Cardiology · USMLE Step 1

USMLE Rapid Review: Cardiovascular and Renal

A condensed rapid review pass over the highest yield cardiovascular and renal facts across pathology, physiology, and pharmacology for final week review.

39 cards · basic cards · AI-written, checked twice. Edit anything.

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What does a third heart sound (S3) usually indicate in an adult?
Volume overload, as in heart failure
What does a fourth heart sound (S4) indicate?
A stiff, non-compliant ventricle (e.g., from hypertrophy)
What is Beck's triad a sign of?
Cardiac tamponade
Define pulsus paradoxus.
A drop in systolic blood pressure of more than 10 mmHg during inspiration
What is Kussmaul sign and what condition classically causes it?
A paradoxical rise in jugular venous pressure during inspiration, seen in constrictive pericarditis
According to the Frank-Starling law, what happens to stroke volume as venous return (preload) increases?
Stroke volume increases
Cardiac output equals stroke volume multiplied by what?
Heart rate
Ejection fraction is calculated as stroke volume divided by what?
End-diastolic volume
What is the mechanism of beta blockers as antiarrhythmics (Class II)?
They decrease sympathetic activity, slowing phase 4 depolarization at the SA and AV nodes
What is the mechanism of Class III antiarrhythmics?
They block potassium channels, prolonging repolarization and the effective refractory period
What enzyme do ACE inhibitors block?
Angiotensin-converting enzyme, preventing conversion of angiotensin I to angiotensin II
Why do ACE inhibitors cause a dry cough?
They prevent breakdown of bradykinin, which accumulates in the lungs
Where do loop diuretics act and what do they inhibit?
The thick ascending limb of the loop of Henle, where they inhibit the Na-K-2Cl cotransporter
Where do thiazide diuretics act and what do they inhibit?
The distal convoluted tubule, where they inhibit the Na-Cl cotransporter
What is the mechanism of digoxin?
It inhibits the Na/K-ATPase pump, raising intracellular calcium and increasing myocardial contractility

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