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Flashcards in Kaplan -Cardiovascular Deck (50)
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A fluid filled neck mass (cystic hygroma), high arched palate, broad chest and pedal edema are associated with what sndrome and what two cardiovascular abnormalities?

Turner's syndrome;

preductal coarctation (femoral pulse < brachial, notched ribs)
and bicuspid aortic valve


what kinds of vessels of the circulatory system have the most blood in them when a person is at rest/ supine?

veins and venules


what is the heredity of familial hypercholesterolemia

autosomal dominant


what is the underlying condition associated with Libman-Sacks endocarditis



how exactly is SLE diagnosed

at least 4 of the following 11 criteria: (RASH OR PAIN)
Rash (malar or discoid), Arthritis, Soft tissues/ serositis, Hematologic disorders (cytopenia), Oral/ nasopharyngeal ulcers, Renal disease and Raynaud's phenomenon, Photosensitivity and Positive VDRL/RPR, Antinuclear antibodies, Immunosuppresants (treatment, not symptom), Neurologic disorders (seizures / psychosis)


what is Wolf-Parkinson white syndrome and what drug is contraindicated in these patients

WPW is a pre-excitation syndrome in which bundles of Kent bypass the AV node (delta waves seen on EKG)
digoxin is contraindicated because it enhances accessory conduction pathways which can cause v. fib in WPW patients


for vessels in parallel, what will removing one of the vessels do to resistance

increase resistance
(for parallel: 1/Rtotal= 1/R1 + 1/R2 + 1/R3)


Coronary blood flow is driven by pressure changes in which part of the circulatory system? what part(s) of the ventricular cycle (isovolumetric contraction/ ejection/ isovolumetric relaxation/ filling)

aortic pressure drives coronary artery filling

isovolumetric contraction is associated with a sharp drop in coronary blood flow


what are the normal values for pulmonary artery pressure and pulmonary wedge pressure

pulmonary artery pressure= 25/8
PCWP < 12 normally


when Swan-Ganz catheter shows that left ventricular BP is much higher than aortic BP and you also observe a systolic murmur what disease do you suspect?
what character does the murmur have?

aortic stenosis

cresc. decresc. systolic ejection murmur following ejection click that is loudest at the base of the heart and radiates to the carotids


rheumatoid arthritis is associated with which kind of cardiomyopathy and why

restrictive cardiomyopathy: amyloid-associated protein deposits in the myocardium leading to decreased compliance and decreased diastolic filling


in compensated coarctation what happens to blood flow above and below the coarctation?
what happens to resistance above and below the coarctation?

since it is compensated blood flow must be normal above and below

pressure= flow x resistance
therefore, to maintain flow at a higher pressure (above coarctation) resistance must increase


what does a larger vessel arteriorvenous fistula do to cardiac output

increases cardiac output (by roughly the same amount as the flow through the fistula)


what are some common toxicities of digoxin

dysrhythmias due to increase atrioventricular conduction (such as premature ventricular contractions), nausea/ vomiting, dizziness, dyspnea, agitation, ocular disturbances (halos, scotomas, blurred vision)


what are the histologic features of infarcted myocardium 2 days post-MI

on H&E stain there will be lost of neutrophils, necrosis, and contraction bands


what are the three types of creatinine kinase and what do they measure

CK-MB measures myocardial damage
CK-MM measures skeletal muscle damage
CK-BB measures brain tissue damage


in the setting of trauma with multiple injuries what kind of creatinine kinase measurement would you use to try to determine if there was cardiac contusion (hint: not simply creatinine kinase-MB)

CK-MB to total CK ratio (CK-MB should be greater than the other CK's if there is a focal cardiac insult)


which is more specific for cardiac injury CK-MB or troponin I

troponin I


which better allows for determination of reinfarction, CK-MB or troponin I

CK-MB since it normalizes within ~3 days


which can indicate cardiac damage AST or ALT?

AST; AST increase with normal ALT suggests cardiac abnormality rather than liver since AST is found in liver and heart, but ALT is only found in liver


name some drugs that prolong QT

sotolol, disopyramide, procainimide, quinidine, TCA's ("some drugs prolong Q T")


what joints are usually the first to be affected by gout and what blood pressure medication can cause gout

MTP (metatarsophalangeal) and big toe;

thiazides have gout as a side effect because they can cause hyperuricemia


what kinds of substances are stained by a trichrome stain



what is the first step in atherosclerotic plaque formation

endothelial injury:
endothelial injury leads to release of free radicals that oxidize LDL as well as decreases in NO which is anti-atherosclerotic


what is the most common cause of acute endocarditis

Staph aureus


what is the most common valvular abnormality in IV drug users and its accompanying murmur

tricuspid insufficiency; holosystolic murmur heard best at the 4th intercostal space on the left parasternal border


what is another (more descriptive) name for Churg-Strauss disease

eosinophilic granulomatosis with polyangitis


what are the three clinical phases of Churg-Strauss

1. prodrome of allergic rhinitis or asthma
2. eosinophilic phase: eosinophilia in multiple organs
3. vasculitic phase: vasculitis of medium and small vessels, fever, malaise, weight loss


what is Wegener's granulomatosis, its symptoms and its characteristic autoantibody

granulomatosis with polyangitis: a vasculitis of small vessels that affects mainly the respiratory tract (sinusitis, rhinitis, otitis media, hemoptysis)

c-ANCA positive


what is a lethal complication that can arise 5 days post MI?
1 month post-MI?

5 days post-MI ventricular wall rupture can occur
1 month post-MI ventricular aneurysm can occur due to weakened, but intact fibrosed area of myocardium