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Boards > Cardio Anderson > Flashcards

Cardio Anderson Flashcards

1
Q

What does the IVS come from

A

endocardial cushions

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2
Q

25% of all ventricular septal defects occur in the

A

membranous portion due to the complexity of fusing three separate components together

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3
Q

tetralogy of fallot

A

VSD, dextroposed aorta overriding the VSD, pulmonic stenosis, RV hypertrophy

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4
Q

IVS defect

A

most common congenital defect, may have asymptomatic holosystolic murmur or CHF, increased risk of endocarditis

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5
Q

bicuspid aortic valve

A

formed in two cusps as opposed to three, may lead to aortic stenosis

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6
Q

Where is the SA node

A

wall of Rt Atrium at SVC

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7
Q

where is the AV node

A

Septal wall of Rt. Atrium near coronary sinus

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8
Q

what valves close to form S1

A

mitral and tricuspid

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9
Q

what valves close to form S2

A

aortic and pulmonic valves

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10
Q

What is between S1 and S2

A

systole

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11
Q

what is between S2 and S1

A

diastole

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12
Q

Where is a regurgitant sound during systole

A

tricuspid or bicuspid

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13
Q

where is a stenotic sound during systole

A

aortic or pulmonic

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14
Q

where is a regurgitant sound during diastole

A

aortic or pulmonic

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15
Q

where is a stenotic sound during diastole

A

tricuspid or bicuspid

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16
Q

right and left coronary arteries fill during

A

diastole…right carries more blood

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17
Q

what does the right coronary artery supply

A

right ventricle and posterior left ventricle

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18
Q

what does the left coronary artery supply

A

divides into two main branches and feeds the anterior and lateral portions of the left ventricle

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19
Q

ischemic heart Dz

A

reduced coronary flow due to athersclerotic narrowing of coronary vessels and/or thrombosis, also may be due to coronary artery spasm

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20
Q

acute bacterial endocarditis

A

destructive, severe infection in normal heart valves, virulent organisms

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21
Q

subactue bacterial endocarditis

A

insidious course, previously abnormal heart, often microbes of low virulence

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22
Q

rheumatic heart Dz (everything plus what histologically)

A

secondary myocarditis, children following group A beta hemolytic strep infection, autoimmune… Aschoff Bodies

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23
Q

mitral valve prolaspe

A

most common valve disease, valve leaflets prolapse into atria during systole

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24
Q

calcific aortic stenosis

A

aortic semilunar valve becomes calcified, creating decreased aortic flow and increased left ventricular pressure, MC due to calcification of a congenitally bicuspid aortic valve

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25
Q

bacterial myocarditis

A

staph, strep, corynebacterium diptheria…flabby ventricular myocardium, four chamber dilation, endocardium and valves unaffacted, may be symptomatic or get CHF

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26
Q

viral myocarditis

A

most common myocardial disease, cardiac involvement occurs a few weeks after primary vire infection at another site…Coxsacki B, flu, CMV, ECHO

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27
Q

parasitic myocarditis

A

toxoplasmosis, Trypansosoma cruzi, Trichinosis

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28
Q

Immune Origin Myocarditis

A

SLE, Scleroderma

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29
Q

Dilated Cardiomyopathy

A

most common, young adults, very enlarged heart with R & L heart failure

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30
Q

Restrictive Cardiomyopathy

A

decreased distensibility, decreased output…primary is rare with young onset but secondary could be from Pompe’s, Hurlers, Sarcoidosis and Hemochromotosis

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31
Q

Hypertrophic Cardiomyopathy

A

idiopathic hypertrophic subacute stenosis, outflow is restricted from left ventricle and wall of left ventricle hypertrophies

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32
Q

hemopericardium

A

blood in pericardial sac, causes tamponade and death may occur

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33
Q

pericarditis

A

can lead to pericardial fibrosis, leads to cardiac hypertrophy & dilation…constrictive pericarditis = no hypertrophy dt constriction –> cardiac failure

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34
Q

effusion

A

any fluid beyond the normal 30-50 ml found in pericardial space

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35
Q

metastatic disease of heart is mostly from

A

lung tumors

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36
Q

what does the right vagus nerve do to the heart

A

slows frequency (sinus node)

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37
Q

what does the left vagus nerve do to the heart

A

slows conduction (AV node) and decreases force of contraction (atria not ventricles)

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38
Q

what does sympathetic innervation do to the heart

A

increases frequency, conduction, and force of contraction (atria and ventricles)

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39
Q

polyarteritis nodosa

A

necrotizing inflammation of small/medium arteries

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40
Q

temportal arteritis

A

vasculitis, small and medium cranial vessels especially temporal

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41
Q

thromboangitis obliterans/Buerger’s

A

men, heavy smokers, gangrene, inflammation of arteries of extremities

42
Q

Raynaud’s dz

A

vasospasm

43
Q

Raynaud’s Phenomenon

A

arterial narrowing secondary to SLE, scleroderma, atherosclerosis, or Buergers

44
Q

Aneurysms

A

localized dilation of vessel lumen, true means that the walls are intact

45
Q

Aortic Dissection

A

lumen of aorta dissects due to pressure and loss of patency

46
Q

Kaposi Sarcoma

A

associated with HIV, purple/black papules that may scale, probably from HHV 8, metastatic and dangerous

47
Q

hemangioma

A

capillary and cavernous types. capillary type is benign…cavernous type found on head and neck and are larger,could be associated with Lindau von Hipple

48
Q

difference between heme and non-heme (free) iron

A

heme has unregulated uptake and is from animal sources. non-heme is essentially rust and has to use transferrin for uptake

49
Q

free iron uptake is blocked by

A

high plasma Fe, phytates, tannins, oxylates, phosphates

50
Q

Ferrous

A

Fe 2+

51
Q

Ferric

A

Fe 3+

52
Q

Lactoferrin

A

sequestering agent in blood, used when infection active to keep Fe from bacteria

53
Q

how is hemoglobin broken down

A

to biliverdin, then to unconjugated bilirubin, then that is acted on by UDP glucoronide which turns it into conjugated bilirubin or into sterco/uro bilin

54
Q

what are the two original substances that eventually make hemoglobin

A

succinyl coA and glycine which are put together using ALA synthetase

55
Q

R form of heme

A

relaxed, Hb has 4 open O2 sites

56
Q

T form of heme

A

Taut, Hb has no oxygen…taken after O2 dumping at peripheral sites, 2-3-BPG stabilizes

57
Q

what binds oyxgen tighter, myoglobin or hemoglobin

A

myoglobin, only releases O2 under low O2 situations. in muscle

58
Q

what stimulates the dumping of oxygen

A

increased acidity/CO2, increased temperature, 2,3-BPG (needed to move O2 off Hb)

59
Q

what is the major form of CO2 for transport

A

HCO3-

60
Q

what is the Bohr effect and what enzyme is used on both ends

A

changes CO2 to various forms to balance acidity, carbonic anhydrase is used

61
Q

what two things always work together during methylation

A

folate and B12

62
Q

most common reason for hemolytic anemia and what histological sign is associated

A

G-6-PD deficiency, Heinz bodies

63
Q

iron deficiency anemia

A

most common, hypochromic/microcytic, could see upper esophageal webs (Pummer Vinson)

64
Q

pernicious anemia

A

megaloblastic/macrocytic, could be from loss of parietal cells and IF or from B12 deficiency

65
Q

alpha thalassemia

A

4 genes for alpha chains…more is worse.

66
Q

beta thalassemia

A

2 genes for beta chain, homozygotes are worse

67
Q

both thalassemias show what histologically

A

teardrop cells, basophilic stippling, target cells…hypochromic/microcytic

68
Q

polycythemia vera

A

myeloproliferative dz, high Hgb, viscous blood treated with phlebotomy

69
Q

multiple myeloma

A

lytic lesions, plasma cells, hypercalcemia..bence jones proteins in urine

70
Q

Acute Lyphoblastic Leukemia

A

most common leukemia and cancer in children

71
Q

Acute Myeloblastic Leukemia

A

most common leukemia in adults 15-39, auer rods

72
Q

Chronic Myelogenous Leukemia

A

25-60, philadelphia chromosome, may include any cells line

73
Q

Chromic Lymphocytic Leukemia

A

most common overall leukemia and most common after 60, well differentiated B-cell, more in males

74
Q

Hairy Cell Leukemia

A

B cells with hair like projections, middle aged men

75
Q

what stimulates the intrinsic pathway of clotting

A

blood trauma or collagen and blood contact

76
Q

what stimulate the extrinsic clotting pathway

A

damage outside of blood vessels

77
Q

what measures the intrinsic pathway

A

PTT

78
Q

what measures the extrinsic pathway

A

Pt/INR

79
Q

heparin acts on which clotting pathway

A

intrinsic

80
Q

warfarin, ASA, vit E, and EFAs work on what pathway

A

extrinsic

81
Q

Poiseuille’s Equation

A

about resistance in the blood vessels, thicker the blood the greater the resistance

82
Q

Hemophilia A

A

factor VIII def., sex-linked recessive, males show it and females carry it, spontaneous bleeding into joints

83
Q

Hemophilia B/Christmas Dz

A

Factor IX, male only with female carrier

84
Q

Von Villebrand’s

A

autosomal dominant, VWF needed for platelet clumping, needed for factor VIII activity, prolonged bleeding time and PTT in these people but normal platelet numbers

85
Q

Vit K dependent factors

A

II, VII, IX, X, protein C

86
Q

thrombocytopenia

A

too few platelets, below 70k

87
Q

if arterial pressure decreases due to hemorrhage, what does the baroreceptor reflex do

A

causes increases sympathetic outflow…renin system and hydrostatic systems will also work to increase arterial pressure

88
Q

if a hemorrhage causes greater than 20% blood volume lost it can cause

A

hemorrhagic (hypovolemic) shock

89
Q

transudate edema

A

protein poor, found in edema secondary to alterations in starlings forces

90
Q

exudate edema

A

protein rich, found in acute inflammatory states

91
Q

interstitial edema

A

pitting edema

92
Q

anasarca

A

generalized edema

93
Q

infarction

A

localized area of necrosis resulting from circulatory insufficiency within an organ or tissue…nearly all due to thrombi or emboli

94
Q

characteristic morphology of all infarcts except those in the brain is

A

coagulation necrosis

95
Q

CNS becomes irreversibly damaged after how much hypoxia

A

3-4 minutes

96
Q

Burkitts lympoma

A

B lymphocyte tumor, maxilla or mandible, EBV/malaria associated

97
Q

Hodgkins lymphoma

A

young adults or 60+, curable, familial, intermittent spiking fever, single/asymptomatic node and then it spreads…see Reed-Sternberg cells

98
Q

Non-Hodgkins lymphoma

A

most common lymphoma, more deadly, associated with Burkitt’s and Immunoblastic lymphomas

99
Q

what is stroke-work

A

principle that as ventricular pressure increases the stroke work output increases (up to physiological limits)

100
Q

right sided heart failure caused by

A

emphysema, mitral stenosis, left ventricular failure…youll see enlarged spleen and liver and dependent edema/ascites

101
Q

left sided heart failure caused by

A

aortic or mitral valve disease, ischemic heart dz, systemic HTN…youll see PND, tachycardia, cardiac asthma, crackles, cough, cyanosis

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