Cardio

Question 1

Stroke volume

Answer 1

EDV - ESV

Question 2

Frank Starling

Answer 2

Increased preload –> increased contractility

Question 3

Ejection Fraction

Answer 3

Stroke volume / EDV

Question 4

Increased preload

Answer 4

Increased EDV, stroke volume, and EF

Question 5

Increased afterload

Answer 5

Increased ESV, decreased stroke volume, decreased EF

Question 6

Increased contractility

Answer 6

Changes ESPVR

Decreased ESV, increased SV, increased EF

Question 7

Decreased compliance

Answer 7

Changes EDPVR

Decreased EDV, and increased EDP

Question 8

Aortic stenosis PV Loop

Answer 8

Increased afterload

Decreased SV

Question 9

Mitral regurgitation PV loop

Answer 9

Isovolumic contraction is disrupted

Question 10

Aortic regurgitation PV loop

Answer 10

Isovolumic relaxation is disrupted

Question 11

Mitral stenosis PV loop

Answer 11

Ventricle can’t fill properly

PV loop looks just slightly smaller than normal

Question 12

Mitral stenosis murmur

Answer 12

Holodiastolic murmur with an opening snap
Worse = decreased time for opening snap
Louder with expiration

Question 13

Aortic stenosis murmur

Answer 13

Systolic crescendo-decrescendo
Worse = murmur peaks closer to S2
Radiates to carotids and pulsus parves et tardus

Question 14

Mitral regurgitation murmur

Answer 14

HoloSystolic

Louder with expiration, handgrip, and squatting

Question 15

Aortic regurgitation murmur

Symptoms

Answer 15

Diastolic decrescendo
Increased pulse pressure
Louder with expiration and handgrip

Question 16

Mitral valve prolapse murmur

Answer 16

Late ejection click during systole
Young healthy female/Marfan
Louder w/ Valsalva and standing (low preload)

Question 17

Carcinoid heart disease

Answer 17

GI or lung tumors that metastasize liver –> serotonin

Flushing, abdominal pain, diarrhea, tricuspid or pulmonic valve disease

Question 18

Ventral septal defect murmur

Answer 18

Holosystolic murmur

Question 19

Patent ductus arteriosus

Answer 19

A continuous machine-like murmur

Question 20

3 things associated with bicuspid aortic valve

Early ejection click

Answer 20

Marfan syndrome
Turner syndrome
Coarctation of the aorta

Question 21

Atrial septal defect mumur

Answer 21

Fixed S2 split with systolic ejection murmur

Question 22

S3

Answer 22

Occurs early diastole
Due to high RA pressure usually due to HF
Louder on exhalation

Question 23

S4

Answer 23

Occurs in late diastole

Due to stiff ventricle

Question 24

Subclavian steal syndrome

Answer 24

Severe stenosis of the proximal subclavian artery –> reversal in blood flow from the contralateral vertebral artery to the ipsilateral vertebral artery

Question 25

Left axis deviation

Answer 25

LBBB Ventricular rhythm Lead II should be negative

Question 26

Right axis deviation

Answer 26

RBBB Right ventricular hypertrophy Lead I should be negative

Question 27

Normal PR interval

Answer 27

120-200ms

Question 28

Normal QRS interval

Answer 28

<120

Question 29

Cause of short QT interval

Answer 29

Hypercalcemia

Question 30

Congenital long QT syndrome

Answer 30

Abnormal K/Na channels Family history of sudden death, pass out recurrently

Question 31

Sinus rhythm EKG

Answer 31

P waves regular and upright in leads II, II, and F

Question 32

LBBB EKG

Answer 32

Wide QRS with negative V1

Question 33

RBBB EKG

Answer 33

Wide QRS with positive V1

Question 34

Tented T wave U waves

Answer 34

Hyperkalemia Hypokalemia

Question 35

AFib EKG and concerns

Answer 35

No p waves Irregularly irregular rhythm Major concern is thrombus formation Can also cause shock if person has Aortic Stenosis

Question 36

Pericarditis findings

Answer 36

Diffuse ST elevation and PR depression Friction rub Pain worse laying down and better leaning forward

Question 37

Tamponade Constriction pericarditis Restrictive cardiomyopathy

Answer 37

Pulsus paradoxus, electrical alternans, sharp x descent and blunted y Kussmauls, rapid y descent, pericardial knock Kussmauls

Question 38

How to fix an AVNRT

Answer 38

Massage neck --> increase parasympathetic --> decreased conduction through AV node

Question 39

ST segment depression

Answer 39

Stable/unstable angina (subendocardial ischemia)

Question 40

ST segment elevation

Answer 40

Transmural ischemia Prinzmetal angina MI

Question 41

Complications of returning blood to dead tissue

Answer 41

``` Contraction band necrosis (Ca+ --> contraction) Reperfusion injury (O2--> free radicals) ```

Question 42

Timeline of microscopic changes after MI

Answer 42

``` <4 hrs --> no change Within 24 hrs --> coagulative necrosis 1-3 days --> neutrophils 4-7 days --> macrophages 1-3 weeks --> granulation tissue Months --> fibrosis ```

Question 43

Timeline of complications after MI

Answer 43

<1 day --> arrhythmia 1-3 days --> pericarditis 4-7 days --> rupture of free ventricular wall, papillary muscle (RCA), or interventricular septum Months --> aneurysms, mural thrombus, dressler syndrome

Question 44

Dressler syndrome

Answer 44

Autoimmune pericarditis

Question 45

VSD

Answer 45

Most common congenital defect Associated with fetal alcohol syndrome Complications: pulm HTN and Eisenmenger syndrome

Question 46

ASD

Answer 46

Associated with Down syndrome | Split S2

Question 47

Transposition of great vessels

Answer 47

Creates two separate circuits Can give prostaglandin E to maintain ductus arteriosus Associated with maternal diabetes

Question 48

Coarctation of the aorta

Answer 48

Congenital exists between aortic vessels and PDA Associated with Turner syndrome Adult: associated with bicuspid aortic valve and rib notching

Question 49

Hypertrophic cardiomyopathy

Answer 49

Gene mutation in sarcomere genes (beta myosin heavy chain) Septum blocks LV outflow, arrhythmias, and mitral regurg Common cause of sudden cardiac death in young athletes

Question 50

Cardica myxoma histo

Answer 50

Benign mesenchymal proliferation with abundant ground substance Obstructs the mitral valve

Question 51

Rhabdomyoma

Answer 51

Benign hamartoma of cardiac tissue that arises in the ventricles of children Associated with tuberous sclerosis

Question 52

Dilated cardiomyopathy causes

Answer 52

``` Coxsackievirus Chagas Muscular dystrophy Doxorubicin Alcohol (beriberi) Pregnancy Hemochromatosis ```

Question 53

Restrictive cardiomyopathy signs

Answer 53

Prominent y descent | Kussmaul sign

Question 54

Restrictive cardiomyopathy causes

Answer 54

Amyloidosis Sarcoidosis Lysosomal storage diseases