CV-FC

Question 1

What two ionic imbalances may cause Torsades?

Answer 1

hypokalemia ( low K+ -> QT prolongation as more K+ is moving out extracellularly)

hypomagnesemia ( Mg2+ can treat Torsades)

Question 2

What is pulsus parvus et tardus? What cardiac condition is this seen?

Answer 2

pulses are late with delayed peak
seen in aortic stenosis

*delayed peak = delayed carotid upstroke

Question 3

What is Bechet’s disease? what are clinical features?

Answer 3

• painful oral ulcers that recur at least three times a year
• uveitis, arthritis, erythema nodosum: similar with sarcoidosis
• Do not get confused with sarcoidosis, although they present similarly, sarcoidosis will not show oral ulcers

Question 4

What is a good diagnostic test to differentiate between cardiogenic shock vs. hypovolemic shock?

Answer 4

pulmonary catheterization to measure PCWP

• cardiogenic shock: increased PCWP (due to congestion caused by cardiac insufficiency)
• hypovolemic shock: decreased PCWP
• think PCWP as preload

Question 5

What four structures are embedded in carotid sheath?

Answer 5

• common carotid artery
• internal carotid artery
• internal jugular vein
• vagus nerve

Question 6

What abnormality will be seen in jugular venous pressure in 3rd degree AV block?

Answer 6

Cannon “a” waves

• In 3rd degree AV block, the atria contracts against a closed tricuspid valve
  : third degree AV block -> irregular electrical conduction between atrium and ventricle. Atrium contracts even when ventricle is contracting (closed tricuspid valve)