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*TA Henry:Aneurysms: remember the dilation is caused by weakening of the *media* most often due to
atherosclerosis.

ALSO remember WHERE aneurysms occur: AAA most commonly, and we fix these at 5cm.
*TA Henry:An Aortic Dissecting Aneurysm will spread along the aorta and can interfere with flow to the
subclavian and even the recurrent laryngeal nerve!
*TA Henry:Beck's Triad: distant heart sounds, JVD, and decreased BP. Why? Imagine squeezing the heart
while it tries to beat - if it cannot beat blood cannot flow
*TA Henry:Berry, cherry, saccular - whatever you want to call these sac-like aneurysms they are usually in
the Circle of Willis. Keep these in mind with ADPKD (the ADult type)
*TA Henry:DVT: think sedentary, elderly, females (especially on OCPs), and people with malignancies!
Virchow's triad!
*TA Henry:Tie hemorrhoids into anatomy: superior rectal veins drain into the portal system, but the inferior
do not!
*TA Henry:Port wine hemangioma with intellectual disability and seizures? Sturge-Weber syndrome. Why
this triad? The proliferation of vessels we can see with the hemangioma is ALSO occuring in the meninges!
*TA Henry:Kaposi sarcoma can present similarly to Bartonella angiomatosis: the key differential on step 1
will be the presence of lymphocytes (viral) or neutrophils (bacterial)
*TA Henry:Angina, MI, and sudden-cardiac death are the big 3 ischemic heart disease processes we MUST
know not just for test day, but for clinical practice
*TA Henry:Two good starting points for differentiating angina: rest or with exertion? responds to nitro, or
does not?
*TA Henry:Rather than memorizing constellations of presentations, master the anatomy of the heart and use
that to think through symptoms presented
*TA Dr. Owen:The most sensitive early marker for myocardial infarction is myoglobin. Troponin (most
specific) levels should be measured at presentation and again 10-12 hours after the onset of symptoms.
*TA Dr. Owen:Complications of MI: arrhythmia, CHF, shock, mural thrombus, thromboembolism, and
rupture.
Dressler - type II AI disease, 2-6 weeks after MI, present with friction rub, pericarditis.
*TA Dr. Owen:Clinically, the degree of orthopnea is often quantified in terms of the number of pillows the
patient needs in order to sleep comfortably (e.g., “three-pillow orthopnea”).
*TA Dr. Owen:Cor pulmonale is right-sided heart failure caused by pulmonary hypertension from intrinsic
lung disease.
Lung disease → pulmonary HTN → ↑ right ventricular pressure → right ventricular hypertrophy → right-
sided heart failure
*TA Dr. Owen:Carcinoid -> increased serotonin causing skin flushing, diarrhea, cramping, bronchospasm,
wheezing, and telangiectasias. Dx w/ urinary 5-HIAA
*Content TA AJ*:If see fever, chills and murmur, that is a good sign that we have bacterail endocraditis.
Staph aureus is the most common acute cause
*Content TA AJ*:Tricuspid valve is affected in IV drug users: this is very high yield
*Content TA AJ*:Osler: OWsler: they are painful
*Content TA AJ*:Think about colon cancer when you see Clostridium speticum and Strep gallolyticus
*Content TA AJ*:A lot of the prompts for rheumatic heart disease will mention a history of a pharygenal
infection during childhood
*Content TA AJ*:MIgratory large joint arthiritis bugs: Group A strep, lyme disease, and gonorrhea
*Content TA AJ*:Fusion of commissures is an indication of aortic stenosis due to rheumatic fever
*Content TA AJ*:3-8 weeks of life is when teratogenesis is most likely because that is when organogenesis
occurs
*Content TA AJ*:Tretralogy of Fallot is very high yield. You should know what the four lesions are:
pulmonary outflow tract obstruction, right ventricular hypertrophy, overriding aorta; ventricular septal defect.
The boot shaped heart on imaging is high yield as well
*Content TA AJ*:Tranposition of the great vessels is basically switching of the compartments that the aorta
and pulmonary artery arise from. This is a death sentence without surgery
*Content TA AJ*:Prostaglandin E keeeeeeeeps the PDA open
*Content TA AJ*:VSD: left to right shunt (b/c the left ventricle has higher pressure). What you will hear is a
harsh holosystolic murmur
*Content TA AJ*:Two types of coarcatation: preductal and postductal. Pre comes first, so I remember that
this one is in infants. Postductral is in adults and is less severe. Preductal has cyanosis and weak pulses in
lower extremities. Postductal has high yield notching of the ribs on chest x ray