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Cardiology FA2 > UW Q and A > Flashcards

UW Q and A Flashcards

1
Q

Acute graft rejection (t, histo, rxn, Sx)

A

1-4 weeks posttransplant; end-myocardial biopsy-dense infiltrate of mononuclear cells of T-lym; sensitization against foreign MHC antigens; dyspnea on exertion/paroxysmal not dyspnea). Can be humoral rejection-direct immunofluorescence.

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2
Q

Histo of hypersensitivity myocarditis

A

Due to drug therapy, perivascular infiltration w/abundant eosinophils

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3
Q

Ischemic damage to the donor heart histo

A

Patchy necrosis w/granulation tissue

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4
Q

Chronic rejection of organ

A

scant inflammation cells, interest fibrosis, host T, B cells, abs. Months-years.

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5
Q

MAP during exercises why a modest increase

A

Because despite increased CO, SVR decreases due to arteriolar dilation in active muscles -local adenosine, K, ATP, CO2, lactate.

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6
Q

Collagen subtypes

A

Type 1: skin, bone, tendons, ligaments, dentin, cornea, BV, scar (infarct)-OsteogImp; 2- cartilage, vitreous h, null pulp-skew dysplasias; 3- skin, lungs, BV, BM, lymph, granulation-vast Ehlers-Danlos; 4- Basem member-Alport.

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7
Q

T for MI histo (0-4h, 4-12, 12-24, 1-3D, 3-7, 7-10, 10-14, 2-8w)

A

0-4 h: no, 4-12: wavy fibers, narrow, long myocytes; 12-24: hypereosinoph, shrunken nuclei; 1-3 D: coagulation near (no nuclei, striations), neutrophils infiltrate; 3-7 D: disintegrated of dead neutrophils, myofibers, Macrophage infiltr at borders; 7-10D: phagocyt of dead cells, granul tissue begins at margins; 10-14 D: granul w/neovascul; 2-8 w: collagen deposit, scar.

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8
Q

a1 agonists (phenylephrine, methoxamine)

A

vasoconstriction (renal, splanchnic as well>decr perf), mydriasis, incr intern urethral sphincter tone and prostate contraction, Increased BP>reflexive inc in vagal tone on heart> inh SA node, slowed AV cond, decr contract> decr HR.

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9
Q

a2 agonists

A

CNS mediated decr in BP, dear IOP, dear lipolysis, dear presynap NE release; inc plates aggreg.

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10
Q

Hibernating myocardium, CABG/PCI

A

chronic ischemia, prevents necrosis; reduced ca responsiveness, decreased expression, disorgan of contractile and cytoskel proteins, ch adrenerg control. > dear contract, LV syst dysf.

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11
Q

Ischemic preconditioning

A

brief repet ischemia w/reperfusion>greater time for salvage. Ex:Angina prior MI.

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12
Q

Reperfusion injury

A

Sx: arrhythmias, myoc stunning, myocyte injury, death.

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13
Q

LV P and V loop

A

Vertical-afterload; horiz-preload (decr=left shift, N=1 or EDV), contract (decr=right shift), SV-width. Compliance - lower line (4 (MV opens) to 1).

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14
Q

Isovolumetric contraction

A

1-LV contract, closure of MV, S1, EDV. 2- AV opens.

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15
Q

Ventricular ejection

A

Blood from LV>aorta. 3- AV closes, S2.

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16
Q

Isovolumetric relaxation

A

3 to 4- LV P falls.

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17
Q

Ventricular filling

A

4-MV opens. S3, S4 -b/w 1-4.

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18
Q

dyspnea on exertion (decr SV), chest tight, tachy, low voltage QRS (distance-fluid), beat to beat variation in QRS axis. E:?. CXR:?

A

Pericardial effusion. E: acute peric, injury (MI), tumor, RF w/uremia. CXR: enlarged, clear lungs.

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19
Q

CXR COPD

A

Hyperinflation (>10 posterior ribs), incr bronch markings, flat diaphragm.

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20
Q

CXR Pull edema

A

Patchy perihilar infiltrates

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21
Q

CXR pneumothorax

A

no peripheral lung markings, collapsed lung

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22
Q

CXR pleural effusion

A

costophrenic, cardiophrenic angles obscured, loss of diaphr contour, white-up. Fluid meniscus.

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23
Q

role of arginine in vasodilation

A

Acetylcholine, shear stress, bradykinin from endoth> Ca cat incr> eNOS> Arginine+O2>NO+citrulline. NO goes for GC in muscle to turn GTP>cGMP.

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24
Q

SE from dual chamber pacemaker

A

TR to RHF (SVC>RA>RV)

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25
Q

Myocyte relaxation pumps

A

Na-3Ca exchanger on T tubule, SERCA (Ca ATPase) on Sarc retic from cytoplasm where myofilaments.

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26
Q

Thiazide diuretics MOA

A

inhibit Na/Cl cotransp in DCT, decrease reabs.

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27
Q

RAAS

A

Blood volume/pressure drop>RAAS> renin (Angiotensinogen>Ang1)> ACE (ang1 to ang2). ANg2> vasoconstriction and aldosterone. Aldosterone> Na (3), H2O reabs incr, K (2) and H secretion (NaK ATPase -basal membrane).

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28
Q

ACE ink

A

decrease Ang2

29
Q

Amiloride, triamterene

A

Inhibit Na epithel channel (ENaC), can’t enter principal cell (apical membr).

30
Q

SLE Dx

A

Hemolytic anem, thrombcytop, leukop, low C3,4. ANA, Anti-dsDNA, antiSm.

31
Q

Sick sinus syndrome

A

age degeneration of SA node in the right atrial wall> Brady with dropped p waves, escape beats (AVN). reduced CO>syncope.

32
Q

His bundle

A

Interatrial septum. Causes Mobitz (1-prol, 2-dropped QRS, 3- diss.).

33
Q

Skeletal muscles ca channels

A

Unlike others, here RyR and L type mechanically coupled (one opens another by conform change). Not dependent on extracell ca. not affected by verapamil.

34
Q

Cardiac muscles ca channels

A

L type channels take few ca from extracell> bind to RYR> open them> Ca into intracell from SR.

35
Q

Nutcracker effect

A

left renal vein runs between SMA and aorta, can be compressed. Longer, also gonadal vein directly comes from it (not IVC like right). Varicocele. hematuria, flail/abd pain.

36
Q

MR, cardiac cycle, catheter of LH

A

high left atrial pressure (N=10), easy and large V wave.

37
Q

AR, cardiac cycle, LH pressure

A

Backflow to LV>drop in aortic pressure. N=70-100. Increased LVEDP (N=120). Loss of aortic dicrotic notch, MV faster closes.

38
Q

AS, LH pressure

A

LVP much higher than AP.

39
Q

MS, LH pressure

A

LA Pr elevated, atrial kick just before MV closes.

40
Q

femoral triangle, cannulation

A

lateral to medial: femoral nerve, artery, vein, deep ing LNs/vess. Artery (midway of ing lig, b/w AIS and pubic s.). Cannulation: 1 cm medial to pulsation, 1 cm below ing lig.

41
Q

Digoxin toxicity

A

anorexia, nausea, vom, abd pain, fatig, conf, weakn, color vision changes. inhibits Na/K ATPase (K extracell incr).

42
Q

Aspirin toxicity

A

Vertigo, tinnitus, vomit, diarrhea, if severe=coma, hyperpyrexiam pulmonary edema.

43
Q

AVNRT

A

narrow QRS, regular, nonviable p- PSVT. Young.

44
Q

ANP, BNP

A

activate GC(cGMP). Afferent vasodilation, efferent vasoconstriction- GFR incr. Decreases renin-ang2 (prox)-aldost (distal).

45
Q

AVRT

A

Accessory conduction pathway

46
Q

Familial DCM

A

Titin truncation mutation, incomplete penetrance -delayed/absent Sx.

47
Q

histo of myxoma, Sx

A

amorphous ECM, hemoptysis, dyspnea positional murmur-mid-diastolic plop, left atrium, emboli.

48
Q

Adenosine effect on AVN

A

hyper polarizes it and causes conduction delay

49
Q

b blocker overdose

A

glucagon- increases cAMP for intracellular ca for contraction.

50
Q

stable angina moa

A

stable plaque obstructing >70% lumen, demand supply mismatch, substernal chest pain.

51
Q

unstable angina moa

A

ulcerated plaque partially obstructive thrombus

52
Q

SVC, portal veins originate from

A

cardinal and vitelline veins

53
Q

epinephrine effects, doses

A

increase HR (b1), SBP (b1+a1). Decreased DBP (b2) if b2>a1 at low= Vasodilation.

54
Q

milrinone

A

pde-5 inhibitor- more cAMP>more Ca> contractility and venodilation by cAMP dependent kinase. Reduces pre, afterload, increases CO.

55
Q

cardiovascular dysphagia

A

LA enlargement. Mid esophagus dysphagia.

56
Q

aortocavitary fistula

A

from endocarditis, Aorta=120/80. RV=25/5, continuous flow from A>RV.

57
Q

wernicke Korsakoff

A

ataxia, oculomotor abn, confusion, perm memory loss.

58
Q

wet beriberi

A

cardiac also not PN only, fluid.

59
Q

great saphenous vein

A

if multicoronary bypass, superficial, longest vein. Medial.

59
Q

complications of MI

A

Acute: RVF-hypotension, Kussmaul, clear lungs. Acute/3-5 D: Papill.muscle rupture-Severe MR, fall leaflet, new murmur, severe pull.edema; IVS rupture- chest pain, new murmur, bivalent.failure, shock. 5D-2 W: Ventricular free wall-rupture-ChP, tamponade, shock, distant heart sounds. Months: LV aneurysm- subacute HF, stable angina.

60
Q

carotid sinus hypersensitivity

A

shaving, rubbing a shirt collar, turn the head, vasovagal response, decreased SVR.

61
Q

phenylephrine

A

a1 agonist, vasoconstriction, SVR incr, pressor-BP. Dear HR by barorecep reflex. Increased IP3.

62
Q

PCWP

A

LV function-LV filling pressure, pressure in LA. Introduced to PA the/RH.

63
Q

Dobutamine

A

b1, HR-Na funny, Contractility-cAMP>Ca. But decreased SVR by cAMP on smooth muscle cells-vasodilation> not strong pressor.

64
Q

prevention of doxorubicin toxicity

A

Dexrazoxane (chelator prevents complex formations with topoisomerase and free radicals)

65
Q

histology after MI time

A

4-24 h- hypereosinophilic myocytes w/shrunken nuclei. 1-3 D-neutrophils at borders. 3-10 D- neuter in center, 10-14D-collagenm neovascularization of granul. 2w-2m-scar.

66
Q

fenoldopam

A

dopamine agonist, decreases BP by vasodilation the/cAMP increase. Renal perfusion, natriuresis. Hypertensive emergency.

67
Q

AV node place, ablation

A

coronary sinus, interatrial septum

68
Q

DVT Tx If contra to anticoagulant

A

IVC filter, L5-merging of common iliac veins to IVC.

Cardiology FA2 (1 decks)

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