Inherited cardiac conditions

Question 1

what do genes to

Answer 1

make proteins

Question 2

three types of cardiomyopathies

Answer 2

hypertrophic
dilated
Restrictive

Question 3

cardiomyopathy refers to?

Answer 3

primary heart muscle disease

Question 4

what is HCM caused by

Answer 4

sarcomeric protein gene mutations such as gene encoding b myosin or myosin binding protein c

Question 5

cause and pathology for hypertrophic CM

Answer 5

Inherited
thick non compliant heart = impaired diastolic filling as the inter ventricular septum thickens — decreased CO

Question 6

characteristics of hypertrophic CM

Answer 6

Myofibrillar hypertrophy with chaotic and disorganised fashion myocytes and fibrosis on biopsy

Question 7

symptoms, diagnosis and tx for hypertrophic cardiomyopathy

Answer 7

Sx - often asymptomatic , exertionak dyspnoea , syncope with exercise

SUDDEN DEATH in young patients
DX- echo, ecg

Question 8

echo findings for hypertrophic cardiomyopathy

Answer 8

MR SAM ASH
mitral regurgitation (MR)
systolic anterior motion (SAM) of the anterior mitral valve leaflet
asymmetric hypertrophy (ASH)

Question 9

ECG findings for hypertrophic cardiomyopathy

Answer 9

• left ventricle hypertrophy
• ## deep q waves

Question 10

what is dilated cardiomyopathy often caused and its pathology

Answer 10

Most common CM leading to predominantly systolic function

all 4 chamoers dilated but LV more so
Idiopathic - most common cause

Question 11

symptoms, dx and tx of dilated cardiomyopathy

Answer 11

SOB, heart failure, atrial fibrilation , thromboemboli

ECG, ECHO

Treat underlying cause

Question 12

features of dilated cm

Answer 12

classic findings of heart failure
systolic murmur: stretching of the valves may result in mitral and tricuspid regurgitation
S3
‘balloon’ appearance of the heart on the chest x-ray

Question 13

cause and pathology of restrictive cardiomyopathy

Answer 13

cause - granulomatous disease, idiopathic

path- rigid fibrotic myocardium, fills poorly and contracts poorly

Question 14

symptoms, diagnosis and tx of restrictive cardiomyopathy

Answer 14

severe dyspnoea , S3 + S4 sounds, oedema

ECG, ECHO
none- consider transplant

Question 15

white areas on HCM are

Answer 15

fibrosis

Question 16

ecg characteristic wave for ARVC

Answer 16

EPSILON WAVES

Question 17

hypertension is a risk factor for ?

Answer 17

Stroke – ischaemic and haemorrhagic
Myocardial infarction
Heart failure
Chronic renal disease
Cognitive decline
Premature death

Question 18

issue with hypertension

Answer 18

peripheral resistance

Question 19

Cardiac output is an interplay between

Answer 19

a. Renin-Angiotensin-Aldosterone system
b. Sympathetic nervous system (noradrenaline)

Question 20

potent vasoconstrictor

Answer 20

ANGIOTENSIN 2

Question 21

Sympathetic nerves to the kidney cause ?

Answer 21

increase in release of renin

Question 22

main mechanism of ACE inhibitor

Answer 22

block the ace enzyme and reduce production of ang2

Question 23

what med can support the peripheral resistance

Answer 23

calcium channel blockers

Question 24

main clinical indications for ace inhibitors

Answer 24

hypertension
heart failure
diabetic neuropathy

Question 25

side effect of reduce ang2 production

Answer 25

• hypotension
  -acute renal failure
  -hyperkalaemia
  -teratogenic effects in pregnancy

Question 26

common example of ccb

Answer 26

amlodipine
nifedipine
verapamil

Question 27

three groups of ccb’s

Answer 27

dihydropyridines
phenylalkylamines
benzothiazepines

Question 28

adverse effects of ccb due to peripheral vasodilation

Answer 28

flushing
oedema
headache
palpitations

Question 29

adverse effects of ccb;s due to negative chronotropic effects ?

Answer 29

bradycardia
atrioventricular block

Question 30

adverse effect of verapamil

Answer 30

worsening of cardaic failure

Question 31

beta blockers main clinical indications

Answer 31

Ischaemic heart disease (IHD) – angina
Heart failure
Arrhythmia
Hypertension

Question 32

common examples of bb

Answer 32

bisoprolol
atenolol
proranolol

Question 33

main adverse effects of bb

Answer 33

Fatigue
Headache
Sleep disturbance/nightmares

Bradycardia
Hypotension
Cold peripheries
Erectile dysfunction

Question 34

beta blockers cause worsening of

Answer 34

ASTHMA
PVD
HEART FAILURW

Question 35

Clinical indications of diuretics

Answer 35

hypertension
heart failure

Question 36

what do nitrates do

Answer 36

arterial and venous dilators
reduction of preload and afterload
lower BP

Question 37

MAIN uses for nitrates

Answer 37

ihd
heart failure