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Qbank missed questions Flashcards

(101 cards)

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1
Q

MOA of digitalis/cardiac glycosides

A

Increase the force of cardiac muscle contraction by inhibiting the Na+/K+-ATPase in the myocardial cell membrane; intracellular Na+ increases (decreasing Na+ gradient across membrane), causing inhibition of Na+/Ca+ exchange so Ca+2 stays intracellularly -> more contraction

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1
Q

Continuous machine-like murmur

A

PDA (patent ductus arteriosus)

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1
Q

What infectious disease can result in 3rd degree AV heart block

A

Lyme disease (B. burgdorferi)

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2
Q

Mental retardation, gout, self-mutliation

A

Lesch-Nyhan Syndrome, X-linked deficiency of HGPRT

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2
Q

CCCK (cough, coryza, conjunctivitis, koplik)

A

Measles (Rubeola, Paramyxovirus)

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2
Q

What action will enhance a Mitral valve prolapse

A

standing or valsalva (decreasing venous return)

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3
Q

When muscle stretched, monosynaptic reflex activation of motor neuron causes contraction to resist the stretch

A

Fxn of muscle spindles/intrafusal muscle fibers

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4
Q

“Sausage” fingers or toes (DIP joints)

A

Psoriatic Arthritis

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4
Q

Xerophthalmia, xerostomia, arthritis

A

Sjogren’s syndrome

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5
Q

Microangiopathic hemolytic anemia, thrombocytopenia, renal insufficiency caused by E.coli

A

Hemolytic Uremic syndrome

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5
Q

Progressive lengthening of PR interval until a beat is ‘dropped’

A

2nd degree, Mobitz I Wenckebach AV block

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5
Q

Which organ has the largest blood flow

A

Lung

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6
Q

Projection defense mechanism

A

Immature form, unacceptable or personally disagreeable impulses or drives are attributed to others around them

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6
Q

HLA-DR4

A

Rheumatoid arthritis

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6
Q

Rheumatic fever and infective endocarditis cause which type of heart murmurs?

A

Tricuspid regurgitation

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6
Q

2 congenital long QT syndromes

A

Jervell and Lange-Nielson syndrome (can present with severe congenital sensorineural deafness)

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7
Q

Treatment for Torsades de pointes

A

Magnesium Sulfate

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8
Q

Bamboo spine, uveitis, aortitis

A

Ankylosing spondyloarthritis

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9
Q

pulsus parvus et tardus - weak pulses with a delayed peak

A

Seen in Aortic stenosis (crescendo-decrescendo systolic ejection murmur with ejection click)

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10
Q

Acanthosis

A

increased thickness of stratum spinosum, seen in Psoriasis

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10
Q

What congenital infection is most common cause of PDA

A

Rubella (German measles)

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11
Q

Ecthyma gangrenosum

A

Caused by Pseudomonas in immunocompromised, virulence factors are Elastase, phospholipase C, exotoxin A (protein synth. inhibition) and pyocyanin

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11
Q

Uveitis, aortic regurgitation, stiff spine

A

Ankylosing spondyloarthritis

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12
Q

what can torsades de pointes progress to

A

Ventricular fibrillation

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12
Concomitant withdrawal of sympathetic efferent activity with enhanced parasympathetic activity, causing bradycardia, vasodilation and orthostatic hypotension
Vasovagal syncope
12
Main thing to remember about CHF
Decreases cardiac output!! (decreased ability to perfuse body, afterload is increased)
13
What action will enhance a VSD
hand grip (increase afterload)
15
Yellow-green foamy vaginal discharge
Trichomonas vaginitis
15
Which 2 stimuli/substances act on phase 4 of the cardiac nodal cell action potential to reduce the rate of spontaneous depolarization?
Adenosine & acetylcholine
16
Heart failure will increase or decrease RAAS system?
Increase, leads to increased ACE II production in lungs (since heart failure causes decreased CO and subsequent inadequeate visceral perfusion
16
Opening snap followed by rumbling diastolic murmur heard best over apex
Mitral stenosis
17
Synovitis, tenosynovitis, dermatitis
STD in Infectious Arthritis
17
Prolonged PR interval \>200msec that is asymptomatic
1st degree AV block
18
High-pitched "blowing" diastolic decrescendo murmur with bounding pulses and head bobbing
Aortic regurgitation
19
Disease in females associated with coarctation of the aorta
Turner syndrome (XO)
20
Lecithinase/Alpha toxin/Phospholipase C
Made by C. perfringens, causes hemolysis and tissue necrosis by destroying cellular membranes
21
Osteosarcoma predisposing factors
"RARE PAIN" = RAdiation, REtinoblastoma, PAget's disease, Infarcts
22
Diminished femoral pulses compared to brachial pulses, sx of inadequate perfusion of lower extremities during ambulation, enlarged intercostal arteries
Coarctation of the aorta
24
Anemia of chronic disease w/ arthritis
Rheumatoid
24
Bounding femoral pulses, carotid pulsations (water-hammer pulses) w/ head-bobbing
Aortic regurgitation
26
Sublimation defense mechanism
Mature mechanism, redirecting emotions toward completely acceptable targets (ex: working out)
26
Reaction defense mechanism
Immature form, unacceptable feelings are ignored and opposite sentiment is adopted
26
Colchicine
Treatment of gouty arthritis; S/E nausea, abd pain, diarrhea; affects tubulin polymerization into microtubules
28
Amenorrhea, parotid gland hypertrophy, osteoporosis
Anorexia nervosa
29
Binge alcohol consumption, increased cardiac sympathetic tone, and pericarditis are precipitating factors for which cardiac event?
Isolated Atrial fibrillation episodes
31
Most common metastatic tumors to brain
Lung CA, breast CA, melanoma
33
Multi-nucleated giant cells, intranuclear inclusions, vaginal discharge
HSV2
33
2 most common causes of an S3 heart sound in adults
LV systolic failure or restrictive cardiomyopathy
33
Characteristics of mitral valve stenosis heard on auscultation
Opening snap (from fusion of leaflet tips) with low diastolic rumble -\> prior rheumatic cardidits most common cause
34
Nitrates
Vasodilators, decrease blood pressure, decrease venous return (venodilators) = decrease preload
35
Crescendo-decrescendo systolic ejection murmur
Aortic stenosis
36
List the locations of the heart in order of speed of conduction (fastest to slowest)
"Park At Ventura Avenue" - Purkinje fibers, atrial muscle, ventricular muscle, AV node
38
Thymic hyperplasia with ocular disturbances
Myasthenia Gravis
40
HLA-DRB1
Rheumatoid arthritis
41
Displacement defense mechanism
Redirection of emotions from a person/object causing the emotions, to a more acceptable, but still inappropriate, person or object
41
Dupuytren's contracture
slowly progressive fibroproliferative disease of palmar fascia, nodules form and fingers lose flexibility
42
Immunodeficiency, albinism, neurologic defects (such as nystagmus)
Chediak-Higashi syndrome - defect in phagosome lysosome fusion (will also have recurrent pyogenic infections)
42
Rapid succession of identical, back-to-back atrial depolarization waves
"Sawtooth appearance" of Atrial flutter
44
Rate-limiting step in steroid hormone synthesis
Transport of cholesterol to the inner mitochondrial membrane so that it can be converted to pregnenolone
45
Sx of hypovolemic shock
Low BP, tachycardia (increased heart contractility), cool extremities (caused by increased TPR to shunt blood toward vital organs)
46
Nitroprusside action
Balanced venous and arterial vasodilator that decreases BOTH preload and afterload
48
Secondary causes of gout
Leukemia/myoproliferative disorders, Lesch-Nyhan syndrome, Renal insufficiency
49
Fxn of golgi tendon organs
Cause sudden muscle relaxation as part of a feedback inhibitory mechanism to prevent damage to muscles when sense contraction against heavy object
50
Which organ has the largest arteriovenous O2 difference
Heart (high O2 demand, extraction of O2 is high)
51
Phenylephrine action
Alpha-agonist, increases sympathetic tone resulting in vasoconstriction
52
Supine hypotension syndrome
Also known as Aortocaval compression syndrome, when a pregnant woman lies supine and the gravid uterus compresses IVC, decreasing venous return/preload
54
C5-C9 complement deficiency
Results in inability to form Membrane Attack Complex, predisposes to recurrent infetions by Neisseria species
56
Urethritis, uveitis, arthritis
Reiter's syndrome (Reactive arthritis) -\> "can't see, pee, or climb a tree"
58
HLA-B27
Seronegative spondyloarthropathies
60
Ring fibers on muscle biopsy (NADH)
Myotonic dystrophy
62
Curd-like discharge
Candida albicans vaginitis
64
Pneumocystis infections
T-cell deficiency
66
Anti-histone antibodies positive
Drug-Induced SLE (lupus)
67
Clue cells
Gardnerella vaginalis causing bacterial vaginosis
68
Leukocyte adhesion deficiency (kids)
late separation of umbilical cord, poor wound healing, recurrent skin infections w/o pus, gingivitis/periodontitis; genetic absence of CD18 antigen necessary for iNTEGRINS formation
69
Hydralazine activity on heart
Vasodilator, decreases afterload
70
Holosystolic harsh sounding murmur
VSD
72
Poor feeding, macroglossia, constipation, umbilical hernia, w/ HYPOTONIA
Congenital Hypothyroidism (necessary for normal brain development)
74
Secondary amyloidosis w/ arthritis
Rheumatoid
75
76
What action will enhance a mitral regurg
squatting, hand grip (increasing total peripheral resistance/afterload)
78
Anti-CCP antibodies
Rheumatoid arthritis
79
completely erratic ECG rhythm with no identifiable waves, fatal
Ventricular fibrillation
80
What maneuver enhances Mitral stenosis
expiration (increase LA return)
81
Furosemide
Loop diuretic, causing decreased ESV
83
Splitting defense mechanism
Immature form, events or actions are either all good or all bad
84
NSAID that is associated with Stevens-Johnson syndrome (Enolic Acid class)
Piroxicam
85
Holosystolic high-pitched "blowing" murmur
Mitral, Tricuspid regurgitation
86
An AV shunt will cause what kind of change in CO and venous return curves?
Decreases TPR (as in exercise), so equilibrium point will be higher at same level of R.atrial pressure/EDV = increase preload, decrease afterload
87
Expanded trinucleotide repeat muscular disorder
Myotonic dystrophy (CTG repeats)
88
Kartagener syndrome
Immotile cilia due to microtubular dynein arm defect (associated with situs inversus)
90
Telomere lengths for stem cells vs. differentiated cells
SC: long telomeres, active telomerase w/ shortening (vs.) DC: low telomerase activity
92
small cell carcinoma of lung can cause muscle manifestations
Lambert-Eaton syndrome
93
2 most important mediators of vasodilation in controlling coronary autoregulation
NO and Adenosine
94
Pulmonary-Renal syndromes
Lupus, Wegener's granulomatosis, Goodpasture's syndrome
95
Triad of hypertension, respiratory depression, BRADYCARDIA
Cushing reaction (cerebral ischemia due to increased intracranial pressure constricting cerebral arterioles)
96
Are steroid hormones all made from one single substance? And if so, what is it?
Yes, cholesterol
98
Serum sickness
Type III hypersensitivity reaction (Antigen-Antibody-Complement) w/ fever, urticaria, arthralgias, gloerulonephritis, lymphadenopathy 5-10 days after exposure to antigen (can have systemic deposition of circulating immune complexes in arteries/arterioles) = Sulfonamides!
99
Left lateral decubitus position enhances which heart sound
Pathologic S3, by decreasing volume of lungs and bringing heart closer to chest wall
100
Most of blood supply to heart occurs during systole or diastole? Why?
Diastole (duration is important factor in determining coronary blood flow); Because during systole, the contracting myocardium compress the coronary arteries
101
Atria and ventricles beat independently of e/o
Complete, 3rd degree AV block

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