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on 22-Apr-2016 (Fri)

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Flashcard 1333193477388

Tags
#nephrology
Question
Spironolactone/Eplerenone does what
Answer
Blocking action of Aldosterone

NB: spironolactone = K+ sparing diuretic


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Flashcard 1334639987980

Tags
#cardiology
Question
What is heart failure?
Answer
Heart Failure – “inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body (forward failure) or is only able to do so if the cardiac filling pressures are abnormally high (backward failure)”


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Flashcard 1334641822988

Tags
#cardiology
Question
What are the 3 prinicpal functional classes of heart failure?
Answer
1. Heart failure with reduced ejection fraction (usually dilated heart)
2. Heart failure with preserved ejection fraction (usually stiff heart)
3. Right heart failure


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Flashcard 1334643657996

Tags
#cardiology
Question
[...] is often the end stage of numerous pathological processes that injure the myocardium
Answer
Heart failure is often the end stage of numerous pathological processes that injure the myocardium


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Flashcard 1334645493004

Tags
#cardiology
Question
Heart failure is often the [...] stage of numerous pathological processes that injure the myocardium
Answer
Heart failure is often the end stage of numerous pathological processes that injure the myocardium


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Flashcard 1334647328012

Tags
#cardiology
Question
Heart failure is often the end stage of numerous pathological processes that injure the [...]
Answer
myocardium


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Flashcard 1334649163020

Tags
#cardiology
Question
Initially, changes to the heart represent [...] and [...] alterations meant to improve cardiac performance after an insult to the heart or abnormal hemodynamics
Answer
Initially, changes to the heart represent structural and molecular alterations meant to improve cardiac performance after an insult to the heart or abnormal hemodynamics


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Flashcard 1334650998028

Tags
#cardiology
Question
Primary cardiomyopathies have significant potential for [...] .
Answer
heritability


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Flashcard 1334652833036

Tags
#cardiology
Question
What are 3 types of primary cardiomyopathies?
Answer
genetic, mixed, acquired


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Flashcard 1334662794508

Tags
#cardiology
Question
What are the genetic causes of primary cardiomyopathies?
Answer
  • HCM, ARVD/C, LVNC, Glycogen storage. Conduction defects, mitochondrial myopathies, Ion channel disorders ( LQTS, Brugada, SQTS, CVPT, Asian SUNDS)


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Flashcard 1334665415948

Tags
#cardiology
Question
What are mixed causes of primary cardiomyopathies?
Answer
  • DCM, restrictive (non-hypertrophied and non-dilated)


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Flashcard 1334667513100

Tags
#cardiology
Question
What are acquired causes of primary cardiomyopathies?
Answer
  • inflammatory( myocarditis), stress-provoked (tako-tsubo), peripartum, tachycardia-induced, infants of insulin-dependent diabetic mellitus

    NB: young person death usually due to toxicity


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Flashcard 1334669348108

Tags
#cardiology
Question
What are causes of secondary cardiomyopathies?
Answer
Infiltrative (extracellular), Storage (intracellular) ,Toxic (alcohol known toxin) , Endomyocardial Fibrosis , Inflammatory, Endocrine (diabetes, thyroid). Genetic Syndromes. Neuromuscular. Nutritional (from alcohol) . Autoimmune / CVD


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Flashcard 1334671183116

Tags
#cardiology
Question
[What type of cardiomyopathy] is a specific type of heart muscle disease (primary cardiomyopathy) because it predominantly involves the heart only and typically has a genetic basis.
Answer
Hypertrophic cardiomyopathy


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Flashcard 1334673018124

Tags
#cardiology
Question
Hypertrophic cardiomyopathy is a specific type of heart muscle disease ( [primary/secondary] ) because it predominantly involves the heart only and typically has a genetic basis.
Answer
primary cardiomyopathy


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Flashcard 1334674853132

Tags
#cardiology
Question
What are the 3 structural patterns of heart disease?
Answer
hypertrophied/hypertrophic - enlarged heart often with an enlarged and thickened left ventricle

Dilated (most common) – primary or secondary DCM

Restrictive – idiopathic or due to some infiltrative process such as amyloidosis, sarcoidosis, systemic sclerosis, etc….


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Flashcard 1334676688140

Tags
#cardiology
Question
A hypertrophic pattern of heart disease includes many possible candidates – only one of which is a true [...]
Answer
“hypertrophic cardiomyopathy”


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Flashcard 1334678523148

Tags
#cardiology
Question
Other forms of hypertrophy that one may see is causing a hypertrophied pattern can include: (not all hypertrophied hearts are HCM)
Answer
  1. Hypertensive heart disease (commonest cause of hypertrophy in our population)
  2. Fabry’s disease
  3. LVH in the setting of aortic valve disease (both aortic stenosis and aortic insufficiency associated with LVH)
    d. acromegaly
NB: These other forms may or may not have an underlying genetic basis and most are acquired forms of heart disease


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Flashcard 1334680358156

Tags
#cardiology
Question
In structural patterns of heart muscle disease, [...] is important
Answer
apex formation


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Flashcard 1334683241740

Tags
#cardiology
Question
In [...], the apex is distorted, valves don't close properly, and it may or may not show increased thickness
Answer
dilated cardiomyopathy


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Flashcard 1334685076748

Tags
#cardiology
Question
In dilated cardiomyopathy, the [...] is distorted, valves don't close properly, and it may or may not show increased thickness
Answer
apex


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Flashcard 1334686911756

Tags
#cardiology
Question
In dilated cardiomyopathy, the apex is distorted, valves [...] , and it may or may not show increased thickness
Answer
don't close properly


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Flashcard 1334688746764

Tags
#cardiology
Question
In dilated cardiomyopathy, the apex is distorted, valves don't close properly, and it may or may not show [...]
Answer
increased thickness


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Flashcard 1334690581772

Tags
#cardiology
Question
In [...] pattern cardiomyopathy, the thickness is widened, there is decreased blood, and it's less able to relax
Answer
hypertrophied


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Flashcard 1334692416780

Tags
#cardiology
Question
In hypertrophied pattern cardiomyopathy, the thickness is [...] , there is decreased blood, and it's less able to relax
Answer
widened


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Flashcard 1334694251788

Tags
#cardiology
Question
In hypertrophied pattern cardiomyopathy, the thickness is widened, there is [...] blood, and it's less able to relax
Answer
decreased


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Flashcard 1334696086796

Tags
#cardiology
Question
In hypertrophied pattern cardiomyopathy, the thickness is widened, there is decreased blood, and it's less able to [...]
Answer
relax


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Flashcard 1334697921804

Tags
#cardiology
Question
In [...] , there may or may not be hypertrophy of muscle, the composition of the wall is changed, and the normal elastic pattern isn't there anymore.
Answer
restrictive cardiomyopathy


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Flashcard 1334699756812

Tags
#cardiology
Question
In restrictive cardiomyopathy, there may or may not be hypertrophy of muscle, the composition of the wall is changed, and [...] isn't there anymore.
Answer
the normal elastic pattern


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Flashcard 1334701591820

Tags
#cardiology
Question
Dilated cardiomyopathy can possess [2 things]
Answer
remodelling and hypertrophy


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Flashcard 1334703426828

Tags
#cardiology
Question
Dilated cardiomyopathy typically exhibits [...] failure
Answer
‘forward’ (+/‐ ‘backward’)


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Flashcard 1334705261836

Tags
#cardiology
Question
What is the process of dilated cardiomyopathy?
Answer
  • First stage of compensation is hypertrophy, then muscle function increase so 02 demand is high but o2 supply is the same so get damaged muscle
  • When thin out, can affect corda tendon and papillary muscle
  • Valve can’t close properly
  • If Heart can’t function properly get stasis and get mural thrombosis


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Flashcard 1334707096844

Tags
#cardiology
Question
Describe the gross anatomy observed in dilated cardiomyopathy.
Answer
ventricle enlarged, atria often enlarged and the apex is rounded rather than pointed and base is blunted
  • May lead to dilation of RV and then into RA at that point we call 4 chamber dilation


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Flashcard 1334708931852

Tags
#cardiology
Question
The most common pattern in hypertrophic cardiomyopathy is [...]
Answer
asymmetric septal hypertrophy


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Flashcard 1334709456140

Tags
#cardiology
Question
Very thick and reduced volume in hypertrophic cardiomyopathy => [...]
Answer
diastolic dysfunction


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Flashcard 1334712601868

Tags
#cardiology
Question
[...] is common in hypertrophic cardiomyopathy
Answer
Myocardial fibrosis/scar


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Flashcard 1334714436876

Tags
#cardiology
Question
What is SAM? In what condition do you see it?
Answer
systolic anterior motion of the mitral valve

Hypertrophic cardiomyopathy


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Flashcard 1334716271884

Tags
#cardiology
Question
The [...] also frequently hypertrophied in HCM
Answer
right ventricle


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Flashcard 1334718106892

Tags
#cardiology
Question
What makes a pt prone to sudden death in HCM?
Answer
Scarring- arrhythmogenic foci


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Flashcard 1334720204044

Tags
#cardiology
Question
What happens in restrictive cardiomyopathy?
Answer
Infiltration of fibrous tissue or some other substance in myocardium –very stiff ventricles
  • Still has apex forming unlike dilated
  • E.g. sarcoidosis which is a type of non-caseating granulomatous inflammation
  • Idiopathic restrictive cardiomyopathy – fibrous tissue from unknown cause


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Flashcard 1334724660492

Question
What does 'prima facie' mean?
Answer
At face value (only rough definition)
adverb
1. at first appearance; at first view, before investigation.

adjective
2. plain or clear; self-evident; obvious.


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