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trueger
all cardio
404
Medical
Graduate
05/08/2006
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Term
truncus arteriosus
 Definition
asc Ao & pulm trunk
Term
asc Ao & pulm trunk
 Definition
truncus arteriosus
Term
bulbis cordis
 Definition
smooth parts of LV & RV
Term
smooth parts of LV & RV
 Definition
bulbis cordis
Term
prim ventr
 Definition
trabeculated parts of LV & RV
Term
trabeculated parts of LV & RV
 Definition
prim ventr
Term
prim atria
 Definition
trab'd LA & RA
Term
trab'd LA & RA
 Definition
prim atria
Term
left horn of sinus venosus
 Definition
coronary sinus
Term
coronary sinus
 Definition
left horn of sinus venosus
Term
right horn of SV
 Definition
smooth part of RA
Term
smooth part of RA
 Definition
right horn of SV
Term
right common card vein & right anterior cardinal vein
 Definition
SVC
Term
SVC
 Definition
right common card vein & right anterior cardinal vein
Term
transposition of the great vessels
 Definition
AP septum fails to spiral: R-L shunt & cyanosis
Term
AP septum fails to spiral: R-L shunt & cyanosis
 Definition
transposition of the great vessels
Term
tetralogy of fallot
 Definition
AP septum misaligns w/ AV septum: 1-pulm.sten 2-overriding.Ao 3-VSD 4-RVH R-L & cyanosis
Term
mesodermal endocardial heart tubes -> prim heart tube
 Definition
endocardium
Term
endocardium
 Definition
mesodermal endocardial heart tubes -> prim heart tube
Term
mesoderm surrounding prim heart tubes
 Definition
myo&epi cardium
Term
myo&epi cardium
 Definition
mesoderm surrounding prim heart tubes
Term
AV septum
 Definition
dorsal & ventral AV cushions
Term
dorsal & ventral AV cushions
 Definition
AV septum
Term
membr VSD
 Definition
failure of IV septum to develop (cf ASD: exc resorption): L-R shunt ->PHTN, fatigue on exertion
Term
1st Ao Arch
 Definition
MAXillary a (part)
Term
MAXillary a (part)
 Definition
1st Ao Arch
Term
2nd Ao Arch
 Definition
Stapedial & hyoid aa
Term
Stapedial & hyoid aa
 Definition
2nd Ao Arch
Term
3rd Ao Arch
 Definition
Common Carotid & prox ICA
Term
Common Carotid & prox ICA
 Definition
3rd Ao Arch
Term
4th Ao Arch
 Definition
L: Ao arch; R: prox rt subclav a
Term
L: Ao arch; R: prox rt subclav a
 Definition
4th Ao Arch (4 limbs)
Term
6th Ao Arch
 Definition
R&L: prox pulm aa; L: ductus arteriosus
Term
coarctation Ao
 Definition
postductal, up BP in UE, no fem art pulse, risk: cer hem & bac endocarditis
Term
patent ductus arteriosus
 Definition
nl: sm mm contraction closes it; PDA: premature infants, preggers w/ rubella
Term
carotid sheath
 Definition
VAN - IJV, CCA, CNX
Term
SA & AV node blood supply
 Definition
most: RCA
Term
inferior LV blood supply
 Definition
80%: PDA (from RCA)
Term
most common coronary occl
 Definition
LAD
Term
when coronaries fill
 Definition
diastole
Term
posterior heart -> dysphagia
 Definition
LA
Term
LA -> clin problem
 Definition
dysphagia (posterior)
Term
CO=
 Definition
SVxHR
Term
Fick Principle
 Definition
CO=rate O2 cons/(artO2-venO2)
Term
CO=rate O2 cons/(artO2-venO2)
 Definition
Fick Principle
Term
MAP=
 Definition
COxTPR = sys/3 + (2/3)dias
Term
COxTPR=
 Definition
MAP
Term
(1/3)sys + (2/3)dias =
 Definition
MAP
Term
Pulse pressure=
 Definition
sys-dias
Term
sys - dias =
 Definition
pulse pressure
Term
SV=
 Definition
EDV - ESV
Term
what affects SV?
 Definition
contractility, afterload, preload (up = up, down, up)
Term
what raises contractility (and SV)?
 Definition
catecholamines (up SR Ca++ pump act'y)
up IC Ca++
dn EC Na+
Digitalis (up IC Na+ -> up Ca++)
Term
what lowers contractility (and SV?)
 Definition
B1 block
HF
acidosis
hypoxia
hypercapnia
CCBs
Term
catecholamines -> contr?
 Definition
up contr
(up SR Ca++ pump act'y)
Term
up IC Ca++ -> contr?
 Definition
up contr
Term
dn EC Na+ -> contr?
 Definition
up contr
Term
Digitalis -> contr?
 Definition
up contr
(up IC Na+ -> up Ca++)
Term
B1 blockers -> contr?
 Definition
dn contr
Term
HF -> contr?
 Definition
dn contr
Term
acidosis -> contr?
 Definition
dn contr
Term
hypoxia -> contr?
 Definition
dn contr
Term
hypercapnia -> contr?
 Definition
dn contr
Term
CCB -> contr?
 Definition
dn contr
Term
what settings is SV up?
 Definition
anxiety
exercise
preggers
Term
anxiety, exercise, preggers?
 Definition
SV up
Term
what raises myocardial O2 demand?
 Definition
up afterload (dias BP)
up contr
up heart size (up wall tension)
Term
up afterload, contr, heart size -> O2 demand?
 Definition
up O2 demand
Term
preload =
 Definition
ventr EDV
Term
afterload =
 Definition
systolic arterial pressure
(proportional to TPR)
Term
venous dilators -> heart fn?
 Definition
dn preload (nitro)
Term
vasodilators -> heart fn?
 Definition
dn afterload (hydralazine)
Term
preload w/ exercise?
 Definition
up slightly
Term
what raises preload?
 Definition
exer (slightly)
up BV
SNS

"preload pumps up the heart"
Term
up BV -> preload?
 Definition
up preload
Term
SNS -> preload?
 Definition
up preload
Term
EF=
 Definition
SV/EDV
=
(EDV-ESV)/EDV
Term
nl EF?
 Definition
>55%
Term
deltaP=0
 Definition
QxR (V=IR)
Term
resistance =
 Definition
driving pressure (deltaP)/flow(Q)
=
8 visc x length/ Pi x rad^4
Term
what determines visc?
 Definition
nl: Hct
abnl:polycythemia, up protein (eg MM), hered spherocytosis
Term
driving pressure (deltaP)/flow(Q)
=
8viscxlength/Pixrad^4
=?
 Definition
resistance
Term
inotropy moves which line?
 Definition
CO up or down
Term
what moves venous return line?
 Definition
BV (& vasodil'n)
Term
which phase of cardiac cycle consumes the most O2?
 Definition
isovolumetric (mitral & Ao valve both closed)
Term
S1?
 Definition
mitral & tricuspid close
Term
S2?
 Definition
Ao & pulm close
Term
S3?
 Definition
end of rapid ventr filling
(dn EF), CHF
Term
S4?
 Definition
atrial kick (stiff ventr)
Term
abnl sound at end of rapid ventr filling?
 Definition
S3 (dn EF), CHF
Term
abnl sound w/ atrial kick?
 Definition
S4 (stiff ventr)
Term
stiff ventr-> what sound?
 Definition
S4 (w/ atrial kick)
Term
dn EF-> what sound?
 Definition
S3 (CHF)
Term
a wave?
 Definition
atrial contraction
Term
c wave?
 Definition
RV contraction (tricuspid pushes up)
Term
v wave?
 Definition
up atrial pressure fr closing against closed tricuspid
Term
atrial contraction -> which wave?
 Definition
a
Term
RV contraction -> which wave?
 Definition
c (tricuspid pushing up)
Term
pushing against tricuspid -> which wave?
 Definition
v
Term
when JVD?
 Definition
RHF
Term
when parox splitting?
 Definition
Ao stenosis
Term
WPW danger?
 Definition
reentry -> SVT
Term
SNS w/ dn MAP
 Definition
b1-> up CO (via HR & contr)
a1 up CO (via venconstr-> up ven return)
a2 ->up TPR (via art vasoconstr)
Term
carotid sinus ->?
 Definition
medulla via CNIX
Term
Ao baroR ->
 Definition
medulla via CNX
Term
what do carotid and Ao bodies respond to?
 Definition
dn pO2 (<60mg)
up pCO2
dn blood pH
Term
what do central chemoRs respond to?
 Definition
dn pH
up pCO2
not pO2
Term
cushing rxn?
 Definition
up ICP->HTN(SNS) & bradycardia (PSNS)
Term
largest share of systemic BF?
 Definition
liver
Term
most BF/mass?
 Definition
kidney
Term
how does the heart meet up O2 demand?
 Definition
incr cor BF
(not incr extraction of O2)
Term
RA nl pressure?
 Definition
<5
Term
RV nl pressure?
 Definition
<25/<5
Term
PT nl pressure?
 Definition
<25/10
Term
LA nl pressure?
 Definition
<12 (approx = pulm wedge)
Term
LV nl pressure?
 Definition
<130/10
Term
Ao nl pressure?
 Definition
<130/90
Term
heart autoreg factors?
 Definition
O2
adenosine
NO
Term
brain autoreg factors?
 Definition
CO2 (pH)
Term
kidney autoreg factors?
 Definition
myogenic & tubuloglomerular feedback
Term
lungs autoreg factors?
 Definition
hypoxia (causes vasoconstr, not diln)
Term
skel mm autoreg ractors?
 Definition
lactate
adenosine
K+

LAKtic acid
Term
skin autoreg factors?
 Definition
SNS (temp control)
Term
Starling capillary forces
 Definition
P(c)-pi(c)+pi(i)-P(i)
Term
causes of edema:
 Definition
up cap pressure (HF)
down plasma proteins (nephrotic syndr, LF)
up cap perm (up Kf: toxins, infn's, burns)
up interstitial colloid (lymph block)
Term
congen R-L shunts
 Definition
Tetr fallot
Transposition
Truncus arteriosus

3T's
early cyanosis = blue babies
squat to up ven return
Term
congen L-R shunts
 Definition
VSD (most common congen card)
ASD - loud S1, wide fixed split S2
PDA (close w/ indomethacin)

late cyanosis = blue kids
up pulm res fr arteriolar thick'n
->PHTN
-> R-L shunt (eisenmenger's)
Term
eisenmenger's
 Definition
L-R -> R-L as pulm resistance increases
leading to late cyanosis: clubbing & polycythemia
Term
loud S1, wide fixed split S2
 Definition
ASD
Term
most common congen card
 Definition
VSD
Term
squatting helps kids
 Definition
R-L shunts
Term
indomethacin fixes which congen card?
 Definition
closes PDA
Term
late cyanosis
 Definition
L-R shunts
Term
early cyanosis
 Definition
R-L shunts
Term
progression of L-R shunts
 Definition
PHTN & R-L (eisenmenger's)
Term
tetr of fallot
 Definition
Pulm sten, RVH, Overriding Ao, VSD
early cyanosis due to R-L
X-Ray: boot shape due to RVH
"cyanotic spells"
ant.sup. displ of infund sept
Term
xray: boot shaped heart
 Definition
tetr of fallot: RVH
Term
transposition of the great vessels
 Definition
ant Ao leaves RV
pos PT leaves LV
-> sep sys & pulm circ'n
fatal w/in mos. w/o shunt to allow mixing
(egVSD,PDA,patent for ov)
Term
ant Ao, pos PT
 Definition
transposition of the great vessels
Term
coarc Ao
 Definition

m:f::3:1
infantile: Ao sten prox to insertion of ductus art (preductal)
adult: postductal:notching ribs
UE HTN, wk LE pulse
Term
infantile coarc Ao
 Definition
preductal
Infant=IN close to heart
Term
adult coarc Ao
 Definition
postductal: notching ribs
UE HTN, wk LE pulse
aDult=Distal to Ductus
Term
preductal coarc Ao
 Definition
infant
Term
postductal coarc Ao
 Definition
adult
Term
notching ribs, UE HTN, wk LE pulse
 Definition
adult coarc Ao
Term
PDA
 Definition
fetal: nl R-L
neonatal: dn lung res -> L-R -> RVH and RHF
cont machine-like murmur
PGE & low O2 maintain patency
tx:indomethacin
Term
cont machine-like murmur
 Definition
PDA
Term
PGE
 Definition
maintains patency of PDA (low O2also)

PGE used w/trans great vessels
Term
Rx trans great vessels
 Definition
PGE
Term
R-L -> L-R
 Definition
PDA at birth
Term
22q11
 Definition
truncus arteriosus
tetr of fallot
Term
down syndrome
 Definition
ASD
VSD
(trisomy 21)
Term
trisomy 21
 Definition
downs
ASD
VSD
Term
congen rubella
 Definition
septal defects
PDA
Term
Turner's Syndrome
 Definition
coarc Ao
45x,0
Term
45,x,0
 Definition
turner's
coarc Ao
Term
marfan's
 Definition
Ao insuff
Term
mom=DM
 Definition
transposition of the great vessels
Term
geno truncus arteriosus & tetr of fallot
 Definition
22q11
Term
geno ASD
 Definition
downs = trisomy 21
Term
geno VSD
 Definition
downs = trisomy 21
Term
geno septal defects
 Definition
congen rubella
(ASD & VSD: trisomy 21)
Term
geno PDA
 Definition
congen rubella
Term
geno coarc Ao
 Definition
turner's = 45x,o
Term
geno Ao insuff
 Definition
marfan's
Term
geno trans great vessels
 Definition
mom w/ DM
Term
HTN def'n
 Definition
>140/90
Term
HTN RFs
 Definition
age, obesity, DM, tob, gens, AA>wh>asian
Term
HTN features
 Definition
90% essential & rel'd to up CO or up TPR
most of rest: renal dz
malign HTN: severe, rapid progr
Term
risks of HTN
 Definition
athersclerosis, stroke, CHF, RF, retinopathy, Ao diss'n
Term
signs of hyperlipidemia
 Definition
atheromata, xanthoma, tendinous xanthoma, corneal arcus
Term
artheromata
 Definition
plaques in blood vessel walls
Term
xanthoma
 Definition
plaques/nodules in skin
comp'd of lipid-laden histiocytes
esp eyelids
Term
tendinous xanthoma
 Definition
lipid deposit in tendon, esp achilles
Term
corneal arcus
 Definition
lipid deposit in cornea, non spec (arcus senilis)
Term
plaques in blood vessel walls
 Definition
artheromata
Term
plaques/nodules in skin
comp'd of lipid-laden histiocytes
 Definition
xanthoma (esp eyelids)
Term
lipid deposit in tendon, esp achilles
 Definition
tendinous xanthoma
Term
lipid deposit in cornea
 Definition
corneal arcus, non spec (arcus senilis)
Term
types of arteriosclerosis
 Definition
Monckeberg
arteriolosclerosis
atherosclerosis
Term
monckeberg
 Definition
calc'n of aa
esp radial & ulnar
us. Benign
Term
arteriolosclerosis
 Definition
hyaline thickening of sm aa in essential HTN
hyperplastic onion skinning in malign
Term
atherosclerosis (basic def'n)
 Definition
fibrous plaques and atheromas in intima of aa
Term
calc'n of aa
 Definition
monckeberg
esp radial & ulnar
us. Benign
Term
hyaline thickening of sm aa
 Definition
arteriosclerosis
essential HTN
Term
fibrous plaques and atheromas in intima of aa
 Definition
atherosclerosis
Term
hyperplastic onion skinning
 Definition
arteriosclerosis
malign HTN
Term
which aa get atherosclerosis?
 Definition
elastic & med & lg mm
Term
atherosclerosis RFs
 Definition
tob, HTN, DM, hyperlipidemia, FamHx
Term
atherosclerosis progression (pathophys?)
 Definition
fatty streaks->prolif plaque->complex atheromas
Term
atherosclerosis compl'ns
 Definition
aneurysms, ischemia, infarct, periph vasc dz, thrombi, emboli
Term
atherosclerosis loc'ns
 Definition
abd Ao > cor > popl > carotids
Term
atherosclerosis sx
 Definition
angina, claudication

or no sx
Term
age, obesity, DM, tob, gens, AA>wh>asian
 Definition
HTN RFs
Term
atheromata, xanthoma, tendinous xanthoma, corneal arcus
 Definition
signs of hyperlipidemia
Term
tob, HTN, DM, hyperlipidemia, FamHx
 Definition
atherosclerosis RFs
Term
angina, claudication
 Definition
atherosclerosis sx

or no sx
Term
aneurysms, ischemia, infarct, periph vasc dz, thrombi, emboli
 Definition
atherosclerosis compl'ns
Term
ischemic heart dz possible manifestations
 Definition
angina
MI
sudden cardiac death
chronic isch heart dz
Term
angina
 Definition
CAD narrowing >75%
a-stable
b-unstable
c-prinzmetals
Term
stable angina
 Definition
us. 2nd to athersclerosis

retrosternal exertional CP
Term
unstable angina
 Definition
thrombosis w/o necr

worsening CP
Term
prinzmetal angina
 Definition
at rest 2nd to cor aa spasm
Term
retrosternal exertional CP
 Definition
stable anginaus.

2nd to athersclerosis
Term
thrombosis w/o necr & worsening CP
 Definition
unstable angina
Term
CP at rest 2nd to cor aa spasm
 Definition
prinzmetal angina
Term
MI
 Definition
acute thromb due to atherosclerosis
myocyte necr
Term
sudden cardiac death
 Definition
w/in 1 hr of sx
us lethal arrhythmia
Term
chronic isch heart dz
 Definition
progr onset of CHF (yrs)
due to ischemic myocardial dmg
Term
progr onset of CHF (yrs)
due to ischemic myocardial dmg
 Definition
chronic isch heart dz
Term
acute thromb due to atherosclerosis
myocyte necr
 Definition
MI
Term
red infarct
 Definition
hem, in loose tissues w/ collaterals (eg lung, int)
or on reperfusion (esp brain)
Term
pale infarct
 Definition
solid tissues w/ 1 blood supply
eg brain, heart, kidney, spleen
Term
infarct in loose tissues w/ collaterals
 Definition
red infarct
(eg lung, int)
or on reperfusion (esp brain)
hem
Term
infarct in solid tissues w/ 1 blood supply
 Definition
pale infarct

eg brain, heart, kidney, spleen
Term
cor aa occl freq
 Definition
LAD>RCA>circumflex
Term
MI sx
 Definition
diaphoresis, N+V, severe retrosternal pain, L arm/jaw rad'n, SOB, fatigue, adrenergic sx
Term
MI histo 2-4hrs
 Definition
no changes
Term
MI histo >4hrs
 Definition
coag necr, contr'n bands
release of necr cell contents into blood
begin PMNs
Term
MI gross 1st day
 Definition
dark mottling
pale w/ tetrazolium stain
Term
MI gross 2-4 days
 Definition
hyperemia
Term
MI histo 2-4 days
 Definition
inflam'n in surrounding tissue
dil'd vessels (hyperemia)
PMNs
mm w/ extensive coag necr
Term
MI gross 5-10 days
 Definition
hyperemic border
central: yellow-brown softening -> yellow
Term
MI histo 5-10 days
 Definition
ingrowth of granulation tissue in outer zone
macs at edge
PMNs in infarct
Term
MI gross 7 weeks
 Definition
recanalized a
gray-white myocardium
Term
MI histo 7wks
 Definition
complete contracted scar
Term
first MI histo
 Definition
4 hrs
Term
coag necr, contr'n bands
release of necr cell contents into blood
begin PMNs
 Definition
MI histo >4hrs
Term
dark mottling
pale w/ tetrazolium stain
 Definition
MI gross 1st day
Term
hyperemia
 Definition
MI gross 2-4 days
Term
inflam'n in surrounding tissue
dil'd vessels (hyperemia)
PMNs
mm w/ extensive coag necr
 Definition
MI histo 2-4 days
Term
hyperemic border
central: yellow-brown softening -> yellow
 Definition
MI gross 5-10 days
Term
ingrowth of granulation tissue in outer zone
macs at edge
PMNs in infarct
 Definition
MI histo 5-10 days
Term
recanalized a
gray-white myocardium
 Definition
MI gross 7 weeks
Term
complete contracted scar
 Definition
MI histo 7wks
Term
dx MI: 6hrs
 Definition
ECG (gold std)
troponin I up after 4 hrs x7-10 days (most spec)
CK-MB,AST up but less spec
Term
MI: ECG changes
 Definition
STE (transmural)
STD (subendocardial)
path Q waves (transmural)
Term
STE,Q waves
 Definition
transmural infarct
Term
STD
 Definition
subendocardial infarct
Term
troponin w/ MI
 Definition
up at 4hrs x7-10 days
most spec
Term
transmural infarct
 Definition
STE,Q waves
Term
subendocardial infarct
 Definition
STD
Term
MI compl'ns
 Definition
arrhythmia
LVF & pulm edema
cardiogenic shock
rupture of free wall, Vseptum,pap mm or tamponade
aneurysm form'n
fibr pericarditis
dressler's

TLDCRAAPP
Term
MI -> arrhythmyia
 Definition
big cause of death b/f reaching hosp
common in first few days
Term
MI-> cardiogenic shock
 Definition
large infarct
high mortality risk
Term
MI-> pap musc rupture
 Definition
4-10 days post-MI
Term
MI-> aneurysm form'n
 Definition
dn CO
risk of arrhythmia
mural thrombus embolus
Term
MI-> fibr pericarditis
 Definition
friction rub
3-5 days post MI
Term
Dressler's syndrome
 Definition
autoimmune -> fibr pericarditis (sev wks post MI)
Term
autoimmune -> fibr pericarditis
 Definition
MI -> Dressler's syndrome (sev wks post MI)
Term
big cause of death b/f reaching hosp
common in first few days

MI -> ?

 Definition
MI -> arrhythmyia
Term
large infarct
high mortality risk: MI -> ?
 Definition
MI-> cardiogenic shock
Term
dn CO
risk of arrhythmia
mural thrombus embolus

MI -> ?

 Definition
MI-> aneurysm form'n
Term
friction rub
3-5 days post MI

MI -> ?

 Definition
MI-> fibr pericarditis
Term
dilated cardiomyopathy
 Definition
congested
most common (90%)
looks like balloon on CXR
sys dysfn
Term
etio dil'd cardiomyopathy
 Definition
Alcohol
Beriberi
Coxsackie B
Chr Cocaine
Chagas' dz
Doxorubicin tox
peripartum
hemochromatosis
Term
HOCM
 Definition
IV septum
assym
50% familial
AD
yg athlete -> sudden death
dias dysfn
Term
HOCM ssx
 Definition
loud S4
apical impulse
sys murmur
Term
HOCM tx
 Definition
beta blocker
Term
loud S4
apical impulse
sys murmur
 Definition
HOCM ssx
Term
restrictive/obliterative cardiomyopathy etios
 Definition
(dias dysfn)
sarcoidosis
amyloidosis
postrad'n fibrosis
endocardial fibroelastosis
endomyocardial fibrosis (Loffler's)
Term
these -> ?
sarcoidosis
amyloidosis
postrad'n fibrosis
endocardial fibroelastosis
endomyocardial fibrosis (Loffler's)
 Definition
restrictive/obliterative cardiomyopathy (dias dysfn)
Term
holosys high pitched "blowing murmur"
loudest at apex
 Definition
mitral regurg sounds
Term
Ao sten sounds
 Definition
ejection click followed by
cresc-decresc sys murmur
LV>>Ao pressure in sys
rad->carotids/apex
wk pulses cf sounds
"pulsus parvus et tardus"
Term
VSD sounds
 Definition
holocystolic murmur
Term
mitral prolapse sound
 Definition
late sys murmur
w/ mid sys click
most freq vasc lesion
Term
Ao regurg sound
 Definition
immed high pitched blowing dias murmur
wide pulse pressure
Term
mitral stenosis sound
 Definition
opening snap followed by
del'd rumbling late dias murmur
LA>>LV pressure in dias
tricuspid sten diff: louder w/ insp
Term
tricuspid sten sound
 Definition
opening snap followed by
del'd rumbling late dias murmur
mitral sten diff: quieter w/ insp
Term
PDA sound
 Definition
cont machine like murmur
loudest at time of S2
Term
mitral regurg sounds
 Definition
holosys high pitched "blowing murmur"
loudest at apex
Term
ejection click followed by
cresc-decresc sys murmur
LV>>Ao pressure in sys
rad->carotids/apex
wk pulses cf sounds
"pulsus parvus et tardus"
 Definition
Ao sten sounds
Term
holocystolic murmur
 Definition
VSD sounds
Term
late sys murmur
w/ mid sys click
most freq vasc lesion
 Definition
mitral prolapse sound
Term
immed high pitched blowing dias murmur
wide pulse pressure
 Definition
Ao regurg sound
Term
opening snap followed by
del'd rumbling late dias murmur
LA>>LV pressure in dias
 Definition
mitral stenosis sound
tricuspid sten diff: louder w/ insp
Term
opening snap followed by
del'd rumbling late dias murmur
LA>>LV pressure in dias
 Definition
tricuspid sten sound
mitral sten diff: quieter w/ insp
Term
cont machine like murmur
loudest at time of S2
 Definition
PDA sound
Term
card tumor: adults
 Definition
myxoma: most common
90%atria
ball-valve obstr in LA

mets most common overall
Term
card tumor: kids
 Definition
rhabdomyoma
(assoc'd w/ tuberous sclerosis)

mets most common overall
Term
myxoma
 Definition
ball-valve obstr in LA
Term
rhabdomyoma
 Definition
assoc'd w/ tuberous sclerosis
Term
ball-valve obstr in LA
 Definition
myxoma
Term
CHF ssx
 Definition
DOE
card dil'n
pulm edema, PND
orthopnea
HSM/nutmeg liver
ankle & sacral edema
Term
CHF -> DOE?
 Definition
no up LV output w/ exercise
Term
CHF-> card diln?
 Definition
up EDV
Term
CHF-> pulm edema & PND
 Definition
LVF->up pulm ven pressure->
->distention & transudation of fluid

hemosiderin-laden macs (HF cells)
Term
CHF->orthopnea?
 Definition
up ven return in supine exacerbates pulm vasc congestion
Term
CHF-> HSM & nutmeg liver?
 Definition
up CVP -> up res to portal flow
rarely -> cardiac cirrh
Term
CHF -> ankle/sacral edema
 Definition
RVF -> up ven pressure -> up fluid transudation
Term
CHF: viscious cycle?
 Definition
dn CO-> up SNS -> up LV contr -> up preload, up CO (compensatory) -> up sys ven pressure -> edema

dn CO -> renin etc -> up BV -> edema

dn LV contr -> pulm cong -> pulm edema & dn RV output -> periph edema
Term
embolus types
 Definition
fat, air, thrombi, bac, amniotic fluid, tumor

FATBAT
95%=DVT
Term
fat emboli
 Definition
long bone fx
liposuction
Term
amniotic fluid emboli ->?
 Definition
DIC, esp post partum
Term
pulm emb sx
 Definition
CP
tachypnea
dyspnea
Term
long bone fx
liposuction
 Definition
fat emboli
Term
embolus->DIC
 Definition
amniotic fluid emboli
esp postpartum
Term
?-> DVT
 Definition
virchow's triad:
stasis
hypercoaf
endoth dmg
Term
virchow's triad
 Definition
DVT:
stasis
hypercoaf
endoth dmg
Term
cardiac tamponade
 Definition
compression of heart by fluid in pericardium
->dn CO
equilibration of pressure in all 4 chambers
Term
cardiac tamponade ssx
 Definition
hypotn
up ven pressure (JVD)
distant heart sounds
paradox pulse
ECG: electrical alternans (alt big and lil QRS)
Term
hypotn
up ven pressure (JVD)
distant heart sounds
paradox pulse
ECG: electrical alternans (alt big and lil QRS)
 Definition
cardiac tamponade
Term
DOE
card dil'n
pulm edema, PND
orthopnea
HSM/nutmeg liver
ankle & sacral edema
 Definition
CHF
Term
CP
tachypnea
dyspnea
 Definition
pulm emb
Term
diaphoresis, N+V, severe retrosternal pain, L arm/jaw rad'n, SOB, fatigue, adrenergic sx
 Definition
MI
Term
bacterial endocarditis ssx
 Definition
new murmur
anemia
fever
osler's nodes
roth spots
janeway lesions
splinter hems
Term
new murmur
anemia
fever
osler's nodes
roth spots
janeway lesions
splinter hems
 Definition
bacterial endocarditis ssx
Term
which valve in bac endocarditis?
 Definition
mitral (tricuspid w/ IV drug use)
Term
acute endocarditis properties
 Definition
staph aureus
lg vegetations on prev. nl valves
rapid onset
Term
subacute endocarditis properties
 Definition
strep viridins
sm vegetations on congen abnl or dz'd valves
postdental
insidious onset
Term
strep viridins
sm vegetations on congen abnl or dz'd valves
postdental
insidious onset
 Definition
subacute endocarditis properties
Term
staph aureus
lg vegetations on prev. nl valves
rapid onset
 Definition
acute endocarditis properties
Term
nonbac endocarditis
 Definition
mets
RF
(marantic or thrombotic)
Term
osler nodes
 Definition
tender raised lesions on finger & toe pads
Term
roth spots
 Definition
round white spots on retina
surrounded by hem
Term
janeway lesions
 Definition
small erythrem lesions on palm or sole
Term
tender raised lesions on finger & toe pads
 Definition
osler nodes
Term
round white spots on retina
surrounded by hem
 Definition
roth spots
Term
small erythrem lesions on palm or sole
 Definition
janeway lesions
Term
compl'ns of bac endocarditis
 Definition
chordae rupture
glomerulonephritis
suppurative pericarditis
emboli
Term
bacterial endocarditis mnemonic
 Definition
Fever, Roth spots, Osler nodes, Murmur
Janeway lesions, Anemia, Nailbed hem,Emboli

FROM JANE
Term
Libman-Sacks endocarditis
 Definition
veg'ns on both sides of valve
->mitral stenosis
no emboli
SLE causes LSE
Term
veg'ns on both sides of valve
->mitral stenosis
no emboli
lupus
 Definition
Libman-Sacks endocarditis
Term
Rheumatic heart dz
 Definition
rh F = post GAS
late:->Rh heart dz: mitral>Ao>>tricuspid valve (high pressure)
Aschoff bodies, migr polyarthritis, erythema marginatum, up ASO
immune mediated
Term
mitral>Ao>>tricuspid valve (high pressure)
Aschoff bodies, migr polyarthritis, erythema marginatum, up ASO
immune mediated
 Definition
rh heart dz
Term
rh heart dz mnemonic
 Definition
Fever, Erytherma marginatum, Valvular dmg
ESR up,Redhot joints,SubQ nodules, St.vitus's dance (chorea)

FEVERSS
Term
Aschoff bodies
 Definition
granuloma w/ giant cells
in rh heart dz
Term
Anitschkow's cells
 Definition
act'd histiocytes
in rh heart dz
Term
granuloma w/ giant cells
in rh heart dz
 Definition
Aschoff bodies
Term
act'd histiocytes
in rh heart dz
 Definition
Anitschkow's cells
Term
serous pericarditis
 Definition
SLE
Rh arthr
infection
uremia
Term
SLE
Rh arthr
infection
uremia

pericarditis

 Definition
serous pericarditis
Term
fibrinous pericarditis
 Definition
uremia
MI
rh fever
Term
uremia
MI
rh fever

-> pericarditis

 Definition
fibrinous pericarditis
Term
hem pericarditis etios
 Definition
TB, malign (eg melanoma)
Term
hem pericarditis ssx
 Definition
pericardial pain
friction rub
diffuse STE
paradox pulse
distant heart sounds
Term
pericardial pain
friction rub
diffuse STE
paradox pulse
distant heart sounds
 Definition
hem pericarditis ssx
Term
resolution hem pericarditis
 Definition
no scarring or
chronic adhesive or constrictive pericarditis
Term
chronic adhesive or constrictive pericarditis
 Definition
resolution hem pericarditis
Term
syph heart dz
 Definition
tertiary syph disrupts vasa vasora of Ao->
dil'n of Ao & valve ring
s/t Ao root, s/t calc'n of asc Ao arch
s/t->aneur of asc Ao or arch and Ao valve incomp
Term
disrupted vasa vasora of Ao->
dil'n of Ao & valve ring
s/t Ao root, s/t calc'n of asc Ao arch
s/t->aneur of asc Ao or arch and Ao valve incomp
 Definition
tertiary syph
Term
HCTZ SE
 Definition
dnK
up lips
up urea
lassitude
upCa
upGlu
Term
loop diuretic SE
 Definition
K waste
met alk
hypoTN
ototox

furosemide & butamide
Term
SE: dnK
up lips
up urea
lassitude
upCa
upGlu
 Definition
HCTZ
Term
SE: K waste
met alk
hypoTN
ototox
 Definition
loop diuretics
furosemide & butamide
Term
MOA: pos inos for HTN
 Definition
up CO (dn path compensations)
Term
MOA: B blockers for HTN
 Definition
dn renin release
Term
MOA: ACE inh for HTN
 Definition
dn ATII
Term
MOA: ATII inh for HTN
 Definition
dn preload
dn afterload
dn remodeling
Term
MOA: diuretics & vasodilators for HTN
 Definition
dn preload
dn afterload
Term
clonidine SE
 Definition
dry mouth, sedn, severe rebound HTN
Term
beta blocker SE
 Definition
impotence, asthma, CV SE (bradycardia, CHF, av block), CNS SE
Term
hydralazine SE & Rx
 Definition
use w/ BB to avoid reflex tachy
(lupus-like & salt ret'n)
Term
captopril SE
 Definition
Cough, Angioedema, Proteinuria, Taste changes, hypOtn, Preg: fetal renal dmg, Rash, Incr renin, hyperkaLemia
Term
losartan SE
 Definition
fetal renal tox, hyperK
Term
hydralazine MOA
 Definition
up cGMP->sm mm relax.
vasodiln>veins -> dn afterload
Term
hydralazine Rx
 Definition
severe HTN
CHF
Term
what are the CCBs
 Definition
verapamil
nifedipine
diltiazem
Term
verapamil
nifedipine
diltiazem
 Definition
what are the CCBs
Term
CCB MOA HTN
 Definition
dn contr & sm mm relax
VSM: N>D>V
heart: V>D>N
Term
CCB Rx
 Definition
HTN, angina, arrhythmias (not nifedipine)
Term
nitro MOA
 Definition
vasodilate (NO) ->up cGMP ->sm mm relax
veno>>vaso diln (dn preload)
Term
nitro RX
 Definition
angina, pulm edema
Term
up cGMP->sm mm relax.
vasodiln>veins -> dn afterload
 Definition
hydralazine MOA
Term
dn contr & sm mm relax
VSM: N>D>V
heart: V>D>N
 Definition
CCB MOA
Term
vasodilate (NO) ->up cGMP ->sm mm relax
veno>>vaso diln (dn preload)
 Definition
nitro MOA
Term
goal of antianginal tx
 Definition
reduce myocard O2 consumption by decr EDV, BP, HR, contr or ejection time
Term
digoxin MOA
 Definition
inh Na/K -> up IC Na -> up IC Ca -> pos inotropy
Term
inh Na/K -> up IC Na -> up IC Ca -> pos inotropy
 Definition
digoxin MOA
Term
dig -> ECG?
 Definition
up PR
dn QT
scoop ST
twave inv
Term
dig rx?
 Definition
CHF, afib (dn AV condn)
Term
class I antiarrythmics
 Definition
Na: dn condn (esp in depol cells)
slow phase 4 depol (state dependent)
up threshold for firing in abnl pacemakers
Term
class Ia antiarrythmics
 Definition
quinidine, procainamide, disopyramide, (amiodarone)
up AP dur'n, up refr period, up QT
effect A&V arrhyth
Term
class Ib antiarrythmics
 Definition
lidocaine (mexiletine & tocainide: PO)
dn AP durn
affect isch & depol Purk & ventr
rx: ventr arrhythm esp post MI
Term
class Ic antiarrythmics
 Definition
flecainide, propafenone
no effect on AP but slow condn but -> arrhythm
Rx: vtach->VF; SVT
Term
class II antiarrythmics
 Definition
BB: dn cAMP, dn CA current.
Suppress abnl pacemakers (phase 4) esp AV node.
Up PR
may mask hypoglycemia
Term
class III antiarrythmics
 Definition
sotalol, ibutilide, bretylium, amiodarone
up AP durn, up refr period, up QT
check LFT, PFT, TFT
recurrent V arrhythms
->torsades
Term
class IV antiarrythmics
 Definition
CCB: verapamil, diltiazem
AV node: slow condn, up refr, up PR
rx: prevent SVT, VT, nodal arrhythm
SE: torsades
Term
adenosine antiarrhythm
 Definition
AV nodal
Term
K antiarrhythm
 Definition
ectopic pacemakers (dig tox)
Term
Mg antiarrhythm
 Definition
torsades, dig tox
Term
Na: dn condn (esp in depol cells)
slow phase 4 depol (state dependent)
up threshold for firing in abnl pacemakers
 Definition
class I antiarrythmics
Term
up AP dur'n, up refr period, up QT
effect A&V arrhyth
 Definition
quinidine, procainamide, disopyramide, (amiodarone)
class Ia antiarrythmics
Term
dn AP durn
affect isch & depol Purk & ventr
rx: ventr arrhythm esp post MI
 Definition
lidocaine (mexiletine & tocainide: PO)
class Ib antiarrythmics
Term
no effect on AP but slow condn but -> arrhythm
Rx: vtach->VF; SVT
 Definition
flecainide, propafenone
class Ic antiarrythmics
Term
Suppress abnl pacemakers (phase 4) esp AV node.
Up PR
may mask hypoglycemia
 Definition
BB: dn cAMP, dn CA current.
class II antiarrythmics
Term
up AP durn, up refr period, up QT
check LFT, PFT, TFT
 Definition
sotalol, ibutilide, bretylium, amiodarone
class III antiarrythmics
Term
AV node: slow condn, up refr, up PR
rx: prevent SVT, VT, nodal arrhythm
SE: torsades
 Definition
CCB: verapamil, diltiazem
class IV antiarrythmics
Term
AV nodal arrhythmias (class v)
 Definition
adenosine antiarrhythm
Term
ectopic pacemakers (dig tox) (class v)
 Definition
K antiarrhythm
Term
torsades, dig tox (class v)
 Definition
Mg antiarrhythm
Term
class Ia antiarrythmics RX
 Definition
A&V arrhyth
maintain sinus after Afib cardioversion
Term
class Ib antiarrythmics RX
 Definition
ventr arrhythm esp post MI
Term
class Ic antiarrythmics RX
 Definition
vtach->VF (refr)
SVT
atrial: WPW
Term
class II antiarrythmics RX
 Definition
Suppress abnl pacemakers (phase 4) esp AV node

NOT CHF
Term
class III antiarrythmics RX
 Definition
recurrent V arrhythms
check LFT, PFT, TFT
->torsades
Term
class IV antiarrythmics RX
 Definition
prevent SVT, VT, nodal reentry
htn, angina
SE: torsades
Term
class Ia antiarrythmics phys effect
 Definition
up AP dur'n, up refr period, up QT
Term
class Ib antiarrythmics phys effect
 Definition
dn AP durn
Term
class Ic antiarrythmics phys effect
 Definition
no effect on AP but slow condn but -> arrhythm
Term
class II antiarrythmics phys effect
 Definition
BB: dn cAMP, dn CA current.
Suppress abnl pacemakers (phase 4) esp AV node
Term
class III antiarrythmics phys effect
 Definition
up AP durn, up refr period, up QT
check LFT, PFT, TFT
Term
class IV antiarrythmics phys effect
 Definition
AV node: slow condn, up refr, up PR
Term
class I antiarrythmics phys effect
 Definition
dn condn (esp in depol cells)
slow phase 4 depol (state dependent)
up threshold for firing in abnl pacemakers
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