PP Clues Hrt/Lung Flashcards
(154 cards)
1
Q
How do you calculate SV?
A
EDV – ESV = SV
2
Q
How do you calculate CO?
A
SV * HR = CO
3
Q
What is normal CO?
A
5L/minute
4
Q
How much of this CO goes to the brain, heart, and kidney?
A
20% = 1L minute or 60L an hour
5
Q
How do you calculate CPP?
A
MAP – ICP = CPP
6
Q
What organs have resistance in series?
A
placenta
liver
kidney
spleen
Lungs
7
Q
What organs have resistance in parallel?
A
All the rest
except:
placenta
liver
kidney
spleen
Lungs
8
Q
What organ has the highest A-VO2 difference at rest?
A
Heart
9
Q
What organ has the highest
A-VO2 difference after exercise?
A
Muscle
10
Q
What organ has the highest A-VO2 difference after meal?
A
Gut
11
Q
What organ has the highest
A-VO2 difference during a test?
A
Brain
12
Q
What organ has the lowest A-VO2 difference?
A
Kidney
13
Q
What is A-V 02 tell you
A
metabolic activity of the organ
how much 02 is extracted from the arterial compare to the veinous end
14
Q
Where does Type A thoracic aortic dissection occur?
A
Ascending aorta (occurs in cystic medial necrosis, syphilis)
15
Q
Where does Type B thoracic aortic dissection occur?
A
Descending aorta (occurs in trauma, atherosclerosis)
16
Q
What layers does a true aortic aneurysm occur?
A
Intima, media, and adventitia
17
Q
What layers does a
pseudo aortic aneurysm occur?
A
Intima and media
18
Q
What is pulse pressure?
A
Systolic – Diastolic pressure
19
Q
What vessel has the thickest layer of smooth muscle?
A
Aorta
20
Q
What vessels have the most smooth muscle?
A
Arterioles
21
Q
What vessels have the largest cross- sectional area?
A
Capillaries
22
Q
What vessel has the highest compliance?
A
Aorta
23
Q
What vessels have the highest capacitance?
A
Veins and venules
hold 60% of circulating volume
24
Q
What are the three causes of HTN?
A
Increase
1) Volume: SV
2) Rate: HR
3) Resistance: TPR
25
What is your max heart rate?
220 – age (in years)
26
What is Stable angina?
Pain with exertion (atherosclerosis)
27
What is Unstable angina?
Pain at rest (transient clots)
28
What is Prinzmetal's angina?
Intermittent pain (coronary artery spasm)
29
What is Amyloidosis?
| Lab?
Deposition of abnormal protein
Stains Congo red, Echo Apple-green birefringence; deposition of proteins
30
What is Hemochromatosis?
Fe deposit in organs => hyperpigmentation, arthritis, DM
31
What is Cardiac tamponade?
Pressure equalizes in all 4 chambers, quiet precordium, no pulse or BP, Kussmaul sign, pulsus paradoxicus (↓ >10mm Hg BP w/ insp)
32
What is a Transudate?
An effusion with mostly water
Too much water:
* Heart failure
Hypothyroidism
* Renal failure
Not enough protein:
* Cirrhosis (can't make protein)
* Nephrotic syndrome (pee protein out)
33
What is an Exudate?
An effusion with mostly protein
Too much protein:
* Purulent (bacteria)
* Hemorrhagic (trauma, cancer, PE)
* Fibrinous (collagen vascular dz, uremia, TB)
* Granulomatous (non-bacterial)
34
What is Systole?
Squish heart, ↓blood flow to coronary aa., more extraction of O2 (Phase 1 Korotkoff)
35
What is Diastole?
Fill heart, ↑blood flow to coronary aa., less extraction of O2 (Phase 5 Korotkoff)
36
What are the only arteries w/ deoxygenated blood?
Pulmonary arteries and umbilical arteries
37
What is the difference between a murmur and a bruit?
A murmur occurs in the heart
A bruit occurs in blood vessels 70%+ occlusion
38
What murmur has a Waterhammer pulse?
AR
39
What murmur has Pulsus tardus?
AS
40
What cardiomyopathy has
Pulsus alternans?
Dilated cardiomyopathy
41
What disease has Pulsus bisferiens
Idiopathic Hypertrophic Subaortic Stenosis
| hcom
42
What murmur has an irregularly irregular pulse?
A Fib
43
What murmur has a regulary irregular pulse?
PVC
Premature ventricular contraction
44
What sound radiates to the neck?
AS/AR
45
What sound radiates to the axilla?
MR/MS
46
What sound radiates to the back?
PS
47
What disease has a boot-shaped x-ray?
Right ventricle hypertrophy
48
What disease has a banana- shaped x-ray?
IHSS
| Idiopathic Hypertrophic Subaortic Stenosis
49
What disease has an egg-shaped x-ray?
Transposition of the great arteries
50
What disease has a snowman- shaped x- ray?
| figure 8
Total Anomalous Pulmonary Venous Return
51
What disease has a "3" shaped x- ray?
Coarctation of the aorta
52
What is Osler-Weber-Rendu?
AVM in lung, gut, CNS => sequester platelets => telangectasias
53
What is Von Hippel-Lindau?
AVM in brain, retina => renal cell CA risk
54
When do valves make noise?
When valves close
55
What valves make noise during systole?
Mitral and tricuspid regurgitation
56
What are the most common causes of aortic stenosis?
Aging
Dystrophic calcification
57
What are the most common causes of aortic regurgitation?
Aging
Calcifications causing valve to sag
58
What are the most common causes of mitral stenosis?
Rheumatic fever
59
What are the most common causes of mitral regurgitation?
MVP
SBE
Collagen diseases
60
What are the most common causes of tricuspid stenosis?
Rheumatic fever
Carcinoid syndrome
61
What are the most common causes of tricuspid regurgitation?
Acute endocarditis (staph aureus secondary to IV drug abuse)
62
What murmurs occur during systole?
Holosystolic, ejection murmur or click
63
What are the holosystolic murmurs?
TR, MR, or VSD
64
What are the systolic ejection murmurs?
AS, PS, or HCM
65
What valves make noise during diastole?
Aortic and pulmonic
66
What are the diastolic murmurs?
Blowing and Rumbling
67
What are the diastolic blowing murmurs?
AR or PR
68
what are the diastolic rumbling murmurs?
TS or MS
69
What are the continuous murmurs?
PDA or AVMs
70
What has a friction rub while breathing?
Pleuritis
71
What has a friction rub when holding breath?
Pericarditis
72
What does a mid-systolic click tell you?
Mitral valve prolapse
73
What does an ejection click tell you?
A/P stenosis
74
What does an opening snap tell you?
M/T stenosis
75
What does S2 splitting tell you?
Normal on inspiration (b/c pulmonic valve closes later)
76
What does wide S2 splitting tell you?
↑O2, ↑RV volume, or delayed pulmonic valve opening
77
What does fixed wide S2 splitting tell you?
ASD
78
What does paradoxical S2 splitting tell you?
AS (or left bundle branch block)
79
What do you see in left sided heart failure?
Pulmonary edema
Orthopnea
Paroxysmal nocturnal dyspnea
80
What do you see in right sided heart failure?
Hepatomegaly
Peripheral Edema
Jugular venous distension
81
What is cor pulmonale?
Pulmonary HTN => RV failure
82
What is Eisenmenger's?
Pulmonary HTN => reverse L-R to R-L shunt
83
What is Transposition of the great arteries?
Aorticopulmonary septum did not spiral
84
What is Tetrology of Fallot?
* Overriding Aorta: aorta sits on IV septum over the VSD; pushes on PA
* Pulmonary Stenosis "Tet spells"
* RV hypertrophy => boot-shaped heart
* VSD (L to R shunt)
85
What is Total Anomalous Pulmonary Venous Return?
All pulmonary veins to RA, snowman x-ray
86
What is Truncus Arteriosus?
Spiral membrane not develop => one A/P trunk, mixed blood
87
What is Ebstein’s Anomaly?
Tricuspid prolapse,
Pregnant woman on Lithium increases risk
88
What can Lithium do to Mom?
Nephrogenic Diabetes Insipidus
89
What is Cinchonism?
Hearing loss, tinnitus, thrombocytopenia
90
List four types of cells in the lungs?
Goblet: Mucus Production
Type I Pneumocyte: Macrophages (95%)
Type II Pneumocyte: Produce Surfactant
Clara/Dust (Macrophages): Ingest dust particles
91
What is the histology of the trachea?
Top 1/3: Stratified Squamous Epithelium (Protect against abrasion)
Middle 1/3: Mixture
Lower 1/3: Tall Columnar Pseudo-stratified ciliated Epithelium
92
What are the muscles needed to breathe in?
Innermost intercostals (contralateral chest wall)
External Intercostals (ipsilateral chest wall) Diaphragm
93
What are the muscles needed to force air in?
Scalenes
SCM -sternocleidomastoid
Trapezius
Pectoralis Major/minor
94
What are the muscles needed to breathe out?
Passive - recoil
95
What are the muscles needed to force air out?
Internal/external oblique
Rectus abdominus
Transverse abdominus
Quadratus lumborum
96
What is the difference between
a carotid body and a carotid sinus
Carotid body: chemoreceptor
Carotid sinus: baroreceptor
97
What color is air on an x-ray?
Black "radiolucent"
98
What color is fluid/solid on x-ray?
White "radiopaque"
99
What disease has a steeple
sign on neck film?
Croup
100
What disease has a thumb sign on neck film?
Epiglottitis
101
What is a "blue bloater"?
Bronchitis (chronic)
102
What is a "pink puffer"?
Emphysema
103
What diseases have pulmonary eosinophilia?
Aspergillosis, Strongyloides
104
What drugs cause pulmonary eosinophilia?
Nitrofurantoin, Sulfonamides
105
What are the risk factors for lung cancer?
Smoking, Radon, 2nd hand smoke, pneumoconiosis (except anthracosis)
106
What diseases have hemoptysis?
Bronchiectasis, bronchitis, pneumonia, TB, lung cancer
107
Where is a Bokdalek hernia?
Back of diaphragm
108
Where is a Morgagni hernia?
Middle of diaphragm
109
What diseases have respiratory alkalosis?
Restrictive Lung Dz (anxiety, pregnancy, Gram – sepsis, PE)
110
What diseases have respiratory acidosis?
Obstructive Lung Dz
111
What diseases have metabolic alkalosis?
Low Volume State (vomiting, diuretics, GI blood loss)
112
What is the obstructive pattern of blood gases?
↑pCO2 -> ↓pH,
↑RR-->↑pO2
113
What is the obstructive pattern of blood gasses?
↓ pO2 --> ↑RR --> ↓pCO2 -> ↑pH
114
What does stridor tell you?
Extrathoracic narrowing => narrows when breathe in => neck x-ray
115
What does wheezing tell you?
Intrathoracic narrowing => narrows when breathe out => chest x-ray
116
What does rhonchi tell you?
Mucus in airway => obstructive lung disease
117
What does grunting tell you?
Blows collapsed alveoli open => restrictive lung disease
118
What does dull percussion tell you?
Something b/w airspace and chest wall absorbing sound (fluid or solid)
119
What does hyperresonance tell you?
Lungs hyperinflated with air
120
What does tracheal deviation tell you?
Away from pneumothorax OR toward atelectasis "air-phobic"
121
What does fremitus, egophony, and
Consolidation=> pathognomonic for pneumonia
122
What is Restrictive lung disease?
Small stiff lungs, trouble breathing in
123
What is Obstructive lung disease?
Big mucus-filled lungs, trouble breathing
out
124
What is Epiglottitis?
X-ray thumb sign, drooling
125
What is Croup?
X-ray steeple sign, barking cough
126
What is Tracheitis?
Look toxic, grey pseudomembrane, leukocytosis
127
What is Asthma?
Wheeze on expiration, IgE, eosinophils
128
What is Bronchiolitis?
Asthma in kids <2 y/o
129
What is Maxillary Sinusitis?
Teeth pain worse with bending forward
130
What is Bronchiectasis?
Bad breath, purulent sputum, hemoptysis
131
What is Chronic Bronchitis?
Lots of sputum, "blue bloater"
132
What is Emphysema?
Restrictive to obstructive pattern, "pink puffer"
133
What is Laryngomalacia?
Epiglottis roll in from side-to-side
134
What is Pneumonia?
Consolidation of airway
135
What is Pneumothorax?
Air outside of lungs; hyperresonnace on same side
136
How do you detect a Pulomary Embolus?
Tachypnea, increased V/Q scan, EKG: S1Q3T3
137
What is Tamponade?
Decreased breath sounds/BP; increased JVD; fluid in pericardial sac
138
What is Tracheomalacia?
Soft cartilage, stridor since birth
139
What is Cystic Fibrosis?
Meconium ileus, steatorrhea,bronchiectasis
140
What is Aspergillosis?
Allergy to mold, dead plants, compost piles
141
Who gets Asbestosis?
Shipyard workers, pipe fitters, brake mechanics, insulation installers
142
Who gets Silicosis?
Sandblasters, glassblowers
143
Who gets Byssinosis?
Cotton workers
144
Who gets Beryliosis?
Radio, TV welders, those working with bulbs
145
What is Anthracosis?
Coal workers, massive fibrosis
146
What is Sarcoidosis?
Non-caseating granulomas, eggshell calcification of lymph nodes
147
What is Carcinoid syndrome?
Flushing, wheezing, diarrhea
148
What is Small cell CA?
At carina, malignant, Cushing's, SIADH, SVC syndrome
149
What is Large cell CA?
Large stuff
150
What is Squamous cell CA?
Smoker, high PTH, high Ca ++
151
What is Bronchealveolar CA?
Looks like pneumonia; due to pneumoconiosis
152
severe aortic stenosis in pt with scattered bleeding angiodysplasia
pathophys
acquire vW factor deficiency
153
3 action of vW
1. bind sites of endothelial injury for platelet aggregation
2. promote platelet aggregation at high shearing pressure
3. carrier protein for Factor 8
154
how is vW affected in AS
acquire vWF deficiency
the high shearing site allows ADAMTS 13 to cleave vW multimers causing vWF deficiency
