First Aid 291-295 Cardio

Question 1

what are xanthomas?

Answer 1

plaques or nodules composed of lipid laden histiocytes in skin

Question 2

hypercholesterolemia can manifest what eye pathology earlier than the general population?

Answer 2

Corneal arcus?

Question 3

which form of arteriosclerosis affects medium sized arteries?

Answer 3

Monckeberg - medial calcific sclerosis

Question 4

Pipestem appearence of an a. on an CXR is a sign of what?

Answer 4

Monckeberg - medial calcific sclerosis

Question 5

onion skinning of an artery is a proliferation of what cell type/which arteries?

Answer 5

smooth musc cells of small arteries and arterioles

Question 6

Essential hypertension or DB lead to what pathology of arteries?

Answer 6

small arteries and arterioles - hyaline arteriolosclerosis

Question 7

Why is there no obstruction of blood flow with Monckeberg arteriolosclerosis?

Answer 7

Affects tunica media, not intima, so lumen diam not affected

Question 8

Which two growth factors are assoc with atherosclerosis?

Answer 8

PDGF & FGF

Question 9

Complications of atherosclerosis?

Answer 9

Aneuryms, ischemia, infacts, PVD, thrombus, emboli

Question 10

Most common locations of atherosclerosis in order?

Answer 10

Ab aorta > Coronaries > Popliteal a > carotid a

Question 11

Symptoms of aortic aneurysm?

Answer 11

abdominal / back pain

Question 12

Syphilis associated with what type of cardiac pathology? Which stage of syphilis?

Answer 12

Thoracic aortic aneurysm, tertiary syphilis

Question 13

Which sexual genetic disorder could potentially lead to thoracic aortic aneurysm?

Answer 13

Turner’s (45, XO) bc of association with bicuspid aortic aneurysm

Question 14

Cystic medial degeneration associated with which cardiac pathology?

Answer 14

Thoracic aortic aneurysm

Question 15

Tobacco, cocaine, and triptans are associated with triggering which cardiac pathology?

Answer 15

Prinzmetal angina

Question 16

Mediastinal widening on CXR is a sign of ?

Answer 16

aortic dissection

Question 17

Aortic dissection affects which layer of artery?

Answer 17

tunica intima

Question 18

Markedly unequal BP in arms is associated with which cardiac pathology?

Answer 18

Aortic dissection

Question 19

Difference between Stanford A and Stanford B type Aortic dissection?

Answer 19

Stanford A - more proximal, asc aorta –> aortic arch
Tx/surgery
Stanford B - more distal, aortic arch –> desc aorta
Tx/BB, VD

Question 20

What differentiates unstable angina vs NSTEMI?

Answer 20

No rise in cardiac biomarker elevation

Question 21

What is Coronary steal syndrome?

Answer 21

Giving vasodilators in a patient with coronary stenosis will cause the dilation of normal vessels and reduces the flow to area distal to the stenosis. This is the principal behind cardiac stress test.

Question 22

ECG signs of transmural vs subdendocardial MI?

Answer 22

transmural - ST elevation (STEMI), Q waves

subendocardial - NSTEMI = ST depressions

Question 23

1 cause of sudden cardiac death?

Answer 23

lethal arrhythmia (VTACH, VFIB)

Question 24

Diseases associated with sudden cardiac death

Answer 24

CAD, cardiomyopathy, heriditary ion channelopathies (long QT syndrome, Brugada syndrome)

Question 25

wavy fibers appear how soon after an MI?

Answer 25

4-24 hrs

Question 26

Biggest complication 1-3d post MI?

Answer 26

Postinfarction fibrinous pericarditis

Question 27

If one sees macrophages and mariginal granulation tissue, how many days post MI?

Answer 27

3-14d

Question 28

Major complications 3-14 days post MI?

Answer 28

free wall rupture --> tamponade papillary muscle rupture --> mitral regurge, IV septum rupture LV pseudoaneurysm

Question 29

Most likely complication in the first 24hrs after an MI?

Answer 29

Arrythmia, HF, Cardiogenic shock

Question 30

What changes are seen in heart tissue in the first 4 hours post MI?

Answer 30

none

Question 31

First cardiac biomarker to rise post MI?

Answer 31

myoglobin

Question 32

Most specific cardiac biomarker post MI?

Answer 32

Cardiac troponin I

Question 33

Which cardiac biomarker is useful to determine if there was a re-infaction?

Answer 33

CK-MB, normally falls after 48hrs, so if high after that, sign of re-infarction

Question 34

Most common cause of death post MI?

Answer 34

Arrythmia

Question 35

V1 - V2 leads MI = which area of heart? artery?

Answer 35

anterior, over the septum - LAD

Question 36

V3- V4 leads MI = which area of heart? artery?

Answer 36

anterior side to the apex - distal LAD

Question 37

V5 - V6 leads MI = which area of heart? artery?

Answer 37

anterior side to lateral heart - LAD or L circumflex

Question 38

Leads I, aVL = which area of heart? artery?

Answer 38

lateral side - L circumflex

Question 39

Leads II, III, avF = area of heart? artery?

Answer 39

inferior heart - R circumflex

Question 40

What is Dressler syndrome?

Answer 40

Autoimmune, leads to fibrinous pericarditis

Question 41

When would a postinfarction fibrinous pericarditis occur post MI?

Answer 41

1-3 d post MI

Question 42

Which two complications of an MI can occur up to 14 days post MI?

Answer 42

Ventric free wall rupture, ventricular pseudoaneurysm formation (contained free wall rupture)

Question 43

Which complication can appear 2 weeks to months post MI?

Answer 43

True ventricular aneurysm

Question 44

When is the greatest risk for VSD post MI?

Answer 44

3-14 days post MI