2009 Module Exam Flashcards
In a patient who has a block in the anterior-interventricular septum, which is the area most susceptible to myocardial infarction?
Anterior 2/3 interventricular septum
What is the component of the fatty streak?
a. Foam cells
b. Fibro-fatty plaque
a. Foam cells
Where is the apex located?
5th intercostal space 9cm from midline
A patient with chest pain that radiated to the left arm. What is the best way to treat his condition?
Nitrates, Ca++ channel blockers, β-blockers
What are the sympathetic innervations of the heart?
T1-T6
What is the mechanism of action of nitrates?
Increase relaxation of smooth muscle cells
Weight gain is a side effect to clofibrate due to
Inhibiting lipolysis
What is the best drug for increasing HDL levels?
Nicotinic acid
What is a complication of myocardial infarctions in 3 days?
Arrhythmias
What is the feature of the post-transition state?
What changes are seen in post transition countries?
A) Low mortality, high fertility, infectious diseases
B) Low Mortality, low fertility, and chronic diseases
C) High mortality, low fertility, chronic diseases
D) High mortality, high fertility. Infectious diseases
Low mortality, low fertility – chronic diseases
How does glycosylation affect atherosclerosis?
Reduce LDL clearance
An increase of perfusion pressure increases the blood flow. What mechanism is responsible for that?
a. Neural vasoconstriction
b. Metabolic vasodilation
c. Myogenic vasodilation
c. Myogenic vasodilation
A patient has mitral stenosis due to an old rheumatic heart disease. What type of treatment is he given?
Diuretics & β-blockers
Which enzyme is seen in pheochromocytoma?
VMA
What is the mechanism of furosemide?
Inhibit Na/K/Cl pump
What is the mechanism of digoxin?
Increase intracellular Ca++
Kuwait is considered to have low hypertension percentage compared to western countries. Why is that?
Kuwait has a young population
What drug is responsible for blocking angiotensin receptors?
Losartan
What is the mechanism of action of α-methyldopa?
Stimulation of α2 receptors (agonists)
What did the drug do?
Hypotension
What is the likely cause of this condition?
a. Sympathetic dysfunction
b. Vasodilators
b. Vasodilators
What is the most direct cause of cardiac death?
Cardiac arrhythmias
What characterizes acute rheumatic fever?
Aschoff’s nodules
Which causes acute myocardial infarction?
Rupture of plaque
Which drug is responsible for blocking K+ channels?
Type III anti-arrythmatic drugs
Which drug is responsible for blocking Na+ channels?
Quinidine
What is the mechanism of action of Amodarone?
Prolongation of action potential duration
Patient with MI would typically show
QT elongation
What is the problem in the figure?
Aortic stenosis
What would be seen in a post-mortem patient with 10-years history of hypertension?
Left ventricular hypertrophy
A 3-month-infant is diagnosed with VSD, on birth he was diagnosed with a normal heart and no anomalies. What is the biological reason?
A decrease in pulmonary resistance
What is the mechanism of blood flow in the inferior vena cava?
Negative pressure of the thoracic cavity
A 41-year-old male developed sudden chest pain that radiated to the left arm. When he went to the hospital he collapsed. Whats the diagnosis?
Acute myocardial infarction
VO2a = 20, VO2v = 12, MVO2 = 280, HR = 78, what’s the SV?
45
A patient with breathlessness, increased creatinine, low Na, low albumin. What’s the diagnosis?
Heart failure
A male with MI, aerobic exercise is done, which has the highest requirement of O2?
They will give you a table, and the answer is the highest (SBP x HR)
The CO of a normal person is 5 L/min, when exercising it became 3 times more. What is the new venous return?
15 L/min
Which is a potassium channel blocker?
Amiodarone
Which shows a ventricular action potential?
A patient with MI, his SV decreased from 88 to 46, what’s the reason?
a. Decrease in contractility
b. Increase in compliance
c. Increase in pulmonary ridge
a. Decrease in contractility
What is the complication of carotid artery occlusion?
Cerebrovascular event
A 59-year-old male with angina on exertion and aortic stenosis. He is normotensive and coronary angiography is normal. What should we do?
a. Increase VR
b. Give diuretics
c. Increase contractility
d. Coronary angiogram
c. Increase contractility
(or B)
What is responsible for bypassing the liver in the fetal circulation?
Ductus venousus
What changes are seen in a fetus after birth?
a. Increase RA pressure
b. Increase pulmonary pressure
c. Swab of hepatic veins
d. Blood flow in ductus arteriousus is reversed
d. Blood flow in ductus arteriousus is reversed
A patient closes his nose and blow. (valvasa maneuver). What would it cause?
Increase in thoracic pressure
An African American 45-year-old male with murmurs heard on both sides of the 2nd intercostal space is diagnosed with
Aortic stenosis
What is the best way to adjust the volume-pressure relationship?
Adjusting contractility
A patient was diagnosed with heart failure. What is the best combination of drugs?
Diuretics, β-agonists, digoxin, and ARBs
A patient with blood pressure of 160/100. What’s the best treatment?
Diuretics, ACEI, and ARBs
What is the mechanism by which CO increases?
Increase in venoconstriction
There was a cross-sectional study and they made an Odds Ratio inference of 2.4, what do you think about the result?
Disagree. Temporal relationship not found
A case-control study was made on the exercise and respiratory infections. The cases are from the hospital, and the controls are from the spa. What is your interference?
Case: Unbiased – Control: Biased – OR: increased
Which nuclear medicine test is used to identify causes of heart failure?
Myocardial perfusion imaging
What is the most factor that causes cardiac death?
a. Smoking
b. Illegal drugs
c. Obesity
d. Type-A-Behavior
a. Smoking
Some impulses are not conducted through the AV, while others are conducted normally. What anomaly is this?
2nd degree AV block
What sources are needed for HE/HP?
Sociodemographics/epidemiological
What originates from aortic sinus?
Right coronary artery
What supplies the pacemaker of the heart?
Nodal branch
Patient with 90% stenosis of coronary artery with partial blockage?
Unstable angina
Patient with 90% stenosis of coronary artery with complete occlusion?
Myocardial infarction
What is the most prominent feature of arterioles?
Internal Elastic Lamina
Which type of capillary is in the endocrine cells?
Fenestrated capillaries
What is the best marker of cardiac failure?
BNP
A patient came to the hospital after 6 hours of the onset of symptoms of myocardial infarction. What is the best diagnostic marker?
Troponin
What is produced from the endothelial cells in response to high blood velocity?
Nitric Oxide
What is a major vasoconstrictor agent?
Endothelin
Where can you hear the murmur of mitral stenosis?
Diastolic murmur in 5th intercostal space
Where can you hear the murmur of mitral regurgitation?
Systolic apical murmur
Where can you hear the murmur of aortic stenosis?
2nd intercostal space right side systolic murmur
Apo E polymorphism
Type III familial dysbetalipoproteinemia
Lipoprotein lipase deficiency
Familial hyperchylomicronemia
A patient with prosthetic valve was diagnosed with IE. Culture showed gram-positive cocci arranged in chains?
Streptococcus Viridans
A patient with pain in the left leg. No pulses were found in the distal part of the leg. What’s the diagnosis?
Peripheral arterial disease
A 95-year-old patient with floppy mitral valve with friable vegetation. Diagnosis?
a. Degenerative changes in valve leaflets
b. Calcification of aortic valve
?
A patient with senile vegetations. Diagnosis?
Limban sack endocarditis (all the other answers excluded)
(*pretty sure them meant sterile not senile)
A patient with Gamine-Ghaneli bodies in the lab show. Diagnosis?
Congestive splenomegaly
Which phase of the cardiac cycle you see the mitral valve opened, and the maximal volume?
Atrial contraction
Which phase of the cardiac cycle you see maximal pressure?
Rapid ejection
Vagal stimulation of the heart
a. Alpha-1
b. Alpha-2
b. beta-1
c. beta-2
d. beta-3
e. M1
f. M2
f. M2
Inotropic effect on the heart
a. Alpha-1
b. Alpha-2
b. beta-1
c. beta-2
d. beta-3
e. M1
f. M2
b. beta-1
Systemic vasoconstriction
a. Alpha-1
b. Alpha-2
b. beta-1
c. beta-2
d. beta-3
e. M1
f. M2
a. Alpha-1
Patient with asymmetric sub-aortic hypertrophy in interventricular septum. Diagnosis?
Hypertrophic cardiomyopathy
Patient with transient decrease of blood flow. What mechanism is used to compensate?
Reactive hyperemia
Which drug is used for supraventricular tachycardia?
Adenosine
Which drug is exclusive for emergencies of ventricular arrhythmias?
Lidocaine
Which drug affects PRARA-α?
Clofibrate
Appropriate mechanism of tachycardia in hypervolemia
Sympathetic stimulation
Sinus bradycardia. What would be the mechanism?
Decrease frequency of AP in SA node
What’s responsible for developing partition in atria?
Septum primum
What’s responsible for division of atrioventricular canal?
Endocardial cushions
What’s responsible for the development of the infundibulum?
Bulbus cordis
