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IM CV other CV USMLE 2


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difference b/t Type A and Type B Aortic Dissections
Type A: involves the ascending aorta and can extend into the descending aorta

Type B: descending aorta only
Debakey Classification of Aortic Dissection Types I-III Which is most common?
I: Ascending plus part of distal aorta (most common)

II: Ascending only

III: Descending only
What is infected on the aorta when the aortic dissection is due to syphilis?
Vasa Vasorum
Etiology of Aortic Dissection (7)
Pregnancy (3rd trimester);
Aortic Coarctation (Turners or idiopathic);
Congenital heart dz / CT dz (Marfans and E-D syndromes) / Cocaine;
Severe tearing chest pain that radiates to the back, HTN, possible unequal pulses distally, possible aortic regurg murmur
Aortic Dissection
(3) tests to confirm Dx of aortic dissection
Angiogram (gold standard);

CXR - wide mediastinum;

CT w/ contrast
Drug Tx for Aortic dissection to stabilize BP

What is the next step for Type A vs. Type B?
Rx: Beta-blocker + nitroprusside to keep BP < 120

Type A: Immediate surgery

Type B: medical stabilization
Etiologies of Syncope (7)
Situational (valsalva, tight collar);
Vasovagal response (common faint);
Orthostatic hypotension;
Psychiatric (faking it);
Everything else (idiopathic)
At what level is HDL cardioprotective?
> 60
What "type" is all isolated hypercholesterolemia?
Type IIa
What transports cholesterol from the gut to the bloodstream?
What is left over after lipoprotein lipase liberates FFA from chylomicrons for use in tissues?
Chylomicron remnants
What is secreted from the liver and carries endogenous cholesterol?
What is metabolized from VLDL?
Intermediate-Density Lipoproteins (IDL)
What is metabolized from IDL and carries cholesterol in the bloodstream to the tissues?
What takes up free cholesterol secreted by the tissues and transports it to the liver?
What is the name for the (3) Type IIa Isolated Hypercholesterolemias?
What is abnormal with all of them?
What is the total cholesterol range?
Familial Hypercholesterolemia;

Familial defective apo-B100;

Polygenic Hypercholesterolemia

- High LDL
- total cholesterol from 240 - 500
What are the (3) isolated Hypertriglyceridemias and each "Type"?
What is elevated w/ each?
1. familial Hypertriglyeridemia Type IV - high VLDL

2. familial Apo-CII deficiency

3. familial Lipoprotein Lipase deficiency

(2 and 3 are both Type I + V - high chylomicrons)
Class of drugs that that reduce LDL by binding bile acids in the gut.
name (2) drugs
Bile Acid Sequestrants

which drug class is best for reducing triglycerides in VLDL and chylomicrons?

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