Cardiology 2/2 Flashcards
(86 cards)
1
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A
Answer: Option C
2
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Answer: Decreased heart rate and contractility of the myocardium
3
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Answer: Ischaemic heart disease
4
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Answer: Staphyloccous aureus
The presentation of acute infective endocarditis depends on the virulence of the pathogen. Virulent organisms (s. aureus, beta-haemolytic streptococci, pneumococci) attack previously normal cardiac valves and present with a high fever, produce embolic abscesses, and rapidly destroy cardiac structures. Non-virulent organisms (s. viridans, enterococci, coagulase negative staphylococci) tend to produce a more indolent illness, with a low grade fever, and little destruction of cardiac structures.
Staphyloccous aureus is the most common cause of acute infective endocarditis in IV drug users.
5
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A
6
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Answer: S2
7
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8
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Answer: QT interval
9
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Answer: Osler’s nodes
10
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Answer: Infective endocarditis
11
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Answer: ECG changes in leads II, III, and aVF
12
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Answer: Mitral stenosis
13
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Answer: Blanching, non-painful erythematous lesions on palms of hands and soles of feet
14
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Answer: Mitral stenosis
An opening snap is a high-pitched sound that occurs in mitral stenosis
15
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Answer: Phase 3
16
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Answer: 0-8 mmHg
17
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Answer: A patient in congestive heart failure secondary to systolic dysfunction
18
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Answer: Phase 0
19
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20
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Answer: Hyperkalemia: peaked T waves
21
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Answer: Point B
22
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Answer: Aortic regurgitation
23
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Answer: Aortic regurgitation
24
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Answer: S1
25
**Answer: Mitral stenosis**
## Footnote
Malar flush is a plum-red discolouration of the high cheeks, classically associated with mitral stenosis. It occurs secondary to CO2 retention and its vasodilatory effects.
26
**Answer: BNP**
27
**Answer: Aortic stenosis**
## Footnote
During ventricular ejection, LVP (left ventricular pressure) exceeds AP (aortic pressure), as indicated by the grey area, i.e. the pressure gradient generated by stenosis.
28
**Answer: right coronary artery**
29
**Answer: Mitral valve prolapse**
30
**Answer: 1-3 days**
31
**Answer: class I; phase 0**
32
**Answer: Tricuspid regurgitation**
33
**Answer: Point A**
34
**Answer: Infective endocarditis**
35
**Answer: Aschoff body**
36
Which of the following waveforms describes what you will hear when auscultating a patient with MITRAL STENOSIS?
**Answer: Waveform E**
37
Which of the following waveforms describes what you will hear when auscultating a patient with AORTIC REGURGITATION?
**Answer: Waveform D**
## Footnote
Note that depending on the source, aortic regurgitation can also be described as a mid-diastolic murmur continuing into late diastole (contrary to the pan-diastolic murmur illustrated).
38
**Answer: Aortic regurgitation**
39
Which of the following waveforms describes what you will hear when auscultating a patient with PATENT DUCTUS ARTERIOSUS?
**Answer: Waveform F**
40
What heart sound is associated with mitral regurgitation?
This is an example of a pan-systolic murmur, commonly associated with mitral regurgitation.
The first and second heart sounds are normal. A mid-frequency rectangular murmur occurs during the entirety of systole.
41
Which of the following waveforms describes what you will hear when auscultating a patient with AORTIC STENOSIS?
**Answer: Waveform B**
42
**Answer: Hypokalemia: U waves**
43
**Answer: Mitral valve**
44
**Answer: Swollen, red, and painful lesions found on the hands and feet**
45
**Answer: Sinus rhythm, low volume, slow rising**
46
**Answer: Mitral valve stenosis**
47
**Answer: Hypercalcemia: shortened QT interval**
48
* A) A normal person whose stroke volume increases as preload increases
* B) A patient in congestive heart failure secondary to diastolic dysfunction
* C) A patient in congestive heart failure secondary to systolic dysfunction
* D) A patient in congestive heart failure treated pharmacologically with a positive inotrope
* E) A patient with normal left ventricular function who is receiving intravenous dobutamine (an inotropic agent that directly stimulates β₁ receptors)
**= E) A patient with normal left ventricular function who is receiving intravenous dobutamine (an inotropic agent that directly stimulates β₁ receptors)**
## Footnote
If an individual with normal cardiac contractility is administered a positive inotropic agent (such as dobutamine), the contractility will increase without the need for increased preload.
49
**Answer: Point C**
50
**Answer: Polyarthritis, carditis, subcutaneous nodules, erythema marginatum, chorea**
51
Which of the following waveforms describes what you will hear when auscultating a patient with MITRAL REGURGITATION?
**Answer: Waveform C**
52
**Answer: Pulmonary stenosis**
53
**Answer: Aortic stenosis**
54
**Answer: Infective endocarditis**
## Footnote
Roth spots are retinal haemorrhages with small clear centres, and occur due to microembolisation of thrombi from infective endocarditis.
55
**Answer: Fibrinous pericarditis**
56
**Answer: Prosthetic heart valve**
57
**Answer: S3**
58
**Answer: Ventricular tachycardia**
59
**Answer: Posterior MI**
60
**Answer: NYHA II**
61
**Answer: Aortic valve regurgitation**
62
**Answer: Left ventricular aneurysm**
## Footnote
Portable chest radiograph taken in ICU reveals a bulge at the cardiac apex.
63
**Answer: HMG-CoA reductase**
64
**Answer: Contraction band necrosis due an excess of Ca2+**
65
**Answer: It is a recognised presenting feature of pulmonary embolism**
66
**Answer: One large 5mm x 5mm box on an ECG paper represents 0.2 seconds time and 0.5 mV amplitude.**
67
**Answer: Less than 24 hours**
## Footnote
There are no nuclei in the slide, therefore we can suspect coagulative necrosis has occurred; this form of necrosis takes approx. 24 hours to manifest.
Also, there are no neutrophils present, therefore the time from infarction is less than 24 hours.
68
**Answer: Acute ischaemia**
## Footnote
Inferior leads (II, III, and aVF) show T wave inversion due to acute ischaemia
69
**Answer: 20 mmHg; 10 mmHg**
70
**Answer: two of the major criteria, or one major criterion plus two minor criteria, are present along with evidence of Group A streptococcus infection**
71
A 78 year old male with a history of recurrent syncope undergoes surgery for aortic valve disease. A hard, markedly deformed valve is observed, and shown in the image.
What is the likely diagnosis?
**Answer: Calcific aortic stenosis**
72
**Answer: Pulmonary, aortic, bicuspid, tricuspid**
73
**Answer: Months**
## Footnote
A pseudoaneurysm may occur in the first 3-14 days following an infarct, however a true ventricular aneurysm can occur from day 14 onwards, up to months following the event.
74
**Answer: 1-3 days**
## Footnote
This is an image of pericarditis, which is seen from day 1 to 3.
75
**Answer: Isovolumetric relaxation**
76
Einthoven's triangle is a schematic representation of three limb leads used in electrocardiography. Which option depicts the correct Einthoven's triangle?
**Answer: Option A**
77
**Answer: Right Bundle Branch Block (RBBB)**
78
**Answer: Calcification**
79
**Answer: Months**
## Footnote
Type I collagen (i.e. fibrous scarring) is seen in this image; thus the time from the infarction is months.
80
**Answer: S. bovis**
81
**Answer: Coxsackie viruses**
82
**Answer: Coagulative necrosis**
83
**Answer: Rheumatic heart disease**
84
**Answer: 1-3 days**
85
**Answer: 4-7 days**
86
**Answer: Cardiac tamponade**
## Footnote
Front chest x-ray demonstrates marked enlargement of the cardiac outline. This was due to pericardial effusion and is a good example of the water bottle sign. This refers to the shape of the cardiac silhouette on erect frontal chest x-rays in patients who have a very large pericardial effusion.
