cause of dextrocardiaDefect in left-right Dynein (involved in L/R asymmetry) can lead to Dextrocardia, as seen in Kartagener syndrome (1° ciliary Dyskinesia). cardiology HirotoShishido
pharmacologic stress testinguseful in diagnosing atherosclerotic CAD(coronary artery disease)
☆Dobutamine, a beta-1 agonist, increases heart rate and contractility to mimic the increase in myocardial oxygen demand that occurs with exercise. Myocardium that is unable to obtain sufficient blood flow to meet the increased oxygen demand typically demonstrates a ☆transient decrease in contractility . cardiologypharmacologyUWorld HirotoShishido
areas particulary susceptible to neuropathic ulcersare points of localized pressure created by a shoe or weight-bearing bones of the foot (eg, ☆plantar surface of the first metatarsal head)
A wound in this area often goes unnoticed (due to lack of pain sensation and being hidden by socks orshoes) and can develop into a nonhealing foot ulcer. cardiologyendocrinologyUWorld HirotoShishido
the most important intervention to lower the risk of myocardial infarction☆smoking cessation
・cigarrete smoke generates free radicals that oxidaze LDL and accelerate atherosclerosis
・nicotine causes catecholamine release, resulting in α1 mediated vasoconstriction
・arteriolar wall damage induces endothelial cell dysfunction and consequently, prostacycline and nitric oxide production decrease cardiologyUWorld SIM2 HirotoShishido
drug eluting stent☆Everolimus and its pharmacologic counterparts (eg, sirolimus, zotarolimus) are cytostatic drugs that inhibit mTOR (mammalian target of rapamycin receptor), blocking the cell cycle between the G1 and S phase to reduce smooth muscle cell proliferation.
Coating the intracoronary stent surface with an antiproliferative agent such as everolimus creates a drug-eluting stent that helps ☆prevent neointimal hyperplasia and stent restenosis. cardiologypharmacologyUWorld SIM2 HirotoShishido
the diffrence of parameters between cardiogenic and obstructive shockonly PCWP(left sided preload)
cardiogenic→ increase
obstructive→ decrease
heart murmurs occurs with the patients with bacterial endocarditisholosystolic murmur
caused by mitral regurgitation/tricuspid regurgitation cardiologyUWorld SIM2 HirotoShishido
histological findings of cardiac myxomasnumerous ☆bland stellite cells in a background of myxoid ground substances
histologic changes of hypertensive (malignant) nephrosclerosisLeakage of fibrinogen and coagulation factors through the damaged endothelium causes fibrin deposition in vessel walls, which appear as circumferential, acellular eosinophilic deposits (fibrinoid necrosis).
Over time, release of growth factors by damaged tissue stimulates the formation of concentric layers of collagen and proliferating smooth muscle cells, resulting in an☆ "onion skin" appearance (hyperplastic arteriosclerosis) of the arteriole.
manifestations/ presentation of fibromuscular dysplasia☆Fibromuscular webs (luminal stenosis) alternating with areas of aneurysmal dilation
☆Loss of the internal elastic lamina
Most common in women, age <55
pathophysiology of aortic stenosisThere is subendothelial lipid deposition and infiltration of inflammatory cells (ie, macrophages, T lymphocytes) followed by the release of inflammatory mediators (eg,interleukin-1-beta, transforming growth factor beta-1).
Subsequently, there is increased production of proteins involved in tissue calcification (eg, osteopontin). ☆Fibroblasts differentiate into osteoblast-like cells, leading to aberrant bone matrix deposition with progressive valvular calcification and stenosis. cardiologypathologyUWorld HirotoShishido
development of a new systolic murmur that resolved following revascularization in patients with myocardial infarction(MI)Myocardial infarction can cause ischemia of the papillary muscle and the adjacent LV wall on which it is mounted.
This results in hypokinesis and outward ☆displacement of the ☆papillary muscle, creating increased tension on the attached chordae tendineae and preventing complete closure of the corresponding mitral valve cusp.
Timely restoration of adequate blood supply with coronary revascularization restores papillary muscle and LV wall motion, often leading to resolution of the MR. cardiologyUWorld HirotoShishido
signs of hyperlipidemiaobstructive biliary lesions, ☆primary billary cholangitis result in hypercholestrolemia
causes of cutaneous vessel vasculitisOccurs 7-10 days after certain medications (☆penicillin, cephalosporins, phenytoin, allopurinol) or infections (eg, HCV, HIV)
what mediator is closely correlated with the severity of giant cell arteritis(temporal arteritis)the production of cytokines, particularily interleukin-6(IL-6)
what chemical mimics connective tissue disruption in the aorta seen in patients with Marfan syndromeBeta-aminopropionitrile (a chemical found in certain kinds of ☆sweet peas) causes inhibition of lysyl oxidase, an enzyme responsible for cross-linking elastin fibers and collagen fibers.
Ingestion of this compound can cause connective tissue disruption in the aorta that mimics the myxomatous degeneration seen in patients with Marfan syndrome. cardiologybiochemistryUWorld HirotoShishido
difference between arterial and venous insufficiencyarterial
Tips of toes, sharply demarcated, very painful
