Cardiology

Question 1

Inferior ECG leads for Right Coronary Artery

Answer 1

II,III,aVF

Question 2

Lateral ECG leads for Left Circumflex Artery

Answer 2

I,aVL,V5,V6

Question 3

Antero-Septal ECG leads for Left Anterior Descending Artery

Answer 3

V1,V2,V3,V4

Question 4

Is pulseless electrical activity of heart a shockable rhythm

Answer 4

No

Question 5

Rhythms that are shockable by AED

Answer 5

Ventricular fibrillation(v-fin) and pulseless ventricular tachycardia (pulseless v-tach)

Question 6

What is Beck’s triad

Answer 6

Classical signs of acute cardiac tamponade:Low BP,distended jugular veins and muffled heart sounds

Question 7

What should be considered in all immunocompromised patients who are hypotensive

Answer 7

Sepsis/Septic Shock

Question 8

Phenomenon when an unrepaired heart septal defect is reversed over time

Answer 8

Eisenmenger syndrome

Question 9

Narrow complex tachycardia cause

Answer 9

Supraventricular tachycardia

Question 10

Causes of cardiac chest pain in children

Answer 10

Left Ventricular Outflow Tract Obstruction(LVOTO)
-Aortic stenosis
-HOCM

Inflammation
-Myocarditis
-Perocarditis

Arrhythmias

Rare causes
-Kawasaki disease if coronary arteries are involved
-congenital defects of coronary arteries

Question 11

Main drugs for heart failure

Answer 11

1. Beta blockers
2. Ace inhibitors/ARB
3. Diuretics
4. SGLT 2 inhibitors

Question 12

Main cause of mitral stenosis

Answer 12

1. Rheumatic heart disease
2. Infective endocarditis
3. Radiotherapy

Question 13

Signs of atrial fibrillation

Answer 13

1. Absence of p waves
2. Absence of f waves
3. Irregular rhythm of QRS complexes

Question 14

Causes of MR

Answer 14

1. Primary: structural defects eg MVP, RHD
2. Secondary: Atrial MR, nonischemic CMP, ischemic CMP

Question 15

Causes of stenotic valvular lesions

Answer 15

Congenital
Senile
Rheumatic

Question 16

Causes of Tricuspid regurgitation

Answer 16

Primary: Prolapse, infection, congenital

Secondary: AF, pulm HTN, RH dilatation

Question 17

Causes of Aortic regurgitation

Answer 17

Young: Bicuspid AV, Marfans, Anky spon

Old: Degenerative, atherosclerotic dilatation, leutic disease(syphilis)

Question 18

Inheritance pattern of Marfan and the involved gene

Answer 18

Autosomal dominant, 50%

Fibrillin 1

Question 19

Causes of regurgitant valvular disease

Answer 19

Congenital
Rheumatic
Senile
ischemic
Functional
Infective
Traumatic

Question 20

Valve dysfunction often associated with valvular AF

Answer 20

Mitral regurgitation

Question 21

Section of coronary arteries most likely to be affected in heart block

Answer 21

Proximal branch of Right coronary artery, perfuses AV node

Question 22

What is a third degree heart block

Answer 22

Complete AV node dissociation, no r/s between p and qrs

irregular PR interval

normal PP and RR intervals

Question 23

What are the types of 2nd degree heart block

Answer 23

Mobitz type 1: PR lengthens until one beat is not conducted

Mobitz type 2: PR remains normal but some beats are not conducted

Question 24

What is a first degree heart block

Answer 24

All beats are conducted but PR interval is lengthened >200ms( 5 small sq)

Question 25

Causes of aortic stenosis

Answer 25

1. Bicuspid aortic valve in children 2. Degenerative

Question 26

Sx and prognostication of aortic stenosis

Answer 26

ASD Prognosis Angina 5yr Syncope 3yr Dyspnea 2yr

Question 27

Duke Major criteria for IE

Answer 27

1. Positive blood c/s x2 or high risk organism 2. Positive findings on TTE/TEE

Question 28

Duke minor criteria for IE

Answer 28

1. Predispositions for IE( eg prev IE, IVDU, prosthetic valve) 2. Febrile 3. Vascular phenomenon(Osler, janeway, roth, splinter) 4. Immunologic phenomenon 5. Microbiologic findings on blood c/s that does not meet major crit.

Question 29

5 drug classes for Heart failure drugs

Answer 29

Beta Blockers Diuretics ACE-i/ARB + Entresto(Sacubitril-Valsartan) SGLT2 inhibitor

Question 30

Renal diet

Answer 30

Low protein about 0.8g Low phosphate Low K Fluid restriction Low salt

Question 31

HAS BLED score components

Answer 31

Hypertension Abnormal kidney/liver function Stroke Bleeding Labile INR Elderly >65 Drugs or alcohol NOT a contraindication checklist for anticoagulation

Question 32

CHAD VASC score

Answer 32

Congestive Cardiac Failure Hypertension Age Diabetes Vascular Disease Sex Stroke Hx

Question 33

Definition of pulmonary hypertension

Answer 33

Mean pulmonary wedge pressure above 20 measured using Swan Ganz catheter

Question 34

Type of STEMI in pericarditis

Answer 34

Global saddle shaped STE

Question 35

Key investigations for any Shortness of breath/ desaturation

Answer 35

1. Arterial Blood Gas 2. ECG 3. Troponins/ cardiac enzymes

Question 36

Subtypes of atrial fibrillation

Answer 36

- Paroxysmal AF that resolves within 1/52 of treatment - Persistent: continuous AF >1/52 - Longstanding persistent: >1 year - Permanent AF: Persistent AF where therapeutic attempts no longer made to maintain sinus rhythm

Question 37

CHA2DS2 VASc score components

Answer 37

Cardiac Failure Hypertension Age DM Vascular disease hx Atherosclerotic Disease Sex

Question 38

HAS BLED Score

Answer 38

Hypertension Abnormal liver or kidney function Stroke hx Bleeding diathesis or medications Labile INR Elderly >65 Drugs that predispose to bleeding or Drinking(alcohol)