CVS

Question 1

What are the? 3 class 1 antiarrythmics and how do they affect the AP

Answer 1

1a - lengthens AP
2b - Shortens AP
1c - No effect on AP

Question 2

What is the molecular action of beta blockers

Answer 2

inhibit AC to decrease ionotropy

Question 3

What is the MoA of adenosine?

Answer 3

Resets heart by acting on A1 receptors to decresae AC at AVN and increasing K+ conductance.

Question 4

What is the MoA of organic nitrates?

Answer 4

Dilate coronary artery and venodilate to reduce preload

Question 5

What is the MoA of NO?

Answer 5

Increase GC –> increased cGMP –> decreased calcium

Question 6

Draw out the pacemaker AP

Answer 6

See book.

Question 7

What is the funny current?

Answer 7

Na channel activated by hyperpolarisation

Question 8

Draw out the cardiac AP

Answer 8

see book

Question 9

How does the cerebrum ensure adequate circulation?

Answer 9

High cap density, high flow rate, high o2 extraction rate

Question 10

How is a hypoplastic heart formed?

Answer 10

Pinching shut of endocardial tube

Question 11

How long should the QRS and PR interval take

Answer 11

QRS - 0.12s

PR - 0.12-0.2s

Question 12

Name the acyanotic heart defects

Answer 12

ASD, VSD, PFO, PDA, coarctation of aorta

Question 13

Name the cyanotic heart defects

Answer 13

tetralogy of fallot, tricuspid atresia, transposition of great vessels, hypoplastic left heart

3Ts 1H

Question 14

State the histology of cardiac muscle

Answer 14

Striations, branching, central nuclei, intercalated discs, gap junctions

Question 15

What are after depolarisations caused by?

Answer 15

Increased intracellular calcium

Question 16

Give 3 causes of arrhythmias

Answer 16

Ectopic pacemaker activity, After depolarisations, reentry loops

Question 17

What is the tetralogy of fallot?

Answer 17

VSD, overriding aorta, pulmonary stenosis, RVH

Question 18

What is the right and left AV valves called?

Answer 18

MitraL - left

tricuspid - right

Question 19

Where is the vasa vasorum found?

Answer 19

TA of great vessels

Question 20

What 3 things can cause 1st degree heart block?

Answer 20

Digoxin toxicity, coronary artery disease, electrolyte imbalance

Question 21

What is the result of coarctation of the aorta/

Answer 21

increased pressure –> LVH

Question 22

What receptor and neurotransmitter is responsible for increasing and decreasing HR?

Answer 22

Increase HR - NA on alpha2

Decrease HR - ACh on M2

Question 23

What is cushings reflex?

Answer 23

Increased ICP –> decreased blood flow –> Increased sympathetic action to restore blood flow

Question 24

Where do the baroreceptors transmit their signals to?

Answer 24

medulla oblongata

Question 25

Name the pressures found in the RA, LA, LV, RV, PA, Aorta

Answer 25

RA - 2, RV - 20, LA - 5, LV - 120, PA - 20/10, aorta - 120/80

Question 26

How does ischemia lead to vasodilation?

Answer 26

build up of metabolites e.g. H+, co2, adenosine

Question 27

What effect does alpha 1 receptors have?

Answer 27

vasoconstriction

Question 28

What effect does M3 receptors have?

Answer 28

airways and pupil contraction

Question 29

What is the average stroke volume?

Answer 29

80 ml

Question 30

How do you increase the sound of S1 and S2?

Answer 30

S1 - expiration | S2 - inspiration

Question 31

What is the purpose of the fibrous skeleton of the heart?

Answer 31

provides attachments for cusps and electrical insulation

Question 32

When is alpha and beta thalassemia detected?

Answer 32

alpha - before birth | beta - after birth

Question 33

What are the 3 types of arteries?

Answer 33

elastic - aorta and PA. Vasa vasorum muscular - lots of smooth muscl arterioles - thin TI

Question 34

What are the layers of the pericardium?

Answer 34

fibrous and serous (parietal and visceral)

Question 35

Draw the arteries and veins of the heart

Answer 35

see book.

Question 36

How would you investigate a coronary artery blockage?

Answer 36

angiogram

Question 37

what is the fossa ovalis?

Answer 37

remnant of FO

Question 38

What are the muscles in the interior of the ventricles and atria called?

Answer 38

ventricles - trabeculae carnae | atria - pectinate

Question 39

What muscles attach to the chordae tendinae? What is their purpose?

Answer 39

papillary - prevents cusps prolapsing

Question 40

What is eisenmenger syndrome?

Answer 40

Left to right shunt --> increased pulmonary pressure --> right to left shunt

Question 41

Explain how smooth muscle contracts

Answer 41

increase in calcium --> activated CaM --> activating MLCK --> phosphorylates mysoin heads

Question 42

Draw out the JVP wave form

Answer 42

see book

Question 43

What nerve innervates the pericardium

Answer 43

phrenic

Question 44

define shock

Answer 44

circulatory failure with generalised lack of oxygen

Question 45

What is cardiogenic shock + give example

Answer 45

failure of heart to pump blood e.g. arrhythmia

Question 46

What is mechanical shock? How would you treat/

Answer 46

cardiac tamponade. 5th intercostal space left sternal edge aspiration or subxiphoid approach

Question 47

How do you treat angina?

Answer 47

nitrate spray, beta blockers, CCB, statins, ACEi, stent

Question 48

What would show on an ECG if someone had a previous MI?

Answer 48

pathological Q waves

Question 49

How do you diagnose angina?

Answer 49

history, stress test on treadmill (look for ST depression)

Question 50

What are the signs of left and right HF

Answer 50

left - tachy, fatigue, S3/S4, oedema | right - fatigue, ascites, increased JVP, anorexia

Question 51

What is S3 caused by? How does it sound? Is it always abnormal?

Answer 51

Can be normal in children and athletes caused by increased ventricular filling e.g. in HF, mitral regurg, VSD, dilated cardiomyopathy Sounds like Kentucky

Question 52

What is S4 caused by? How does it sound? Is it always abnormal?

Answer 52

always abnormal Caused by ventricular stiffness and forceful contraction of atria to overcome this e.g. in LVH, fibrosis of ventricle Tennessee