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Cardio Flashcards

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1
Q

S3

A

“Kentucky”
Rapid ventricular filling - MR, CHF
Normal in kids and preggers

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2
Q

S4

A

“Tennessee/atrial kick”

High atrial pressure d/t VH

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3
Q

Normal S2 splitting

A

Inspiration –> Pulmonic closes after aortic

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4
Q

Wide S2 splitting

A

Pulmonic stenosis & RBBB –> Delay in RV emptying

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5
Q

Fixed S2 splitting

A

ASD –> L-R shunt delays pulmonic closure

  • secundum = #1
  • primum = DOWN SYNDROME
  • paradoxical emboli
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6
Q

Paradoxical S2 splitting

A

Aortic stenosis & LBBB —> delays LV emptying

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7
Q

Hand grip

A

Inc MR, VSD

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8
Q

Valsalva

A

Most DEC

Inc MVP, hypertrophic

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9
Q

Squatting

A

Dec MVP, hypertrophic

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10
Q

Mitral/Tricuspid regurg

A

Holosystolic, high pitched “blowing”

Rheumatic fever

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11
Q

Radiates to axilla

A

MR

- Complication of MVP, LV dilation, endocarditis, Rheumatic, papillary muscle rupture

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12
Q

Ejection click –> Crescendo-decrescendo

A 
Aortic stenosis
- Radiates to carotids
- Pulsus et tardus - weak pulses
- Wear and tear, bicuspid valve, or chronic RF
-
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13
Q

Angine, syncope w/ exercise, radiates to carotids

A

Aortic stenosis

  • “Fish mouth” commisure
  • -> LVH, anemia
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14
Q

Weak pulses compared to heart sounds

A

Pulsus et tardus - Aortic stenosis

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15
Q

Holosystolic, harsh murmur at left sternal border

A

VSD

  • Most common
  • FETAL ALCOHOL
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16
Q

Mid-systolic click with late systolic crescendo

A

MVP

  • Can predispose to endocarditis
  • Caused by RF, chordae rupture, Marfan, ED syndrome
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17
Q

High-pitched, blowing diastolic murmur

A

AR

  • Widened pulse pressure, bounding pulses, head bobbing
  • Heard over LEFT sternal border (pulmonic area)
  • INC when leaning forward w/ held expiration
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18
Q

Widened pulse pressure, bounding pulses, head bobbing, pistol shot bruit over femoral pulsating uvula

A

AR

  • aortic root dilation - syphiltic aneurysm, dissection, endocarditis
  • LV dilation w/ ECCENTRIC hypertrophy
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19
Q

Opening snap with diastolic rumble in LLD position

A

Mitral stenosis (same as tricuspid)

  • D/T RF…endocarditis, SLE, amyloid, carcinoid
  • -> LA dilation –> pul congestion/HTN –> RHF
  • -> A-fib –> mural thrombi
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20
Q

Continuous machine-like murmur

A

PDA

  • RUBELLA
  • Prematurity
  • LE cyanosis
  • Tx = indomethacin
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21
Q

Pressure formula

A

P = flow x resistance

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22
Q

Resistance formula

A

R = 8(viscosity) x length / pi(radius)^4

Inc viscosity –> inc TPR –> inc work

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23
Q

MAP

A

MAP = 2/3 DBP x 1/3SBP

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24
Q

High-pitched, blowing, holosystolic murmur at the apex

A

MR

Rupture of papillary muscle –> flash pulmonary edema

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25
Day 1-4 post-MI complication
Fatal arrhythmia, pericardial friction rub
26
Day 5-10 or 4-7 post-MI complication
Rupture of papillary muscle, IV septum, Ventricular free wall
27
Months to years post-MI complication
Ventricular aneurysm
28
Peaked T-waves
HyperK --> Torsades --> asystole Tx = calcium gluconate
29
Causes of hyperK
``` Burns, tumor lysis, rhabdo BBs, ACEs, ARBs, Digitalis, K+ sparing Renal failure Acidosis Low insulin ```
30
U-waves
HypOK+
31
Opening snap with high-pitched diastolic rumble, inc with inspiration
Tricuspid stenosis Mitral is the same but inc w/ Expiration
32
4-24 hours post-MI
Hypereosinophilia | No nuclei
33
1-3d post-MI
Lots of neutrophils --> coagulative necrosis | Pericardial friction rub
34
New murmur 1 week post-MI
IV septum rupture
35
ST elevation in V1-6, I, aVL
Left Main coronary artery
36
ST elevation in V1-2
Proximal LAD - septal
37
ST elevation in V3-4
LAD - anterior
38
ST elevation in V5-6
LAD - Apical
39
ST elevation in V1-4
LAD - anteroseptal
40
ST elevation in I, aVL
Left circumflex
41
ST elevation in II, III, aVF
RCA/PD - inferior | - supplies LV papillary muscle
42
Pericardial friction rub with ST elevation in all 12 leads
* **Acute pericarditis*** - SLE, Scleroderma, Post-MI Dressler syndrome - Diffuse ST elevation & PR depression
43
Viral pericarditis
Coxsackie B
44
Chest pain relieved by sitting forward
Pericarditis
45
ST depressions in II, III, aVF + cardiac enzymes
Inferior wall NSTEMI = SUBendocardium | unstable angina can have ST depression but no enzymes
46
Causes of 3rd degree AV block
Lyme, Chagas, endocarditis, Syphilis, Auto-immune
47
Silent MIs
Diabetics and Women - looks for Q waves
48
Q-waves
>25% of R wave or wide | Indicates an OLD MI
49
High TAGs assoc w/?
Pancreatitis
50
QRS >3 boxes, rSR in V1, 2, slurred S waves in I and V6
RBBB
51
HA, lower extremity claudication, UE/LE BP differences
Coarctation of Aorta - Turner syndrome - Rib notching, bicuspid aortic valve - Distal to L subclavian - --> LVH Infantile form = assoc w/ PDA --> cyanosis
52
Elastic lamina fragmentation
Giant cell arteritis - Giant cells w/ intimal fibrosis - ESR >100
53
Middle ages Asian female w/ weak pulses in extremities
Takayasu | - Granulomatous aortic arch
54
Young adult w/ HTN, melena, (+) serum HBsAg, segmental fibrinoid necrosis
Polyarteritis nodosa | - "String of pearls"
55
Asian 4 y/o w/ fever, conjunctivitis, rash on palms and soles
Kawasaki's - Early MI*** - Tx = aspirin***
56
30 y/o male smoker w/ claudication and Raynaud's
Buerger Disease | - necrotizing vasculitis of digits --> gangrene, AUTO-AMPUTATION
57
Middle aged male w/ sinusitis, hemoptysis, hematuria
Wegener's - c-ANCA, GRANULOMAS - Tx = cyclophosphamide Microscopic polyangitis is similar but NO granulomas
58
Middle aged male w/ asthma, peripheral eosinophilia
Churg-Strauss
59
Causes of hyaline arteriolosclerosis/non-enzymatic glycosylation
HTN | Diabetes
60
Hyperplastic arteriolosclerosis
Hyperplasia of smooth muscles --> onion skinning | D/T Malignant HTN ---> fibrinoid necrosis w/ 'flea-bitten' appearance
61
Calcification in linear streaks on mammography
Monckeberg Medial Calcific Sclerosis
62
'Tree bark' aorta thoracic aneurysm
Tertiary syphilis --> aortic valve insufficiency
63
65 y/o male smoker w/ pulsatile abdominal mass
AAA - BELOW renal arteries - atherosclerosis - rupture >5cm
64
Chest pain <20min, ST depression d/t subendocardial ischemia
Stable angina | - Nitro dilates veins
65
Chest pain at rest, ST depression d/t subendocardial ischemia
Unstable angina - rupture of plaque - nitro dilates veins
66
Prinzmetals agina
Coronary vasospasm - ST ELEVATION - Tx = CCBs
67
1-3 wks post-MI
RED border - granulation tissue
68
1 month post-MI
Scar/fibrosis
69
Intralveolar hemosiderin-laden MO
Left sided HF | Tx = ACE
70
Nutmeg liver
Right sided HF --> cirrhosis, pitting edema
71
Boot shaped heart
Tetralogy of Fallot - Stenosis of RV outflow - RVH - VSD - Overriding aorta - -> cyanotic spells --> SQUATTING helps
72
Early cyanosis assoc w/ MATERNAL DIABETES
Transposition | - Tx = PGE to maintain PDA
73
Acute RF Jones Criteria
``` J - joint arthritis O - MR, aschoff bodies, friction rub N - Nodules E - erythema marginatum S - Syndeham chorea ``` ***M-protein MOLECULAR MIMICRY***
74
Most common cause of death in acute RF
Myocarditis
75
Characteristic cells of myocarditis
Anitschkow cell - caterpillar nuclei
76
Chronic RF
Stenosis --> "fish mouth" valves Mitral --> thickened chordae Aortic --> fusion
77
Bug infecting prosthetic valves
S. epi
78
Fever, erythema on palms and soles, painful lesions on finger and toes, splinter hemorrhages in nails
Endocarditis | - anemia of chronic disease = INC FERRITIN
79
NBTE
Sterile vegetations d/t hypercoagulable state or ADENOCARCINOMA --> MR
80
Libman-Sacks endocarditis
Sterile vegetations on BOTH sides of valve = SLE --> MR
81
Causes of dilated cardiomyopathy
``` Genetic Myocarditis - Coxsackie Alcohol Doxorubicin, Cocaine Pregnancy ```
82
Mutation in HOCM
SARCOMERE PROTEINS
83
Haphazard myofibers
HOCM - sudden death in athletes - syncope w/ exercise
84
Causes of restrictive cardiomyopathy
``` Amyloid Sarcoid Hemochromatosis Fibroelastosis = KIDS*** Loeffler - fibrosis + eosinophils ```
85
Low voltage EKG
Restrictive cardiomyopathy
86
Most common primary cardiac tumor in kids
Rhabdomyoma * **Assoc w/ tuberous sclerosis*** - ventricle
87
Metastatic tumors to heart
More common than primary - breast, lung, melanoma, lymphoma - pericardium --> pericardial effusion
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