CVS Flashcards
(141 cards)
1
Q
A pregnant lady came with mitral stenosis and atrial fibrillation what will you give?
A
IV heparin
2
Q
Myxoid degeneration is most likely associated with?
A
Mitral Valve prolapse
3
Q
Women with mitral stenosis at 28 weeks of gestation, her dyspnea worsens due to?
A
Pulmonary HTN
4
Q
Maximum entry of calcium during ventricular myocytes depolarisation shown as?
A
ST segment
5
Q
U wave in ECG is due to?
A
slow repolarisation of papillary muscles
6
Q
AV nodal delay is caused by which phase of cardiac cycle?
A
Ventricular filling
7
Q
54 years old male, palpitations and light headedness, heart rate 200bpm, bp75/40mmHg, what adjustment occurred in cardiac cycle
A
Systolic time has decreased proportionately more than the diastolic time
8
Q
The right bundle branch is supplied by?
A
Left coronary artery
9
Q
Tall QRS complex in lead II on ECG shows?
A
Hypertrophied ventricle
10
Q
Increase in JVP due to increase in?
A
Resistance
11
Q
Absent P waves on ECG occurs in?
A
Nodal Rhythm
12
Q
What will occur in the myocardium of a patient with MI who is being treated with fibrinolytic agents?
A
Free Radical Formation
13
Q
Plateau phase of ventricles on ECG shown by?
A
ST segment
14
Q
ECG recording is done during?
A
partly depolarisation partly repolarisation
15
Q
Aortic insufficiency is seen in which disease?
A
Ankylosing spondylitis
16
Q
A 25yrs old female patient with SOB on exertion, palpitation, and atypical chest pain. O/E BP was 130/90mmHg, pulse 90bpm and a grade 2 systolic murmur in the 4th intercostal space with normal ECG and CXR, diagnosis?
A
Normal Heart
17
Q
23yrs old, stabbed in bar fight, blade enters at 5th intercostal space, just lateral to sternum, pierces depth of 4cm, structure damaged?
A
Pericardium
18
Q
Artery most likely to be damaged in close proximity of phrenic nerve?
A
pericardiophrenic artery
19
Q
Cardiac plexus in the superior mediastinum receives input from?
A
left vagus
20
Q
Epicardium gets its blood supply from?
A
coronary artery
21
Q
RBB is supplied by?
A
LCA
22
Q
If RCA gets blocked after giving marginal artery branch, which portion of the heart will be affected?
A
AV node
23
Q
Blood supply of posterior surface of heart is supplied by?
A
RCA
24
Q
What is the blood supply of heart?
A
Two coronary, auricular, atrioventricular, septal
25
In inferior wall MI which artery is likely to be blocked?
right marginal
26
60 years old male with IHD with palpitation, syncope, dyspnea and sinking of heart. QRS rate 140 to 200 per minute. best treatment?
Lidocaine
27
ECG of patient shows 3:1 ratio of P to QRS. diagnosis?
Mobitz 2
28
During inspiration JVP drops due to?
increase venous return
29
A direct consequence of severe magnesium deficiency would be?
Hypokalemia
30
Wave of depolarisation from endocardium to epicardium represented on ECG as?
QRS complex
31
Normal length of PR interval and QRS complex?
PR interval 120-200msec QRS<100msec
32
Maximum flow pressure in coronary vessels occurs at?
Beginning of diastole
33
Aortic valve opens in left ventricle at what pressure?
80mmHg
34
The maximum left ventricular pressure is during? how much in healthy adult?
rapid ejection phase 120mmHg
35
The audible heart sounds lie in the range of?
40-500 cycles per second
36
During exercise there is decreased blood flow to?
Kidneys > splanchnic
37
Patient with HTN, started on ACE inhibitors, BP controlled but complains of dizziness. Most likely cause of decreased blood supply to brain is?
Decreased sympathetic response
38
Which event occurs just before aortic valve opening?
beginning of systole
39
During which phase calcium will be entering ventricular cells via slow channels?
Rapid ejection phase
40
Patient with murmur, QRS complex +180 axis deviation, diagnosis?
RBBB
41
What is increased in AR?
Preload and EDV
42
75yrs old hx of stable angina presents with SOB, creat 10, urea 200, auscultation reveal a pericardial friction rub and signs of effusion, diagnosis?
Uremic pericarditis
43
Patient with pericardial frictional rub with deranged RFT, urea was increased, creatinine was 8, cause of pericarditis?
Fibrinous
44
Best marker for monitoring the heart in patient with ESRD?
Trop I
45
Superificial cardiac plexus is made of?
left vagus
46
Infarction of apex of heart, vessel thrombosed will be?
LAD
47
Drug to prevent tachy-disarrythmias in patient with Wolf-parkinson-white syndrome?
Droperidol
48
Patient with SVT should be given?
Adenosine > Verapamil
49
A woman usually feels tachycardia during exercise and stress, which settles down at rest, cause?
Sinus Tachycardia
50
In ventricular ECG, changes appeared and ventricles beat slower than atria, diagnosis?
2nd degree heart block
51
Atrial fibrillation leads to?
embolus
52
Massive transfusions cause? Repeated or multiple transfusions cause?
hypocalcemia Hemosiderosis/Hemochromatosis or hyperkalemia
53
Onset of ventricular systole coincides with the peak of?
R wave in ECG
54
Most important cause of low amplitude QRS complex?
Old MI
55
What is higher in peripheral arteries than in the aorta?
pulse pressure
56
Pressure of right ventricle which opens the pulmonary valve?
8mmHg
57
First heart sound is variable in?
Atrial fibrillation
58
in cardiac cycle, QRS complex begins prior to?
ventricular systole
59
Which heart sound produced by hypervolemia?
S3
60
when does the first heart sound become louder?
P-R interval less than normal
61
What is most commonly present along with PDA?
ASD
62
Bicuspid aortic valve association?
Turner syndrome associated with?
Coarctation of aorta
63
The venous pO2 will be close to 70mmHg in which condition?
Left to right shunt
64
Which is most common large vessel disease?
common condition in premature infants?
PDA
65
DURING extra systole what occurs?
Decrease in pulse pressure due to decreased SV
66
AFTER extra systole what occurs?
Increase in pulse pressure due to increased contractility
67
SV increased but neither TPR nor diastolic pressure increased, what will be the effect?
Pulse pressure and MAP will raise
68
During rest in well trained athlete,what decreases?
What increases
HR
SV
69
Maximum resistance in arteries then aorta, what will be the effect?
Pulse pressure will increase
70
Regarding pulse pressure decrease when there is decreased?
systemic pressure
71
Pulse wave velocity is used to?
Detect blood flow to the extremity
72
If heart, after pumping were to be stopped to ensure that circulatory system becomes static, the pressure measured in the rest of the body is?
Mean systemic filling pressure
73
The cardiac output of the right side of the heart is what percentage of the cardiac output of the left side of the heart?
100%
74
A person took stairs to 4th floor, increase in cardiac output will be due to?
Increase preload
75
The best index of after load is?
BP
76
Keep the end diastolic length constant, how can the Cardiac Output be increased?
By increasing HR
77
Dye used during indicator dilution method to measure cardiac output is?
Cardio green
78
Verapamil MOA on heart?
Increases AV nodal delay
79
Characteristic of right ventricle?
Gives rise to pulmonary trunk
80
If absent p waves and normal QRS complex and T wave, where is the pacemaker?
AV node
81
Patient with HR of 25 and wide QRS complexes, where is the pacemaker?
Purkinje fibre
82
SA node acts as a pacemaker of heart because? 4 reasons
1. Generates impulses at a faster rate
2. phase 4 depolarisation
3. inward Na+ current
4. highest firing rate
83
in defective conductive tissue damage of heart, an artificial pacemaker is to be placed in?
Moderator band
84
In person with 3rd degree AV conduction block, where shall the pacemaker electrodes to be placed?
right ventricle
85
Parasympathetic causes decrease HR by causing what at SA node?
decrease Na influx
86
Vagal stimulation of myocardium acts predominantly at?
SA node
87
Difference of increase hydrostatic pressure of kidney from heart is?
increased osmotic pressure along capillary flow
88
Most common complication of HTN?
LVH
89
50yrs old lady with DM/HTN on diuretic presented with hyperkalemia and unconscious and normal RBS, cause is?
ARF
90
Patient with both rheumatic fever and endocarditis, long term prophylaxis to prevent recurrence?
Benzithine penicillin
91
Most common cause of death in rheumatic fever?
Myocarditis
92
Most common organism causing infective endocarditis?
Strep. viridian's
93
Mortality of:
staph aureus
viridian’s?
30%
5%
94
Valves involved in Libman sac endocarditis?
Aortic and Mitral
95
School teacher who after death was diagnosed with endocarditis and lymphocytic infiltration of cardiac tissues, organism?
Coxsackie virus
96
Diagnostic test for infective endocarditis is?
blood culture
97
A 20 yrs old with rheumatic valvular disease with low grade fever for last 2 weeks, pansystolic murmur, splenomegaly, clubbing, treatment should commence with?
inj. penicillin and gentamycin
98
Large friable vegetations are seen in?
infective endocarditis
99
Female patient with known vascular heart disease, wants to insert IUCD, bacteria that could cause infective endocarditis?
Enterococcus faecalis
100
A morbidly obese woman died from heart failure. on autopsy heart was 900gm when normally it is 400g. on histology adipose tissues were intermixed with cardiac cells, this is an example of?
Fatty infiltration
101
HF patient, B/L pleural effusion. In pleural tap what will be seen considering its transudative?
2-3% lymphocytes
102
In which condition mannitol is given with caution? and why?
given in heart failure with caution because can precipitate pulmonary edema
103
In CHF captopril works because?
increases cardiac output
104
Mechanism of edema in CHF?
increase capillary hydrostatic pressure
105
65yrs old with AST and ALT raised, pitting edema grade 2 bilaterally and JVP raised, diagnosis?
heart failure
106
LVH with chest pain and mild SOB, BP 90/70 and pulse 90. What shall be given for pain?
nitrates
107
Female with fever, suddenly collapsed. On autopsy there is dilated heart, pericardial effusion, lymphocytes and necrosis, cause is?
Coxackie B
108
Pt with SOB and pink fluid with no RBC and WBC in alveoli occurs in?
CCF
109
bronchus, diagnosis?
Pt with recent MI, after which he develops SOB upon lying and decrease urine output. O/E pedal edema, distended jugular pressure, basal crepts, tender liver and shifting dullness, diagnosis?
CCF
110
A HTN woman, On standing from sitting his BP decreases from 120/80 to 90/60 and her HR increases from 70 to 120. The mechanism of increased HR is?
decrease firing from the baroreceptors
111
Unconscious pt pale with cold clammy skin, rapid thready pulse, MAP 50mmHg, which parameter will decrease to increase BP?
firing from baroreceptors
112
What is present in the adventitia of large arteries?
baroreceptors
113
Nerve taking afferents from baroreceptors?
Glossopharyngeal
114
Pt with hemorrhage in RTA, unreportable BP, receptors in aortic and carotid detect?
decrease pO2
115
Pt brought to ER for massive haemorrhage because of trauma and leaded hypotension baroreceptor compensation lead to?
dec. venous compliance
116
Pt with decrease MAP from 100 to 70, change would be?
increased cardiac sympathetic efferent activity
117
BP recording of 2 males, a HTN with bp 180/110 and a normal with bp 120/80. If 10mmHg is added to mean BP of both, how will the response in both males vary?
increase parasympathetic activity in HTN pt.
118
p-ANCA granulomatosis vasculitis is associated with?
Hep B
(Hep B seropositivity seen in polyarteritis nodosa as well)
119
Pt with low cardiac reserve, performs exercise tolerance test, what will be observed?
failure of cardiac output to raise in order to meet the demand of acitvity
120
Increased arterial pressure with decrease TPR in?
exercise
121
After stress or exercise what will be different in left and right systolic and diastolic duration?
increase systolic, decrease diastolic
122
In exercise blood flow is increased to?
skeletal muscles
123
During regular exercise, factor that increases respiratory rate?
proprioceptors
124
If GFR increases proximal tubular reabsorption of salt and water increase by process called Glomerulotubular balance. Most likely contribution to this process would be?
increase in peritubular oncotic pressure
125
Formation of interstitial fluid increase with decreased?
plasma colloid osmotic pressure
126
A lady drowned, saved and resuscitated develops ARDS, mechanism is?
pulmonary interstitial edema
127
Factors that do not cause increase in edema?
arteriolar constriction
128
Neurogenic shock? associated with?
due to loss of vasomotor tone and associated with decrease systemic filling pressure
129
Vasodilation and hypotension are features of which shock?
septic
130
Best parameter for fluid resuscitation in hypovolemic shock patient is?
increase in urine output
131
Patient with accidental bruises on thigh, that is foul smelling and Pt is hypotensive, diagnosis?
toxic shock syndrome
132
Boy developed fever, hypotension and erythematous patches all over trunk, toxin involved?
erythrogenic shock/toxic shock syndrome/scarlet fever
133
DIC is caused by which type of toxin
endotoxin
134
Which drug increases chronotropic and ionotropic effect on the heart?
glucagon
135
30yr old male brought to emergency in state of cardiogenic shock/ failing heart, what drug would you use first?
dopamine
136
Patient brought to ER in state of shock (unrecordable BP) with heart failure, which neurotransmitter drug should be given?
norepinephrine
137
The vascular smooth muscle of the circulatory structure is controlled almost exclusively by the nervous system is?
venules
138
Increase in both renal blood flow and GFR caused by?
dilatation of afferent arterioles
139
Pressure in the glomerular capillaries is higher than the other capillaries because?
afferent arterioles are short
140
What is associated with increased risk of death in cardiac patient pt with positive familial hyperlipidemia?
LDL
141
Factor inhibiting fibrinolysis related to coronary artery disease?
LDL-C
