CVS Breakdown Week 1 to 5

Question 1

Week 5

MURMURS

Answer 1

1. Definition: Murmurs are abnormal heart sounds caused by turbulent blood flow.
2. Causes: Narrowed or leaky valves, high blood flow states, or heart defects.
3. Inspiration Effect: Right-sided murmurs get louder.
4. Expiration Effect: Left-sided murmurs get louder.
5. Valsalva Effect: Straining makes most murmurs quieter, except HCM and MVP.
6. Handgrip Effect: Louder murmurs from leaky valves, quieter murmurs from narrow valves.

Question 2

Week 5

HEART SOUNDS

Answer 2

1. S3 Sound: Happens after S2; normal in young people but abnormal in heart failure.
2. S4 Sound: Happens before S1; always abnormal, linked to stiff ventricles.

Question 3

Week 5

VALVE LESIONS

Answer 3

1. Aortic Stenosis: Systolic murmur, harsh sound heard at the right chest, radiates to neck.
2. Aortic Regurgitation: Diastolic blowing sound, heard at left chest, radiates down.
3. Mitral Stenosis: Diastolic rumble with snap, heard at heart apex.
4. Mitral Regurgitation: Constant, high-pitched murmur at heart apex, radiates to armpit.

Question 4

Week 5

AORTIC STENOSIS (AS)

Answer 4

1. What is it: Narrow valve stops blood from leaving the heart.
2. Symptoms: Chest pain, fainting, shortness of breath.
3. Treatment: Surgery for severe cases.

Question 5

Week 5

MITRAL STENOSIS (MS)

Answer 5

1. What is it: Narrow valve blocks blood from the atrium to the ventricle.
2. Symptoms: Difficulty breathing, fatigue, and coughing blood.
3. Treatment: Balloon procedure or surgery.

Question 6

Week 5

AORTIC REGURGITATION (AR)

Answer 6

1. What is it: Valve doesn’t close properly, letting blood flow backward.
2. Symptoms: Pounding heartbeat, tiredness, and breathlessness.
3. Treatment: Medications or valve surgery.

Question 7

Week 5

MITRAL REGURGITATION (MR)

Answer 7

1. What is it: Blood flows backward from the ventricle to the atrium.
2. Symptoms: Fatigue, heart palpitations, and breathing problems.
3. Treatment: Valve repair or replacement.

Question 8

Week 4

ECG BASICS
1. Intervals:

Answer 8

1. Intervals:
   o PR Interval: Start of atrial contraction to start of ventricular contraction.
   o QT Interval: Start of ventricular contraction to end of ventricular relaxation.

Question 9

Week 4

ECG BASICS
1. ECG Components:

Answer 9

1. ECG Components:
   o P Wave: Atrial contraction.
   o QRS Complex: Ventricular contraction.
   o T Wave: Ventricular relaxation.

Question 10

Week 4

HOW TO INTERPRET ECGs
1. Key Steps:

Answer 10

1. Key Steps:
   o Rate: Measure heartbeats per minute.
   o Rhythm: Check if beats are regular or irregular.
   o Axis: See the heart’s electrical direction.
   o Hypertrophy: Look for bigger chambers (e.g., tall waves).
   o Ischemia: Spot signs of poor blood flow (e.g., ST changes).

Question 10

Week 4

ECG BASICS
1. How is a 12-lead ECG set up?

Answer 10

1. How is a 12-lead ECG set up?
   o Limb Leads (I, II, III): Compare electrical signals between limbs.
   o Augmented Leads (aVR, aVL, aVF): Measure one limb’s signal compared to others.
   o Chest Leads (V1-V6): Detect heart’s electrical signals from chest views.

Question 11

Week 4

HOW TO INTERPRET ECGs
1. Sinus Rhythms:

Answer 11

1. Sinus Rhythms:
   o Normal Rhythm: Regular beats, rate 60–100 bpm.
   o Bradycardia: Beats slower than 60 bpm.
   o Tachycardia: Beats faster than 100 bpm.

Question 12

Week 4

TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. What are they?

Answer 12

1. What are they?
   o Heart rate above 100 bpm; symptoms include palpitations and fainting.

Question 13

Week 4

TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Ventricular Tachycardia (VT):

Answer 13

1. Ventricular Tachycardia (VT):
   o ECG: Wide QRS, fast and regular.
   o Cause: Heart disease, low electrolytes.

Question 14

Week 4

TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Ventricular Fibrillation (VF):

Answer 14

1. Ventricular Fibrillation (VF):
   o ECG: Chaotic, no clear waves.
   o Cause: Serious heart damage.

Question 15

Week 4

TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Atrial Fibrillation (AF):

Answer 15

1. Atrial Fibrillation (AF):
   o ECG: No P waves, irregular beats.
   o Cause: Age, high blood pressure.

Question 16

Week 4

TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Atrial Flutter:

Answer 16

1. Atrial Flutter:
   o ECG: Sawtooth pattern.
   o Cause: Heart structure issues.

Question 17

Week 4

BRADYARRHYTHMIAS (SLOW HEART RHYTHMS)
1. What are they?

Answer 17

1. What are they?
   o Heart rate below 60 bpm; symptoms include fainting, tiredness.

Question 17

Week 4

TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Supraventricular Tachycardia (SVT):

Answer 17

1. Supraventricular Tachycardia (SVT):
   o ECG: Narrow QRS.
   o Cause: Stress, caffeine.

Question 18

Week 4

BRADYARRHYTHMIAS (SLOW HEART RHYTHMS)
1. Heart Blocks:

Answer 18

1. Heart Blocks:
   o 1st Degree Block: Long PR interval; slow signal through AV node.
   o 2nd Degree Type I (Wenckebach): PR gets longer until one beat drops.
   o 2nd Degree Type II: Dropped beats without warning.
   o 3rd Degree Block: No connection between atrial and ventricular beats.

Question 19

Week 4

ARRHYTHMIA DIAGNOSIS AND COMPLICATIONS
1. How to diagnose arrhythmias:

Answer 19

1. How to diagnose arrhythmias:
   o ECG, Holter monitor, or long-term devices (e.g., loop recorder).

Question 20

Week 4

ARRHYTHMIA DIAGNOSIS AND COMPLICATIONS
1. Complications:

Answer 20

1. Complications:
   o Fast rhythms: Can cause low blood pressure or clots.
   o Slow rhythms: Can lead to fainting or cardiac arrest.

Question 21

Week 4

MANAGEMENT AND LIFESTYLE
1. Medications:

Answer 21

1. Medications:
   o Sodium blockers: Slow conduction.
   o Potassium blockers: Slow relaxation.
   o Calcium blockers: Reduce heart muscle strength.
   o Beta blockers: Lower heart rate.

Question 22

Week 4

MANAGEMENT AND LIFESTYLE
1. Procedures:

Answer 22

1. Procedures:
   o Defibrillation: Shock to restart normal rhythm.
   o Pacemaker: Controls heartbeats.
   o Ablation: Removes faulty tissue.

Question 23

Week 3 CAPILLARIES 1. What are capillaries?

Answer 23

What are capillaries? * Smallest blood vessels, allowing exchange of substances between blood and tissues.

Question 23

Week 4 MANAGEMENT AND LIFESTYLE 1. Lifestyle Tips:

Answer 23

1. Lifestyle Tips: o Fix heart risks (e.g., high blood pressure). o Avoid triggers like alcohol. o Stay healthy with good diet and exercise.

Question 24

Week 3 CAPILLARIES 2. Key features:

Answer 24

Key features: * Single thin cell layer for exchange. * No smooth muscle in walls. * Basement membrane supports the structure. * Pores or fenestrations for selective permeability.

Question 25

Week 3 CAPILLARIES 3. Processes across capillary walls:

Answer 25

3. Processes across capillary walls: * Diffusion: Moves solutes (e.g., O₂, glucose) down concentration gradients. * Osmosis: Water moves toward higher solute concentrations.

Question 25

Week 3 CAPILLARIES 5. Lymphatic system role:

Answer 25

5. Lymphatic system role: * Collects extra fluid (~10%) from interstitial space. * Prevents swelling (edema) and maintains fluid balance.

Question 25

Week 3 CAPILLARIES * Bulk Flow:

Answer 25

CAPILLARIES * Bulk Flow: o Filtration: Fluid out of capillaries (arterial end). o Reabsorption: Fluid back into capillaries (venous end).

Question 25

Week 3 EDEMA 3. Signs and symptoms of edema:

Answer 25

Signs and symptoms of edema: * Swollen limbs, pitting (press leaves a dent). * Pulmonary edema: Shortness of breath. * Ascites: Fluid in abdomen (distended belly).

Question 25

Week 3 CAPILLARIES 4. Factors affecting exchange:

Answer 25

4. Factors affecting exchange: * Capillary hydrostatic pressure (CHP): Pushes fluid out. * Blood colloid osmotic pressure (BCOP): Pulls fluid in. * Interstitial pressures (IFHP, IFCOP): Affect outward/inward movement.

Question 25

Week 3 EDEMA 1. What is edema?

Answer 25

1. What is edema? * Fluid buildup in interstitial spaces causing swelling.

Question 25

Week 3 EDEMA 2. Causes of edema:

Answer 25

2. Causes of edema: * ↑ Hydrostatic Pressure: E.g., heart failure, venous blockage. * ↓ Oncotic Pressure: Low proteins (e.g., albumin) from malnutrition or liver/kidney issues. * ↑ Capillary Permeability: From trauma, inflammation. * Lymph Obstruction: E.g., cancer, infections, post-surgery.

Question 25

Week 3 HEART FAILURE 1. Definition:

Answer 25

Definition: * Heart can’t pump blood effectively to meet the body’s demands.

Question 26

Week 3 HEART FAILURE 2. Types of dysfunction:

Answer 26

2. Types of dysfunction: * Systolic failure (reduced contraction). * Diastolic failure (reduced filling).

Question 27

Week 3 HEART FAILURE 3. Risk factors:

Answer 27

3. Risk factors: * High blood pressure, coronary artery disease, diabetes. * Obesity, smoking, sedentary lifestyle.

Question 28

Week 3 HEART FAILURE 4. Symptoms:

Answer 28

Symptoms: * Breathlessness, fatigue, swollen limbs, chest discomfort.

Question 29

Week 3 HEART FAILURE 5. Stages (AHA/ACC):

Answer 29

5. Stages (AHA/ACC): * A: Risk only (e.g., diabetes, no disease). * B: Structural issues, no symptoms. * C: Symptoms + structural issues. * D: Severe disease, needing advanced care.

Question 30

Week 3 HEART REMODELING 1. What is cardiac remodeling?

Answer 30

1. What is cardiac remodeling? * Changes in heart size, shape, or function after stress (e.g., MI, hypertension).

Question 31

Week 3 HEART REMODELING 2. Types of remodeling:

Answer 31

2. Types of remodeling: * Concentric: Thick walls due to pressure overload (e.g., hypertension). * Eccentric: Dilated chambers due to volume overload (e.g., valve regurgitation).

Question 31

Week 3 HEART REMODELING 3. Complications:

Answer 31

3. Complications: * Concentric: Stiff heart (diastolic heart failure), arrhythmias. * Eccentric: Weak heart (systolic failure), progressive dilation.

Question 32

Week 3 SHOCK 1. What is shock?

Answer 32

1. What is shock? * Poor tissue perfusion causing cellular and organ failure.

Question 33

Week 3 SHOCK 2. Types of shock:

Answer 33

2. Types of shock: * Hypovolemic: Low blood volume (e.g., bleeding, dehydration). * Cardiogenic: Heart pump failure (e.g., MI). * Distributive: Poor blood flow distribution (e.g., sepsis). * Obstructive: Blood flow blockage (e.g., pulmonary embolism).

Question 34

Week 3 SHOCK 3. Stages of shock:

Answer 34

3. Stages of shock: * Compensated: Body tries to adjust (cold hands, faster pulse). * Progressive: BP drops; confusion, less urine output. * Irreversible: Severe damage and multi-organ failure.

Question 35

Week 3 MANAGING CONDITIONS 1. Acute heart failure:

Answer 35

1. Acute heart failure: * Oxygen therapy, diuretics for fluid removal. * Vasodilators or inotropes for better heart function.

Question 36

Week 3 MANAGING CONDITIONS 2. Chronic heart failure:

Answer 36

2. Chronic heart failure: * Medications: ACE inhibitors, beta blockers, SGLT2 inhibitors. * Lifestyle: Low salt, regular activity, weight control.

Question 37

Week 1 Topic 1: Anatomy Thoracic Cavity

Answer 37

Thoracic Cavity 1. Contents: Includes lungs, heart, esophagus, thymus, major blood vessels, lymph nodes.

Question 38

Week 3 MANAGING CONDITIONS 3. Cardiogenic shock:

Answer 38

MANAGING CONDITIONS 3. Cardiogenic shock: * Oxygen, inotropes, fluids (carefully), mechanical support if needed.

Question 39

Week 1 Topic 1: Anatomy Mediastinum

Answer 39

Mediastinum 1. Boundaries: Central space of the thoracic cavity, bordered by lungs. Divided into superior, anterior, middle, and posterior mediastinum. 2. Contents: o Superior: Thymus, major vessels like aorta and SVC, trachea, esophagus. o Middle: Heart, pericardium, main bronchi. o Posterior: Esophagus, thoracic duct, descending aorta.

Question 40

Week 1 Topic 3: Cardiac Cycle 1. Key terms:

Answer 40

1. Key terms: o Stroke Volume (SV): Amount of blood pumped per beat. o End-Diastolic Volume (EDV): Blood in ventricle before contraction. o Ejection Fraction: Percentage of EDV pumped out.

Question 40

Week 1 Topic 1: Anatomy Pericardium

Answer 40

Pericardium 1. Structure: Double-layered sac; fibrous (outer) and serous (inner). 2. Functions: Protects the heart, reduces friction during heartbeats, prevents over-distension. 3. Blood supply and innervation: o Arteries: Pericardiacophrenic and coronary arteries. o Innervation: Phrenic nerve and vagus nerve.

Question 40

Week 1 Topic 2: Clinically Relevant Anatomy Palpation

Answer 40

Palpation 1. Key areas: Apex beat felt at left mid-clavicular line (5th intercostal space).

Question 40

Week 1 Topic 1: Anatomy Heart

Answer 40

Heart 1. Structure: Four chambers (right atrium/ventricle, left atrium/ventricle); surrounded by pericardium. 2. Great vessels: Aorta, pulmonary arteries/veins, venae cavae. 3. Blood flow: Right side pumps blood to lungs; left side pumps to body. 4. Coronary arteries: Supply blood to heart muscle, branching into circumflex and LAD. 5. Comparison: Left heart thicker (pumps to body), right heart thinner (pumps to lungs).

Question 40

Week 1 Topic 2: Clinically Relevant Anatomy Positioning

Answer 40

Positioning 1. Heart Position: Located centrally in thorax, tilted slightly left. 2. Major vessels: Aorta, venae cavae, pulmonary arteries/veins near heart.

Question 40

Week 1 Topic 2: Clinically Relevant Anatomy Auscultation 1. Sites:

Answer 40

Auscultation 1. Sites: o Aortic valve: Right 2nd intercostal space. o Pulmonary valve: Left 2nd intercostal space. o Tricuspid valve: Lower left sternum. o Mitral valve: Heart apex.

Question 40

Week 1 Topic 4: The Heart as a Pump Myocardium and Cardiomyocytes

Answer 40

Myocardium and Cardiomyocytes 1. Structure: Thick heart muscle; individual cells connected by gap junctions. 2. Function: Contracts in coordination for pumping blood.

Question 41

Week 1 Topic 3: Cardiac Cycle 1. Phases:

Answer 41

1. Phases: o Systole: Heart contracts, pumping blood out. o Diastole: Heart relaxes, chambers fill with blood.

Question 41

Week 1 Topic 4: The Heart as a Pump Cardiac Output

Answer 41

Cardiac Output 1. Definition: Blood volume pumped by heart per minute. 2. Determinants: Heart rate and stroke volume.

Question 41

Week 1 Topic 3: Cardiac Cycle 1. Wigger’s Diagram: Graph showing pressure, volume, and heart sounds during the cardiac cycle.

Answer 41

Graph showing pressure, volume, and heart sounds during the cardiac cycle.

Question 41

Week 1 Topic 4: The Heart as a Pump Venous Return

Answer 41

Venous Return 1. Factors: Blood pressure, muscle contractions, respiratory movements, valve function.

Question 42

Week 1 Topic 5: A Closer Look at Valves

Answer 42

1. Valves: o Atrioventricular: Mitral and tricuspid. o Semilunar: Aortic and pulmonary. 2. Functions: Prevent blood backflow during heartbeats. 3. Heart sounds: First sound (S1): AV valves closing; second sound (S2): Semilunar valves closing. 4. Valvular dysfunction: Leads to regurgitation or stenosis.

Question 43

Week 1 Topic 6: Cardiac Conduction Pathway

Answer 43

Cardiac Conduction Pathway 1. Key Structures: SA node, AV node, bundle of His, Purkinje fibers. 2. Electrical Spread: Begins in SA node, stimulates atria, reaches AV node, and spreads through ventricles.

Question 44

Week 1 Topic 7: Excitation-Contraction Coupling Electrical Phases

Answer 44

Electrical Phases 1. Action Potential: o Resting membrane potential → depolarization → repolarization → refractory period. 2. Mechanical Link: Electrical activity triggers muscle contraction (e.g., repolarization → ventricular relaxation).

Question 45

Week 1 Topic 7: Excitation-Contraction Coupling Ventricular Action Potential

Answer 45

Ventricular Action Potential Phases: Includes plateau phase for sustained contraction

Question 46

Week 1 Topic 7: Excitation-Contraction Coupling Pacemaker Action Potential

Answer 46

Pacemaker Action Potential 1. SA Node: Automatic firing regulates heartbeat.

Question 47

Week 1 Topic 8: Autonomic Control of Cardiac Conduction

Answer 47

Autonomic Control of Cardiac Conduction 1. Sympathetic Effects: Speeds up heart rate; uses noradrenaline to enhance conduction. 2. Parasympathetic Effects: Slows down heart rate; uses acetylcholine. 3. Factors Influencing Conduction: Electrolyte levels, medications, autonomic balance.

Question 48

Week 2 TOPIC 1: ANATOMY OF BLOOD VESSELS 1. Types of Arteries:

Answer 48

Types of Arteries: * Conducting arteries (elastic): Large; include the aorta and carotid arteries. Function: Absorb pressure changes with elastic recoil. * Distributing arteries (muscular): Medium; regulate blood flow to organs. * Small arteries/arterioles: Control blood flow into capillary beds; major role in resistance.

Question 49

Week 2 TOPIC 1: ANATOMY OF BLOOD VESSELS 2. Types of Veins:

Answer 49

Types of Veins: * Venules: Small, collect blood from capillaries. * Medium veins: Contain valves to prevent backflow. * Large veins: E.g., IVC, SVC; return blood to the heart.

Question 50

Week 2 TOPIC 1: ANATOMY OF BLOOD VESSELS 3. Arterial vs. Venous Walls:

Answer 50

Arterial vs. Venous Walls: * Arteries: Thick walls, more elastic tissue and smooth muscle. * Veins: Thin walls, larger lumens, and valves.

Question 51

Week 2 TOPIC 2: PRESSURE, VOLUME, RESISTANCE, AND FLOW 1. Relationships in Blood Flow:

Answer 51

Relationships in Blood Flow: * Blood flow = Pressure / Resistance. * ↑ Pressure = ↑ Flow (if resistance unchanged).

Question 52

Week 2 TOPIC 2: PRESSURE, VOLUME, RESISTANCE, AND FLOW 2. Preload & Afterload:

Answer 52

Preload & Afterload: * Preload: Blood volume filling ventricles before contraction. * Afterload: Pressure ventricles must work against to eject blood.

Question 53

Week 2 TOPIC 2: PRESSURE, VOLUME, RESISTANCE, AND FLOW 3. Cardiac Output (CO):

Answer 53

3. Cardiac Output (CO): * CO = Stroke Volume (SV) × Heart Rate (HR). * Determinants: Contractility, preload, afterload, HR.

Question 54

Week 2 TOPIC 3: MEAN ARTERIAL PRESSURE (MAP)

Answer 54

1. Formula: MAP = CO × Total Peripheral Resistance (TPR). 2. Parameters: * CO (HR × SV), TPR, stroke volume, and HR. 3. Basal Vascular Tone: Constant partial contraction of blood vessels.

Question 55

Week 2 TOPIC 4: EXTRINSIC REGULATORS OF ARTERIAL SMOOTH MUSCLE

Answer 55

1. Main Roles: Regulate blood pressure and blood flow. 2. Effects on Smooth Muscle: * Sympathetic System: Constricts vessels via noradrenaline. * Adrenaline: Can dilate (beta-2 receptors) or constrict (alpha receptors). * Vasodilators: E.g., atrial natriuretic peptide reduces blood pressure.

Question 55

Week 2 TOPIC 5: INTRINSIC REGULATORS OF ARTERIAL SMOOTH MUSCLE

Answer 55

1. Key Factors: * Oxygen (O₂): Low levels dilate vessels. * Carbon dioxide (CO₂): High levels dilate vessels (e.g., in brain). * Nitric Oxide (NO): Vasodilation; lowers BP. * Endothelin-1: Vasoconstriction; raises BP. 2. Autoregulation: * Local tissue adjusts blood flow based on needs (e.g., brain, kidneys).

Question 55

Week 2 TOPIC 7: MEDIUM-LONG TERM REGULATION OF BP

Answer 55

1. RAAS: * Key structures: Kidneys (renin), lungs (ACE), adrenal glands (aldosterone). * Renin converts angiotensinogen to angiotensin I → ACE converts to angiotensin II → increases BP by constricting vessels and retaining sodium. 2. Salt Intake Effect: High salt → Increases blood volume → Raises BP.

Question 55

Week 2 TOPIC 6: SHORT-TERM REGULATION OF BLOOD PRESSURE

Answer 55

1. Baroreceptors: * Found in carotid sinus and aortic arch; sense changes in BP. 2. Reflex Pathway: Baroreceptors → Brainstem → Autonomic adjustments (sympathetic/parasympathetic systems).

Question 55

Week 2 TOPIC 8 & 9: HYPERTENSION & DIAGNOSIS

Answer 55

1. Types of Hypertension: * Primary (essential): No clear cause. * Secondary: Due to other conditions (e.g., kidney disease). 2. Risk Factors: Age, obesity, smoking, sedentary lifestyle, family history. 3. Diagnosis: BP > 140/90 mmHg on multiple occasions.

Question 55

Week 2 TOPIC 11: HYPERTENSION COMPLICATIONS AND LIFESTYLE

Answer 55

1. Complications: * Heart: LV hypertrophy, heart failure. * Kidneys: Nephropathy. * Brain: Stroke. * Eyes: Retinopathy. 2. Lifestyle Modifications: * Reduce salt, quit smoking, regular exercise, maintain healthy weight.

Question 55

Week 2 TOPIC 10: PHARMACOLOGY OF ANTIHYPERTENSIVES 1. Main Drugs:

Answer 55

1. Main Drugs: * ACE Inhibitors: Block angiotensin II production. * Beta Blockers: Lower HR and contractility. * Calcium Channel Blockers: Relax arteries. * Thiazide Diuretics: Remove excess fluid to lower BP.