2019 MC Flashcards
(134 cards)
1
Q
ACE inhibitor that is not a prodrug
A
Lisinopril
2
Q
What disease has direct apposition btwn epi and endocardium
A
Uhls anomaly
3
Q
A dog with HW disease echo is positive for worms but AG neg. what to do next?
A
Retest?
4
Q
What is the effect of Valsalva on ASD murmur?
A
Decrease intensity
5
Q
What common defect is seen with pulmonary anomalous connections?
A
Sinus venosus VSD
6
Q
Effects of vagal stimulation on atrial cells
A
Decrease inotropy, decrease conduction velocity, decrease ach, decrease HR
7
Q
ARVC in boxers and cats- what is true?
A
RV dilation more common in cats
8
Q
What causes paradoxical split S2?
A
Aortic stenosis/ HOCM/ LBBB
9
Q
Tissue Doppler is——frequency and —- velocity
A
High freq
Low vel
10
Q
Epinephrine receptor affect
A
B2>a1=a2
11
Q
What’s the PVARP for?
A
Prevent pacemaker mediated tachycardia
12
Q
Cor triatriatum sinister origin
A
Stenotic connection of the common pulmonary vein to the LA
13
Q
What defect results in reversed differential cyanosis?
A
Transposition with pda and ph
Transposition with pda and coarctation of aorta
14
Q
Main mechanism diuretic resistance
A
Decreased absorption of diuretic vs hypertrophy of distal nephron with increased NA absorption
15
Q
Pulmonary hypertension echo
A
Decreased at:et
16
Q
Atenolol effect atria?
A
Decrease atrial function
17
Q
MMVD-serotonin
A
Serotonin turns VIC into myofibroblasts
18
Q
Most common cause of CHF horse
A
Mitral valve disease
19
Q
Portuguese WD DCM
A
Autosomal recessive
20
Q
Normal cat Holter
A
Sinus arrhythmia common
21
Q
AP in dogs
A
Right sided, retrograde conduction
22
Q
What arrhythmia to give unsynchronized cardioversion
A
Ventricular flutter
23
Q
What wave form coordinates with an valve closure
A
C wave
24
Q
Which b blockers metabolized in liver?
A
All except sotalol
25
German Shepherd best arrhythmia treatment
Sotalol+mexiletine
26
GS arrhythmia mech
```
Abnormal serca
QT not long
EADs
DADs also poss
Die during sleep/bradycardia or right after exercise
```
27
Equine AF
Atrial fnc can improve
28
Vena contracta
Reflects size of hole
| Is OK with eccentric jets? No
29
Coanda effect
Mitral jet impinges the LA wall
30
What does Titin link?
Myosin to z band
31
How does quinidine stop AF
Prolongs AP and refractory period
32
Ferret heart disease
AR
33
Iguana heart disease
MR
34
Bird question
No diaphragm-heart is close to liver
35
QP:QS
2.8
36
MOA abciximab
Glycoprotein 2a/3b inhibitor( antiplatelet)
37
Cause of smoke in LA
Plasma protein interactions with rbcs at low shear rates
38
Side effects of quinidine in horse
Colic, laminitis, tachycardia
39
He disease in cats
I think answer had to do with echo most specific to find worms
40
PDE5 MOA
Breaks down cGMP and amp
41
Sildenafil mech
PDE5 inhibitor
42
Beta blocker which metab in liver
Propranolol>metoprolol
43
BB that crosses BBB
Propranolol
44
Common chem changes with hyperaldosteronism
Low renin, low K, high renal K excretion
45
PROTECT study
| Dobie survival
Median time to Primary endpoint
718 vs 441 days
Know what pimo does for arrhythmias ( no change)
***>4 VPCs on ECG was an independent predictor of survival
46
QUEST
Longer time to end point if a CKCS, lower furosemide dose, higher creatinine
47
What congenital needs PDA
Tet-PA
48
What does hyperk doe to cells
Hypo polarize
49
Most common clinical sign on cows with af
GI disease
50
Things that increase dig level
```
Hyper ca2+
Hypo k+
Hypo mg+
Amiodarone
Quinidine
NSAIDs
BB
```
51
What causes low O2 sat? Pick 3
Options are
exercise ,
Hypoxia
Polycythemia
52
Phosphodiesterase III inhibitor
Increase cAMP
53
Phosphodiesterase 5inhibitor
Increase cGMP
54
What is an Austin flint murmur
AI causing flutter of mitral valve
55
Side effect of spironolactone in cats
Facial dermatitis
56
Left and right coronary dominant
Left- dog,cat, ruminant
Right- people, pigs, horses
57
Accessory pathway characteristics in dogs
Most right sided
Unidirectional
Retrograde
Conduction is all or none fashion
58
Ferrets most common cardiomyopathy is—- and most common heart disease is —-
DCM and valve disease
59
Sc of choice to treat ToF
Modified blalock Taussig
60
What is modified blalock taussig
Graft to connect L subclavian or Ao to PA
61
Blalock taussig
Anastomoses L subclavian to PA
62
Potts
Anastomoses L PA and descending AO
63
Waterson
Anastomoses btwn R PA and Ascending Ao
64
Most common valve regurg in horses
AI
65
Nifedipine MOA
Ca channel blocker
66
Which valve prolapses in the horse
Aortic
67
Pick true statement about horse
Does AI lead to CHF? No
Tricuspid regurg in racehorse- does not negatively affect performance
68
EPIC TRIAL- which is true
* *1/3 longer survival with pimo
- pimo decreased chances of reaching CHF by 1/3 compared to placebo
Dogs live 8 months longer with pimo
Dogs live 12 months longer with pimo
*Primary endpoint (CHF) in placebo group reached at 766 days(25 months); pimo group 1228 days (40months)
69
Good indicator of increased LV filling pressures
*Tall steep E
70
How does ET1 cause vasoconstriction?
Through formation of IP3
71
Embryologic origin of CTD
Complete persistence of the right sinus valve
-in the embryo this valve shunts O2 blood from cdVC to foramen ovale
72
Bosentan mechanism
Endothelin-1 receptor antagonist
73
Pimobendan which is true
Longer elimination half life and higher plasma levels in cats
74
Which is true regarding feline HW dse
You can see Resp signs before a positive test in cats (feline HARD)
75
Most common disease with OAVRT
TVD
76
Which can right ligamentum arteriosum NOT attach to dorsally?
RPA
| Attaches to this ventrally
77
Which class I antiarrhythmic decreases the slope of Phase 0 the most?
Propafenone (class 1c)
78
Mech of digitalis induced arrhythmia
DADs
79
Equine mitral or aortic infectious endocarditis most commonly caused by what?
Strepto and actinobaccilus
| jugular thrombophlebitis causes TRICUSPID
80
True statement regarding equine valve regurg
Tricuspid more common than mitral in racing horses
81
Which is true comparing normal 24 hour feline Holter to that of cat with HCM?
Normal cats have <100 VPCs per day
82
Most common location of canine bypass tract and direction
Anteroseptal and retrograde
83
Bezold jarosch reflex decreases HR in response to what?
LV stretch ( C fibers)
84
Mech of GS inherited arrhythmias
Decreased SERCA2a expression
85
Best treatment for metoprolol overdose
Glucagon
86
ACEi most effective in horse
Benazapril
87
Isolated t wave alternans associated with what electrolyte abnormality
Hypocalcemia
88
Mechanism of long term lasix resistance
Hypertrophy of distal convoluted tubule
89
Other effects of pimo
Resensitizing baroteceptors
Improving lusitropy
Inhibiting TXA Abe platelet aggregation
Anti inflammatory by inhibiting NFkb
90
Rheobase
Pacemaker term-
Lowest voltage resulting in long term capture
91
Chronaxie
Pulse width corresponding to twice the rheobase
92
How to set voltage for pacemaker
Typically should set voltage at twice the threshold value at the chronaxie pulse width
93
Lead impedance normal values
Normal 250-1000 ohms
94
High lead impedence
High voltage threshold
Lead fracture
95
Low impedance
| Low voltage threshold
Insulation break
96
Normal lead impedance
High voltage threshold
Lead dislodgement or exit block
97
Oversensing pacemaker- what to do
Increase the amplitude (raise the fence)
98
Blanking period
25-100ms after pacing spike
No sensing in this period
1st pt of refractory pd
99
Refractory period
Adjusted to patient QT interval
Too long can cause noise reversion with asynchronous pacing
Too short- sense T wave
After blanking pd, signals are sensed but events do not restart the pacing intervals
100
Oversensing
Characterized by loss of capture with no pacing spike.
Need to decrease sensitivity ( increase number)
101
Under sensing
Pm delivers stimulus at wrong time.
1. Sensitivity too high
2. Lead dislodgement
3. Battery failure
4. Magnet application
5. Intrinsic beat falling within device refectory pd.
102
Fusion complexes (pm)
Ventricles stimulated spontaneously by spontaneous and paced beats.
103
Hysteresis
Ventricular pacing programmed to occur only after a pause longer than the programmed lower rate.
104
Noise reversion
Switch to asynchronous pacing when repetitive sensing at a high rate occurs
105
Dobutamine
B1>b2>a
106
Dopamine
>b
| High dose a
107
Norepinephrine
B1>a>b2
108
Epinephrine
B1=b2>a
109
Isoproterenol
B1>b2
| No alpha
110
Best treatment for beta blocker overdose
Isoproterenol- pure b receptor blocker
111
8 factors that affect diastole
```
Age
Ischemia
Hypertrophy
Hypertension
Atrial fibrillation
Fibrosis
Heart rate
Ventricular load at end systole
```
112
On boards, sometimes given deceleration time rather than pressure half time. How is PHT calculated?
Dct x 0.029
113
First aortic arch
Mostly disappears except for maxillary artery
114
Second aortic arch
Hyoid and stapedial arteries
115
Third aortic arch
Common carotid, pt of internal carotids
116
Forth aortic arch
Persists both sides.
L- pt of descending aortic arch (btwn left common carotid and l subclavian)
R- prox r subclavian
117
Fifth aortic arch
Regresses quickly
118
Sixth aortic arch
LPA
L ductus
RPA
119
Kent fibers
Av tract
Short PR and preexcitation
WPW
120
James fibers
Atrionodal
Short PR and normal QRS
No preexcitation
Lien-Ganong- Levine
121
Brechenmyer fibers
Atriohisian
Short PR and normal QRS
No preexcitation
122
Mahaim
Hisiofascicular
Possible short PR
Possible preexcitation
123
Iloprost
Synthetic analog of prostacyclin PG12
| Dilates systemic and pulmonary arterial beds
124
Sildenafil
Increase cGMP by inhibiting PDE5- preferentially improves blood flow to well ventilated pts of lung
125
Simvastatin
Enhances endothelial fnc via BMP pathway
126
Imitibifibi
Platelet derives growth factor receptor antagonist
127
Aspirin
Anti-platelet, irreversible inhibition of Cox 1 to inhibit thromboxane
128
Clopidogrel
Antiplatelet inhibits platelet aggregation via irreversible binding of ADP to Py 12
129
Enoxaparin
Binds anti thrombin to inhibit factor 10a
130
Warfarin
Interferes with vit k dep clotting factors
131
Rivaroxaban
Direct factor 10a inhibitor
132
Definition of severe AS
Peak velocity is >4.5m/s
Peak gradient is >50mmHg
Aortic valve area is
133
Severe AR-11 things
```
LV diastolic dimension increased
Regurg jet width/LVOT diameter>60%
Vena contracta >6mm
Aortic regurgitation PHT<250ms
Restrictive mitral flow pattern
Regurg jet area/LVOT area >60
Holo diastolic flow reversal
Dense continuous wave Doppler signal
Regurg vol>60
Regurg Fx> 55
```
134
3 components of Bernoulli and which 2 are ignored?
Convective acceleration
Flow acceleration- ignored, reasonably accurate estimation of PG
Viscous friction- ignores bc velocity profile in center of lumen usually flat
