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115 Cards in this Set
- Front
- Back
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Boards: 5/31/11: HY Topics
This Set Includes: |
Boards: 5/31/11: HY Topics
This Set Includes: |
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Misc Associations
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Misc Associations
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gARlic breath
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ARsenic poisoning
Tx with deferoxamine |
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Head bobbing
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Aortic regurg
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Battery factory
Ammunition |
Lead poisoning
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Insecticides
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Organophosphate poisoning
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Murmur heard best when pt leans forward
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Aoetic regurg
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Situs inversus
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Kartageners
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Mousy or musty body odor
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PKU from tyrosine hydroxyl ase deficiency
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"crew cut" on skull X-ray
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Sickle cell due to marrow expansion
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Machine like murmur
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PDA
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Stroke Arts of the brain
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Stroke Arts of the brain
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MCA (Middle Cerebral Art) Stroke --> Probs w/:
1) Motor Cortex --> 2) Sensory Cortex --> 3) Wernicke's Area (Sup Temp Gyrus)--> 4) Broca's Area (Inf Frontal Gyrus) --> 5) Hemineglect if: |
1) CL Paralysis of UE & Face
2) CL loss of sensation of UE & Face 3) Fluent Aphasia w/ no comprehension (Wernicke is Wordy but makes no sense) 4) Nonfluent aphaseia w/ intact comprehension (Broca's Broken Boca) 5) Lesion affects nondominant (usually right) side |
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ACA (Ant Cerebral Art) Stroke --> Probs w/:
1) Motor Cortex --> 2) Sensory Cortex --> |
ACA Stroke --> Probs w/:
1) CL Paralysis of LE 2) CL Loss of Sensation of LE |
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Lateral Striate Art Stroke --> Probs w/:
1) Striatum & Internal Capsule --> 2) Striatum & Internal Capsule are a common location of: |
1) CL Hemiparesis & Hemiplegia
2) Lacunar infarcs, secondary to unmanaged HTN |
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ASA (Anterior Spinal Artert) Stroke --> Probs w/
1) Lateral Corticospinal Tract --> 2) Medial Lemniscus --> 3) Caudal Medulla / Hypoglossal Nerve --> |
1) CL Hemiparesis of LE
2) dec CL Proprioception 3) Ips tongue deviation |
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PICA (Post Inf Cerebellar Art) Stroke --> Probs w/
Lateral Medulla: 1) Vestib nuclei, 2) Lat ST Tract, 3)Spinal TG Nucleus & Nucleus Ambiguus, 4) Symp Fibers 5) Inf Cerebellar Peduncle 6) Misc --> |
1) Vomiting, Vertigo, Nystagmus
2) Dec pain and temp sensation of limbs and face 3) Dysphagia, Hoarseness, dec Gag reflex 4) Ips Horners Syndrome 5) Ataxia, Dysmetria 6) Lateral medullary (Wallenberg's Syndrome) |
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AICA (Ant Inferior Cerebellar Art) Stroke --> Probs w/:
1) Lateral Pons: Vestibular Nuclei, FACIAL Nucleus, Spinal TG Nucleus, Cochlear Nuclei, Sympathetic FIbers 2) Middle and Inf Cerebellar Peduncles |
Vomiting, Vertigo, Nystagmus.
Face paralysis, dec lacrimation, dec salivation, dec taste from ant 2/3 tongue, dec corneal reflex. Face - Dec pain and temp sensation. Ips dec hearing. Ips Horner's. "Facial Droop means AICA's Pooped" |
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PCA (Post Cerebral Art) Stroke --> Probs w/
1) Occipital and Visual Cortex |
1) CL Hemianopsia w/ Macular Sparing
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AComm (Anterior Communicating Art)
1) Common site of what? 2) FX? |
1) Saccular (berry) aneurysms --> Impingement on cranial nerves
2) Visual Field Defects |
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PComm
1) Common site of what? 2) FX? |
1) Saccular (berry) aneurysm
2) CN III Palsy - eye is "down and out" |
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Impt Teratogens
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Impt Teratogens
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ACE I
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Renal Damage
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Aminoglycosides (Digoxin??, etc...)
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CN VIII toxicity
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DES
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Vaginal Clear Cell Adenocarcinoma
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MTX (Folate antag)
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Neural Tube Defects
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Lithium
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Ebstein's anomaly (atrialized right ventricle)
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Phenytoin
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Fetal Hydantoin Syndrome:
Microcephaly, Dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects, IUGR, Mental Retardation |
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Tetracyclines
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Discolored teeth in kids
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Thalidomide
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Limb defects (Limb defects w/ tha-LIMB-domide
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Valproate
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Inhibs Folate -->
Neural tube defects |
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ETHOL
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FAS =
#1 cause of birth defects and mental retardation |
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Smoking (nicotine and CO)
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Pre-term labor,
Placental probs, IUGR, ADHD |
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Cocaine
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Fetal addiction
Placental abruption |
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Vit A
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Spontaneous abortions
Birth defects (cleft palate, cardiac abnorms) |
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Warfarin
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?????
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Misc Questions
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Misc Questions
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5 Drugs that can cause a disulfuram rxn?
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Metronidazole
Cephalosporins: A. Cefotetan B. Cefamendole C. Cefoperazone 1st Gen Sulfuonylureas: A. Tolbutamide B. Chlorpropramide (this one too?) |
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Describe the organization of structures in the femoral region?
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NAVEL
From lat to medial: Femoral: Nerve Artery Vein Empty Space Lymphatics |
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Describe Innervation to the Tongue:
TPM 1) Taste: ---> Solitary Nucleus A. Ant 2/3: B. Post 1/3: C. Extreme Posterior: Pain: A. Ant 2/3? B. Post? C. Extreme post? 3) Motor: BL: Taste: VII, IX, X Pain: V3, IX, X Motor: XII |
1)
A. VII B. IX C. X 2) A. V3 B. IX C. X 3) XII |
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Some Embryo:
1) The Parathyroids develop from what phranygeal pouches? 2) The Thymus deevelops from what pharyngeal pouch? 3) If these 2 pharyngeal pouches do not develop correctly, it is most likely from what genetic problsm --> what genetic cond'n? |
1) Inf PT: 3rd PP
Sup PT: 4th PP 2) 3rd PP 3) 22q11 deletion --> DiGeorge's Thymic Aplasia --> Hypocalcemia and Inc viral / fungal infxns (low T-cells) |
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Cardiology from 5/31 Lecs
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Cardiology from 5/31 Lecs
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Some Cardio Embryology
1) The truncus arteriosus gives rise to what 2 structures? 2) The R. Common Cardinal Vein & Right Ant Cardinal Vein give rise to what structure? |
1) Ascending aorta
Pulmonary Trunk 2) SVC |
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1) Now, the truncus arteriosus which gives rise to the ascending aorta and pulmonary trunk, results from the migration of what cells earlier in development
2) What will form in the truncus arteriosus --> Aorticopulmonary septum which divides the truncus arteriosus into the ascending aorta and pulmomary trunk 3) 3 pathologies that result from inappropriate development of truncus arteriosus? |
1) Truncus arteriosus arises from neural crest cell migration
2) Aorticopulmonary septum 3) dTGA Tetralogy of Fallot Persistent Truncus Arteriosus |
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Fetal Circulation: See FA 132 Pic
1) Describe the path of oxygenated blood from Mom and Placenta through fetus? |
1)
Placenta --> Umbilical Vein --> Liver --> DUCTUS VENOSUS --> IVC --> R. Atrium --> Foramen Ovale ---> L. Atrium --> L. Vent --> Pulm Aorta |
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Fetal Circulation: See FA 132 Pic
1) Describe the path of DEoxygenated blood from SVC through fetus? |
1)
SVC --> R. Atrium --> R. Vent --> Pulm Art --> Ductus Arteriosus --> Aorta --> Rest of Fetus |
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Is the umbilical vein or arteries more saturated?
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Umbilical vein
(coming from mom and placenta, who oxygenated the blood) |
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Describe how the foramen ovale and ductus arteriosus closes?
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@ birth infant takes breath -->
Dec resistance in pulm vasc --> LA Pressure > RA Pressure --> Closure of foramen ovale --> Fossa Ovalis @ birth infant takes breath --> Inc O2 --> Dec PGs --> Closure ofDA |
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What drug would help close a PDA?
What drug would keep a PDA open? |
Indomethacin
Alprostadil (PGE analog) |
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Some Cardio Equations:
1) Equation for CO? 2) Fick principle for CO? 3) 2 Equations for MAP (Mean Art Pressure)? 4) Pulse Pressure? 5) Stroke Volume? 6) Draw the PQR triangle 7) Equation for EF (Ejection Fraction)? |
1) CO = SV X HR
2) CO = rate of O2 consump / CaO2 - CvO2 3) MAP = CO X TPR MAP = 2/3 DBP + 1/3 SBP 4) PP = SBP - DBP 5) SV = CO / HR = EDV - ESV 6) 7) EF = SV / EDV = EDV - ESV / EDV |
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1) What are the 3 things which effect stroke volume?
2) Will the Following Inc or Dec Contractility of Heart: A. Catecholamines B. Dec EC Ca++ C. Inc EC Ca++ D. Digitalis E. beta blocker F. Heart Failure G. Acidosis! H. Hypoxia / Hypercapnea I. Ca Chann Blockerss |
1) SV CAP:
Contractility, Afterload, Preload (INC SC = Inc Contrac, Inc Preload, Dec Afterload) 2) A. Inc B. Inc C. Inc D. Inc E. Dec F. Dec G. Dec H. Dec I. Dec |
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1) Preload is roughly equal to what cardiac measurement?
2) Afterload is roughly equal to what cardiac measurement? 3) What do venodilators do? A) ex? 4) What do vasodilators do? A) ex? 5) 2 Rx that do venodilation AND vasodilation --> dec preload AND afterload? |
1) EDV
2) MAP 3) Dilate veins --> Dec Preload! A) Nitroglycerin 4) Dilate arteries --> dec Afterload! A) hydrAlAzine 5) ACE I & ARBs |
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Starling Curve: FA 281
1) What is on the x-axis AND y-axis 2) Will exercise shift the curve to the right or to the left? Why? 3) What will shift the curve to the right? Why? 4) How to improve CO / SV in CHF pts? |
1) X-axis: Preload / EDV
Y-axis: CO or SV 2) Left. BC @ a given preload, the CO will be higher 3) CHF. BC @ a given preload, CO will be less 4) Give Digitalis |
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1) EF is an indicator of what?
2) Using our PQR triangle, what is the equation for vascular Resistance? 3) Vascular resistance is DIRECTLY proportional to what? 4) Vascular resistance is INVERSELY proportional to what? |
1) Ventricular contractility
2) R = P / Q 3) Blood viscosity 4) Radius of the vessel TO THE 4th power (r4) |
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CO Venous Return Curve (See FA 282):
1) What is on the axes of a CO / Venous Return Curve? 2) Positive Inotropic FX will shift the CO curve in what direction? 3) Exercise and AV shunt --> Dec TPR and Pos inotropy which will shift what curves in what direction? 4) Hemorrhage --> Inc TPR and Neg Inotropy which will shift what curve in what direction? |
1) SAME as the starling curve:
X-Axis: EDV Y-Axis: CO / Venous Return 2) To left 3) Venous Return Curve Up, CO curve to the left 4) Venous return curve down, CO curve to right |
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CO Venous Return Curve (See FA 282):
1) Heart failure and narcotic OD will have what FX on what curve? 2) What does the X-intercept of the venous return curve represent? |
1) CO curve to right
2) Mean Systemic Pressure |
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Heart Sounds:
1) S1 = ? 2) S2 = ? 3) S3 = ? A) Normal in who? 4) S4 = ? A) Occurs in who? |
1) Mitral and TC close
2) Aortic and Pulmonic close 3) Rapid ventricular filling during early diastole A) Kids and preggos Dilated cardiomyopathy CHF Mitral Regurn L --> R Shunt 4) "Atrial Kick" in late diastole A) MI & Ventricular hypertrophy --> L. atrium pushes against stiff LV wall |
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S2 Splitting
1) What is S2 splitting? 2) S2 normally splits when? 3) A wide splitting of S2 is assoc w/ what? 4) Fixed splitting is assoc w/ what? 5) Pradoxical spliting: A) What? B) Assoc w/ what 2 things? |
1) When pulmonic valve stays open longer than aortic bc their's more blood in pulmonary circulation than systemic -->
longer time for R. vent to empty 2) With inspiration 3) Pulmonic stenosis and RBBB 4) ASD 5) When Pulmonic valve closes BEFORE aortic valve A) Aortic stenosis and LBBB |
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DRAW ROUGH normal CARDIAC CYCLE BASED OFF FA 283
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DRAW ROUGH pathologies CARDIAC CYCLE BASED OFF FA 283
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1) What Is:
A. CC Phase 1? B. CC Phase 2? C. CC Phase 3? D. CC Phase 4? E. CC Phase 5? |
1)
A. MC, AC --> Isovolumetric Contraction B. AO --> Systolic ejection C. AC --> Isovolumetric relax D. MO --> Rapid Ventric Filling E. MO --> Reduced Filling |
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Understand the drawing of the pathologies slide
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Understand the drawing of the pathologies slide
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DRAW JVP
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DRAW JVP
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"At Carter's X-ing Vehicles Yield"
1) a-wave = 2) c-wave = 3) x-collapse = 4) v-wave = 5) y-collapse = |
1) atrial contraction
2) RV contraction --> bulge of tC valve 3) Downward displacement of closed TC during RV contract 4) RA filling 5) Blood from RA --> RV |
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Heart Murmurs:
1) 4 Types diastolic murmurs? 2) 7 Types systolic murmurs? |
1) Aortic Regurg
Pulmonic Regurg Mitral stenosis TC stenosis 2) Aortic stenosis Pulmonic stenosis Mitral regurg TC regurg VSD PDA Mitral Prolapse |
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What Effect will the following bedside maneuvers have on heart sounds?
1) Inspiration? 2) Expiration? 3) Hand grip --> Inc systemic vasc resistance 4) Valsalva --> dec venous return 5) Rapid squatting --> Inc venous return and Inc afterload |
1) Inc intensity of R. heart sounds
2) Inc intensity of L. heart sounds 3) Inc MR, VSD murmurs 4) Dec murmur intensity Inc MVP Inc Hypertrophic cardiomyopathy murmurs 5) Dec MVP Dec Hypertrophic cardiomyopathy murmurs |
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What Murmur:
Holosystolic, high pitched "blowing" murmur that is loudest @ apex and radiates towards axilla MR is usually the result of what? |
Mitral Regurg
Ischemic heart dz, mitral valve prolapse, LV dilation |
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What murmur:
What Murmur: Holosystolic, high pitched "blowing" murmur that is loudest @ TC area and radiates to right sternal border? TR caused by what? |
Tricuspid Regurg
RV dilation or endocarditis |
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Draw MR / TR
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Draw MR / TR
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What murmur:
EC (ejection click form abrupt halting of valve leaflets) --> Crescendo-decrescendo murmur during systole that radiates to carotids / apex describe pulses in Aor Stenosis? Can --> what? 4 major causes? |
Aor Stenosis
weak comp'd to heart sounds Syncope Calcific aortic stenosis Bicuspid aortic valve (MC) Syphilis --> tree-barking of aorta Rheumatic heart dz |
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Draw Aor Sten
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Draw Aor Sten
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What murmur:
Holosystolic, Harsh sounding murmur that is loudest @ TC area? |
VSD
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DRAW VSD
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DRAW VSD
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What murmur:
Late systolic crescendo murmur w/ mid systolic click (MC) Loudest @ S2 Can predispose to what cond'n? |
Mitral prolapse
Infective endocarditis |
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DRAW MIT PROLAPSE
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DRAW MIT PROLAPSE
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What murmur:
High pitched "blowing" diastolic murmur High pulse pressure Bounding pulses Head bobbing 3 Causes of Aor Regurg? |
Aortic Regurg
Aortic root dilation Bicuspid Aortic valve Rheumatic Fever |
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Draw Aor Regurg
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Draw Aor Regurg
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What murmur:
Delayed rumbling late diastolic murmur Follows opening snap Enhanced by maneuverse that Inc LA return (Expiration) Occurs secondary to what? |
Mitral Stenosis
Rheum Fever |
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Draw Mitral Stenosis
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Draw Mitral Stenosis
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What murmur:
Continuous machine like murmur Hx of rubella or prematurity |
PDA
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Draw PDA
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Draw PDA
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DRAW Ventric Action Potential
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DRAW Ventric Action Potential
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Ventric Action Pot:
P0: P1: P2: P3: P4: |
P0: Na In
P1: K out P2: K out VS Ca in --> Plateau P3: K out P4: K out --> resting potential |
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DRAW pacemaker AP
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DRAW pacemaker AP
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P4:
P0: P1: NO phase 1 P2: NO PHASE 2 P3: |
P4: Slow, spontaneous inc in pacemaker membrane perm to Na
P0: Ca open P1: NO PHASE 1 P2: NO PHASE 2 P3: Ca close, K out |
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EKG Components:
1) Represents atrial depol? 2) Represents slow conduction through AV node ( > .2s) 3) Represents Ventric Depol (.12 s) 4) Represents mechanical contraction of vents? 5) Represents ventricular repol. A) If t-wave is inverted = ? 6) Reps vents depol and isoelectric? 7) Reps hypokalemia |
1) p-wave
2) PR interval 3) QRS 4) QT interval 5) T-wave A) Previous MI 6) ST seg 7) U-wave |
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Give the pacemakers in order of dominant automaticity?
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SA node -->
AV node --> BOH --> Purkinje fibers / vents |
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What's the def of V-tach?
Torsades de pointes has what appearance on ECG? See DIT CV P. 19 for Rx that prolong QT!! |
3 or more PVCs in a row
Ribbon-like appearance |
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Name that arrythmia:
1) Irregularly irregular QRS complexes (rhythm) No discernable p-waves 2) How to tx a-fib? 3) You must p-lax against clots w/ what? |
1) A-fib
2) If < 48 hrs: Cardiovert If > 48 hrs: RATE CTL w/ beta blocks, Ca Chann blocks, digoxin Rhythm CTL w/ sotalol, Amiodarone 3) Warfarin (coumadin) |
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Name That Arrhythmia:
1) Sawtooth p-waves 2) Tx for A-flutter? |
1) Atrial flutter
2) IA, IC, III anti-arrhythmics |
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Name that arrhythmia:
1) PR Interval > .20 2) Progressively lengthening PR Interval --> dropped beat? (p w/out a QRS) 3) NO progressively lengthening PR int --> dropped beat (p w/out QRS), often in 2:1, 3:1, 4:1 etc pattern? A) may progress to what? B) tx? |
1) 1st degree AV block
2) 2nd degree AV block, Mobitz I Wenckebach 3) 2nd degree AV block, Mobitz II A) 3rd degree block B) Pacemaker |
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Name that arrhythmia:
1) delta waves? A) Tx for WPW? |
1) WPW
A) Procainamide Amiodarone |
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Name That Arrhythmia:
1) Atria and ventricles beat independently --> no correlation b/t p and QRS complexes A) Can be the result of an infxn w/ what? |
1) 3rd Degree AV block
A) Borrelia burgdorferi (Lyme Dz) |
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A completely erratic rhythm w/ no ID-fiable waves?
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Ventricular fibrillation
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ANP
1) ANP is released from atria in response to what? 2) Effect on vasculature? |
1) Inc blood volume -->
Inc atrial pressure 2) Relaxes systemic vasculature Constricts Efferent Arts of kidneys Dilates Afferent Arts of Kidneys |
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Receptors
1) Give the path of the baroreceptors A) Aortic arch responds to what? B) Carotid Sinus? |
1) Aortic arch -->
Vagus Nerve --> Medulla Carotid sinus --> Glossopharyngeal Nerve --> Solitary Nucleus of Vagus A) ONLY to Inc BP B) Dec AND Inc BP |
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BC carotid masssage puts pressure on carotid sinus chemoreceptors, what FX will it have on HR?
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Dec HR
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The Peripheral Chemoreceptors of the carotid and aortic bodies will respond to what 3 things?
The Central Chemoreceptors of the brain respond to what 2 things? A) do they respond to pO2? |
Dec pH
Dec pO2 Inc pCO2 Changes in brain interstitial fluid pH and pCO2 resulting from changes in arterial CO2 A) NO |
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What is the Cushing RXN?
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When Inc IC pressure -->
cerebral ischemia --> Inc pCO2 and dec pH as measured by chemoreceptors --> Cushing's Triad: HTN, Bradycardia, Respiratory Depression |
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What organ gets the largest share of CO?
What Organ extracts the most O2 from the blood? |
Liver
Heart |
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PCWP is measured using what?
It approximates what? |
Swanz-Ganz Catheter
L. Atrial Pressure |
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How are the lungs different from every other organ in their response to hypoxia?
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Every other organ will respond to hypoxia by releasing substances to vasodilate.
the lungs will VASOCONSTRICT hypoxic areas in order to shunt blood towards better ventilated areas |
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What do the following forces acting on the capp do:
1) Pc (capp hydrostatic press)? 2) Pi? (interstit hydrostatic press) 3) PIc (plasma oncotic pressure)? 4) PIi (interstitial oncotic pressure)? |
1) Push fluid out of cap
2) push fluid into cap 3) pull fluid into cap 4) Pull fluid out of cap |
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Shunts:
1) Which type of shunt will --> early cyanosis (blue babies) and Late cyanosis (blue kids) 2) Name the 5 R --> L Shunts that lead to early cyanosis (blue babies)? 3) Name the 3 L --> R Shunts that lead to late cyanosis (blue kids)? |
1) early cyanosis (blue babies):
R --> L Shunt Late cyanosis (blue kids): L --> R Shunt 2) 5 Ts: Tetralogy of Fallot Transposition of Great Arts Truncus Arteriosus Tricuspid Atresia TAPVR 3) All have "D" in them: vsD asD pDa |
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What pathology does this describe?
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When a L--> R shunt (vsD, asD, pDa)
--> Pulm vasc hypetrophy --> Inc pulm vasc resistance --> REVERSAL of shunt to R --> Left --> Late cyanosis (blue kids) as evidenced by clubbing and polycythemia |
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1) Give the 4 elements of TOF?
2) What shape will the heart be on CXR? 3) How do TOF pts improve their sx? |
1) PROVe
Pulmonary stenosis RVH Overriding Aorta VSD 2) Boot shaped heart 3) They squat to improve their sx TOF = SQUAT to your BOOTS |
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What must be present for a dTGA kids to survive?
dTGA is the result of what? |
VSD, PDA, Patent foramen ovle
Failure of aorticopulmonary septum to spiral |
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What pathology does this describe:
1) Aortic stenosis PROXIMAL to insertion of DA Assoc w/ Turner's 2) Aortic stenosis distal to insertion of LIGAMENTUM ARTERIOSUS (not DA) Notching of ribs from collat circ HTN UE Weak pulse in LE 3) Adult type coarctation of aorta most commonly assoc w/ what valve defect? |
1) Infantile type Coarctation of aorta
2) Adult type coarctation of aorta 3) Bicuspid aortic valve |
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1) What genetic disorder is assoc w/ ASD, VSD, AC Septal defect from endocardial cushion defect?
2) Infantile coarctation of aorta is assoc w/ what congenital dz in girls? |
1) Down's Syndrome
2) Turner's Syndrome |
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HTN is what?
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BP > or equal to 140 / 90
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NOTE:
Atheromas (plaques in Blood Vessel walls) Xanthomas (lipid filled histiocytes in eyelids) Corneal arcus (lipid deposits in cornea) Are assoc w/ Hyperlipidemia |
NOTE:
Atheromas (plaques in Blood Vessel walls) Xanthomas (lipid filled histiocytes in eyelids) Corneal arcus (lipid deposits in cornea) Are assoc w/ Hyperlipidemia |
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What pathology does this describe:
1) Intraluminal tear in aorta --> formation of a false lumen 2) AD is assoc w/ what 2 things? 3) Pt will present w/ what complaint? 4) Major XRAY sign for AD? 5) @ inc risk for? 6) HOW TO TX AD? |
1) Aortic dissection
2) Cystic medial necrosis of Marfans and HTN 3) Tearing chest pain that radiates to back 4) Mediastinal widening 5) Aortic rupture and death 6) beta-blocker to Dec BP!! |
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3 s/s of Left heart failure?
3 s/s of R heart failure? |
Pulm Edema
PND (Paroxysmal Nocturnal Dyspnea) Orthopnea Hepatomegaly (nutmeg liver) Ankle and sacral edema JVD |
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6 Drugs to tx ACUTE HF?
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LMNOP
Loop Diuretics Morphine Nitrates O2 Positioning and pressors |
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SEE DIT BOOK CV P 14 AND DO THE MURMURS CHART
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SEE DIT BOOK CV P 14 AND DO THE MURMURS CHART
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For each of the following types of shock, give the change in the SVR and CO:
1) Hypovolemic Shock: 2) Heart Failure shock: 3) Septic shock / anaphylaxis: 4) Neurogenic shock: |
1) Inc SVR, Dec CO
2) Inc SVR, Dec CO 3) Dec SVR, Inc CO 4) Dec SVR, Inc CO |
