Week 144 Aortic Stenosis

Question 0

Define Aortic stenosis.

Answer 0

Narrowing of aortic valve

Question 1

Cover cardiac cycle, including sounds, valves, and various lettered stages.

Answer 1

q

Question 2

What causes aortic stenosis?

Answer 2

calcific degenration
bicuspid valve (usually)
Rheumatic

Question 3

What is the consequence of Aortic stenosis?

Answer 3

Pressure < in L ventricle

LV dilation and LV failure as consequence.

Question 4

Px with dyspnoea, syncope and angina type pain - what do you suspect?

Answer 4

LV Failure 2ndary to Aortic stenosis(?)

Question 5

What is NYHA? How is is used?

Answer 5

New York heart association scale - assess heart failure

Question 6

What is CCS classification?

Answer 6

Canadian cardiovascular society

Question 7

How many units should a woman have per day?

Answer 7

2

Question 8

What sound would you hear in aortic stenosis?

Answer 8

Ejection systolic

Question 9

What sound would you hear in mitral regurgitation?

Answer 9

pan systolic murmur

Question 10

What does an ejection diastolic murmur indicate (subtle)?

Answer 10

Aortic regurgitation

Question 11

What does a very subtle pan diastolic murmur, which small “bumps” in sound just after 1st and 2nd heart sound indicate?

Answer 11

mitral stenosi

Question 12

When looking at a cardiac echo what do you look for?

Answer 12

Size
CS area of valves
assess morphology
continuity equation
modified bernioulli equation (?)

Question 13

What is the modified bernioulli equation?

Answer 13

?

Question 14

What are lvels a, b, and c of evidence?

Answer 14

write these up

Question 15

What are classes of recomendations? 1 11 11a 11b 111

Answer 15

write these up

Question 16

What are the class 1 indications for AVR?

Answer 16

Symptomatic patients with severe AS (level of evidence: b)
Severe AS undergoing CABG (LOE:3)
Severe AS with other valve surgery (LOE:3)
One other - see slide from lecture monday 9am

Question 17

Name 4 types of prosthesis?

Answer 17

Autograft
Allograft/Homograft
Xenograft/Bioprosthesis
Mechanical Prosthesis

Question 18

What lifestyle factor affects warfarin (< INR)?

Answer 18

Alcohol

Question 19

Amiodarone has a reaction/interaction with what common drug?

Answer 19

warfarin

Question 20

What is vasculogenesis?

Answer 20

The appearance of blood vessels seemingly out of “nowhere”, as opposed to angiogenesis (formation via branching of existing vessels)

Question 21

Hemangioblasts form what?

Answer 21

Cells of the blood vessels and vascular system - and blood!

Question 22

In day 19, vasculogenesis forms blood ____ in the ____

Answer 22

islands

mesoderm

Question 23

Why is angiogenesis an important area of current research

Answer 23

anti cancer meds

Question 24

Which cavity eventually becomes the thorax?

Answer 24

Primitive pericardial cavity

Question 25

Which 3 pairs of veins are in the primitive vascular system (day 28)?

Answer 25

Sup and inf cardinal veins | vitelline veins

Question 26

which important event occurs between day 23-35 with regards to heart chambers?

Answer 26

Endocardial cushions meet and diverge atrioventricular tube x2

Question 27

What does the septum primum do?

Answer 27

Starts to grow down toward endocardial cushions, to separate atriums.

Question 28

What opens before the ostium primum closes? Why does this happen?

Answer 28

Ostium secondum. To prevent blood pumping to developing respiratory tissue.

Question 29

What forms over the secondum? What happens in birth?

Answer 29

One way valve, when born closes as full vascular system being used. Foramen ovale remains in some adults.

Question 30

What is the conotruncal ridge?

Answer 30

Forms in embryonic heart tube, separating it to pulmonary trunk and aorta, at about 6 weeks. cause spiralled division of vasculature, and also descends to combine with muscular portion of intraventricular septum, separating the ventricles, and attaching aorta to L side and P trunk to R side.

Question 31

If neural crest cells do not descend in to the developing heart, you get what?

Answer 31

congenital heat defects

Question 32

LOOK AT SYMBRYO ON BLACKBOARD FOR EXAM (LIKELY) QUESTIONS

Answer 32

j

Question 33

Where do the umbilical arteries form from?

Answer 33

They are anterior branches of the iliac arteries

Question 34

What is the organ of gas exchange in the fetus and the newborn?

Answer 34

``` Fetus = placenta Newborn = lungs ```

Question 35

In the fetus the lungs are not ____

Answer 35

functional

Question 36

What is the organ of nutrition in the fetus and the newborn?

Answer 36

Fetus - placenta | Newborn - gut

Question 37

In the fetus there is tonic ____ of the lungs to prevent blood flow

Answer 37

vasoconstriction of artieries

Question 38

Blood enters right atrium from?

Answer 38

ivc svc ?

Question 39

Which organ is prioritised in the foetus?

Answer 39

The brain

Question 40

The venous return from the HEART itself comes through the ____?

Answer 40

???? *** sinus

Question 41

see lecture notes (second mon am lecture) for more

Answer 41

u

Question 42

The valve of the IVC is called the _____ valve.

Answer 42

Eustachian valve.

Question 43

How does the ductus arteriosus close?

Answer 43

Pulmonary vascular resistance >, therefore blood (oxygenated) from aorta goes to pulmonary artery. In response to high oxygen conc, smooth muscle contracts, closing the ductus.

Question 44

Ductus arteriosus is known as ____ in later life

Answer 44

ligamentum arteriosum.

Question 45

Decrease in right atrial pressure closes the ______-

Answer 45

foramen ovale

Question 46

learn and make cards for vestigial structrues slide

Answer 46

t

Question 47

What do you know about persistent pulmonary hypertension of the newborn?

Answer 47

failure of pulmonary vasconstriction at birth Usually caused by prenatal fetal hypoxia Right to left shunting across PDA and PFO Cyanosis, acidosis, lower limb sats >, multiorgan failure, death if left.