5. Ca channel blockers
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10
Q

What decreases preload

A

Venodilators (Nitroglycerin)

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11
Q

What decreases afterload

A

Vasodilators (Hydralazine)

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12
Q

Ejection Fraction (EF)=

A

SV/EDV

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13
Q

Aortic area systolic murmur is due to

A

Aortic stenosis

Flow murmur

Aortic Valve sclerosis

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14
Q

Pulmonic area systolic ejection murmur heard in

A

Pulmonic stenosis

Flow murmur

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15
Q

Tricuspid area pansystolic murmur heard in

A

Tricuspid regurgitation

Ventricular spetal defect

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16
Q

Tricuspid area diastolic murmur heard in

A

Tricuspid stenosis

ASD

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17
Q

Hand grip (increased vascular resistance) increases intensity of all murmurs excpet

A

ASD

Hypertrophic cardiomyopathy

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18
Q

P wave represents

A

Atrial depolarization

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19
Q

PR interval represents

A

Conduction delay through AV node

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20
Q

QRS complex represents

A

Ventricular depolarization

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21
Q

QT interval represents

A

Mechanical contraction of the ventricles

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22
Q

T wave represents

A

Ventricular repolarizatioin

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23
Q

ST segment represents

A

Isoelectric, ventricles depolarized

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24
Q

U wave represents

A

Caused by hypokalemia and bradycardia

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25
**S**ome **R**isky **M**eds **C**an **P**rolong **QT**
1. **S**otalol 2. **R**isperdone 3. **M**acrolides 4. **C**hloroquine 5. **P**rotease inhibitors (**-navir**) 6. **Q**uinidine 7. **T**hiazides
26
Romano-Ward syndrome is
AD congenital long QT syndrome Pure cardiac
27
Jervell and Lange-Nielsen syndrome
AR congenital long QT syndrome Sensorineural deafness
28
What causes 3rd degree (**complete**) heart block
Lyme disease
29
Vagus N in aortic arch responds to
Only increase BP
30
Glossopharyngeal N in Carotid sinus responds to
Increase and decease in BP
31
Hypotension sequence on Baroreceptors
* Decrease in arterial P causes decrease in stretch leading to decrease afferent baroreceptor firing * Leads to increase efferent sympathetic firing and decrease efferent parasympathetic stimulation * Leads to: 1. Vasoconstriction 2. Increase HR 3. Increase contractility 4. Increase BP
32
Carotid massage affecet on Baroreceptor
* Increase P on carotid sinus causes increase stretch leading to increase baroreceptor firing * Increases AV node refractory period and decrease HR
33
Transposition of great vessels seen in
Infants of Diabetic mothers
34
Tetralogy of Fallot **PROV**e
1. **P**ulmonary infundibular stenosis 2. **R**VH 3. **O**verriding aorta 4. **V**SD
35
Infantile type Coarctation of the aorta associated with
Turner syndrome
36
MC locations of Atherosclerosis
1. Abdominal aorta 2. Coronary A. 3. Popliteal A 4. Carotid A
37
Thoracic aortic aneurysm associated with
HT Marfan 3o syphilis
38
Leads V1-V4 with Q wave means infarct in
Anterior wall (**LAD**)
39
Leads V1-V2 with Q wave means Infarct in
Anteroseptal (**LAD**)
40
Leads V4-V6 with Q wave means infarct in
Anterolateral (**LAD or LCX**)
41
Leads I and aVL with Q waves means infarct in
Lateral wall (**LCX**)
42
Leads 2, 3 and avF with Q wave means infarct in
Inferior wall (**RCA**)
43
**ABCCCD** of Dilated Cardiomyopathy
1. **A**lcohol abuse 2. **B**eriberi 3. **C**oxsackie B 4. **C**ocaine 5. **C**hagas 6. **D**oxorubicin
44
Endocardial fibroelastosis is
Restrictive cardiomyopathy with thick fibroelastic tissue in young children
45
Löffler syndrome is
Restrictive cardiomyopathy with prominent eosinophilic infiltrate
46
What cardiomyopathy causes decrease EF
Systolic dysfunction Dilated cardiomyopathy
47
Roth spots are
Round white spots on retina surrounded by hemorrhage seen in Bacterial endocarditis
48
Osler nodes are
Tender raised lesions on finger or toe pads seen in Bacterial endocarditis
49
Janeway lesioins are
Small painless, erythematous lesions on palm and sole seen in Bacterial endocarditis
50
Negative-culture bacterial endocarditis caused by
Coxiella burnetii Bartonella
51
Bacterial endocarditis **FROM JANE**
* **F**ever * **R**oth spots * **O**sler nodes * **M**urmur * **J**aneway lesion * **A**nemia * **N**ail-bed hemorrhages * **E**mboli
52
Findings in Cardiac tamponade
1. Beck triad 2. Increase HR 3. Pulsus paradoxus 4. Kussmaul sign
53
Beck triad is
1. Hypotension 2. Distended neck V 3. Distant heart sound
54
Kussmaul sign is
Increase in JVP on inspiration instead of normal decrease
55
Kussmaul seen in
1. Constrictive pericarditis 2. Restrictive cardiomyopathies 3. Right atrial or ventricular tumore
56
Pyogenic granuloma is
Polypoid capillary hemangioma that can ulcerate and bleed
57
Pyogenic granuloma associated with
Trauma and pregnancy
58
Cystic hygroma is
Cavernous lymphangioma of the neck
59
Cystic hygroma seen in
Turner
60
Temporal arteritis associated with
Polymyalgia rheumatica
61
Churg-Strauss syndrome is
Vasculitis with: 1. Asthma 2. Sinusitis 3. Palpable purpura 4. Peripheral neuropathy (**wrist/foot drop**)
62
Churg-Strauss path
Granulomatous necrotizing vasculitis with **eosinophilia**
63
Henoch-Schönlein purpura path
Vasculitis 2o to IgA complex deposition Associated with IgA nephropathy
64
Henoch-Schönlein purpura classic triad
1. Skin: palpable purpura on buttocks/legs 2. Arthraligias 3. GI lesions
65
Henoch-Schönlein purpura often follows
URI
66
How do you treat Primary (**essential**) HT (**4**)
1. Diuretics 2. ACEi 3. ARBs 4. Ca channel blockers
67
How do you treat HT with CHF (**4**)
1. Diuretics 2. ACEi/ARBs 3. β-blockers 4. Aldosterone antagonist
68
How do you treat HT with DM (**5**)
1. ACEi/ARBs 2. Ca channel blockers 3. Diuretics 4. β-blocker 5. α-blocker
69
Mechanism of Ca channel blockers (**-dipine + Diltiazem, Verapamil**)
Block voltage-dependent **L-type** Ca channels reducing muscle contractility
70
What Ca channel blocker given for subarchnoid hemoorhage
Nimodipine
71
Ca channel blocker toxicity (**6**)
1. AV block 2. Edema 3. Flushing 4. Dizziness 5. Hyperprolactinemia 6. Constipation
72
Hydralazine mechanism of action
Increase cGMP causing smooth muscle relation Vasodilates arterioles \> veins **Afterload reduction**
73
What is the first line therapy for HT in pregnancy
Hydralazine and methyldopa
74
Hydralazine toxicity
Lupus-like
75
What is the goal of antianginal therapy
Reduction of myocardial O2 consumption
76
Affect of Nitrates on EDV
Decrease
77
Affect of nitrates on BP
Decrease
78
Affect of Nitrates on contractility
Increase due to Reflex response
79
Affect of Nitrates on HR
Increase due to reflex response
80
Affect of Nitrates on Ejection time
Decrease
81
Affect of β-Blocker on EDV
Increase
82
Affect of β-Blocker on BP
Decrease
83
Affect of β-Blocker on Contractility
decrease
84
Affect of β-Blocker on HR
Decrease
85
Affect of β-Blocker on Ejection time
Increase
86
Affect of β-Blocker + Nitrate on EDV
No effect or a slight decrease
87
Affect of β-Blocker + Nitrate on BP
Decrease
88
Affect of β-Blocker + Nitrate on contractility
Little to no effect
89
Affect of β-Blocker + Nitrate on HR
Decrease
90
Affect of β-Blocker + Nitrate on Ejection time
Little to no effect
91
What β-Blocker contraindicated in Angina and why
Pindolol and Acebutolol because they are Partial agonists
92
-Statins are
HMG-CoA reductase inhibitors
93
-Statin affect on lipds
Greatly decrease LDL Slight increase in HDL Slight decrease in TG
94
-Statin toxicity
Hepatotoxicity Rhabdomyolysis
95
Niacin mechanism of action
Inhibit lipolysis in adipose tissue reducing hepatic VLDL synthesis
96
Niacin affec on lipids
Moderate decrease in LDL Moderate increase in HDL Slight decrease in TG
97
Niacin toxicity
Hyperglycemia (**acanthosis nigricans**) Hyperuricemia (**exacerbates gout**)
98
Ezetimibe mechanism of action
Prevents cholesterol absorption at small intestine brush border
99
Ezetimibe affect on lipids
Moderate decrease in LDL
100
Gemfibrozil + -Fibrate mechanism of action
Upregulate LPL leading to Increase TG clearance Activates PPAR-α to induce HDL synthesis
101
Gemfibrozil + -Fibrate affect on lipids
Slight decrease in LDL Slight increase in HDL Great decrease in TG
102
Digoxin toxicity (**6**)
1. Blurry yellow vision 2. Increase PR 3. Decrease QT 4. T-wave inversiton 5. Arrhythmia 6. AV block
103
What decreases Dioxin clearance
1. Verapamil 2. Amiodarone 3. Quinidine
104
Toxicity of Class 1A antiarrhytmics (**5**)
1. Cinchonism 2. SLE-like 3. HF 4. Thrombocytopenia 5. Torades due to Increase QT
105
Class 1A antiarrhythmics are
Na channel blcokers 1. Quinidine 2. Procainamide 3. Diopyramide
106
Class 1A antiarrhythmics MOA
Increase AP duration Increase effective refractory period Increase QT interval
107
Class 1B antiarrhythmics MOA
Decrease AP duration
108
Class 2 Antiarrhythmics are
β-Blockers
109
Class 2 antiarrhythmics toxicity
Impotence COPD/asthma exacerbated May mask signs of hypoglycemia
110
Class 3 Antiarrhythmics are ## Footnote **AIDS**
K channel blockers * **A**miodarone * **I**butilide * **D**ofetilide * **S**otalol *(also β-Blocker)*
111
Class 4 antiarrhythmics are
Ca channel blockers 1. Verapamil 2. Diltiazem

First Aid (16 decks)

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