Board Review Mix 2

Question 1

ASD with abnml p wave axis

Answer 1

sinus venosus , < 30 degrees

Question 2

what to do with PDA after NEC?

Answer 2

immediate surgical closure

Question 3

immigrant with PDA, risk of IE? where? organisms?

Answer 3

15% total IE in other countries, IE on PA end of PDA

strep species

Question 4

rupture sinus of vals any, MC location, associated defects?

Answer 4

VSD in 50% (outlet septal defect), RV MC

Question 5

coronary sinus diverticulum is associated with?

Answer 5

accesory pathway

Question 6

late truncus repair? most important consideration?

Answer 6

PVR < 8. reactive PVR < 8 if less than2 years old

Question 7

another name for asymetric congenital MS?

Answer 7

parachute mitral valve

Question 8

anatomic feature of arcade mitral valve?

Answer 8

paps connected directly to the valve leaflets, easy to see on PS long

Question 9

mitral valve prolapse, when are sports not OK?

Answer 9

If SVT or NSVT on holter

Question 10

location AV node with ccTGA?

Answer 10

anterior location

Question 11

partial pericardial defect, presentation? Dx? common risk?

Answer 11

Dx: MRI, Risk incarceration of the LAA

Question 12

Restrictive cardiomyopathy, MC arrythmia?

Answer 12

Atrial flutter

Question 13

oxygen excess omega formula

Answer 13

oxygen delivery / oxygen consumptions
Art O2 / (Art O2 - SVO2)
Art O2 / AVO2 difference
higher is better

Question 14

anticoagulant mechanisms:

acetylation of cyclo-oxygenase to inhibit production of thromboxane A2

Answer 14

Aspirin - acetylation of cyclo-oxygenase to inhibit production of thromboxane A2
heparin - mucopolysaccharide that nc rate of AT3 neutralizing thrombin, factor X
streptokinase - interacts with plasminogen to result in plasmin complex
tPA - binds to fibrin
warfarin - vit K blocker

Question 15

anticoagulant mechanisms:

mucopolysaccharide that inc rate of AT3 neutralizing thrombin, factor X

Answer 15

heparin - mucopolysaccharide that inc rate of AT3 neutralizing thrombin, factor X
Aspirin - acetylation of cyclo-oxygenase to inhibit production of thromboxane A2
streptokinase - interacts with plasminogen to result in plasmin complex
tPA - binds to fibrin
warfarin - vit K blocker

Question 16

anticoagulant mechanisms:

interacts with plasminogen to result in plasmin complex

Answer 16

streptokinase - interacts with plasminogen to result in plasmin complex
Aspirin - acetylation of cyclo-oxygenase to inhibit production of thromboxane A2
heparin - mucopolysaccharide that nc rate of AT3 neutralizing thrombin, factor X
tPA - binds to fibrin
warfarin - vit K blocker

Question 17

anticoag mech:

binds to fibrin

Answer 17

tPA - binds to fibrin
Aspirin - acetylation of cyclo-oxygenase to inhibit production of thromboxane A2
heparin - mucopolysaccharide that nc rate of AT3 neutralizing thrombin, factor X
streptokinase - interacts with plasminogen to result in plasmin complex
warfarin - vit K blocker

Question 18

how to calculate MVV?

Answer 18

5 x total lung capacity

35-40 x FEV1

Question 19

what does inert gas rebreathig actually measure?

Answer 19

effective pulmonary blood flow - without shunts, assumed to be Qs

Question 20

how does T wave in lead V1 change over age?

Answer 20

starts as poitive
negative by age 7 DAYS
positive in adulthood in some

Question 21

Qt proloning antiobitocs

Answer 21

azithromycin

erythromycin

Question 22

difference in EKG between cocaine and myocarditis

Answer 22

cocaine is focal ST seg change

myocarditis is diffuse

Question 23

what does alternative T waves mean?

Answer 23

LQTS - risk of 2:1 block

Question 24

significant coarct narrowing?

Answer 24

50% decrease in CSA = 10 mmHg

Question 25

shortening fraction change with age?

Answer 25

starts high (45%) then falls
circumferential predominates at first

Question 26

metal with most artifact

Answer 26

stainless steel

Question 27

associated CHD with coarctation? 1st and 2nd

Answer 27

BAV 1st

VSD 2nd

Question 28

holodiastolic flow reversal indicates what about the aortic valve

Answer 28

consistent with severe regurgitation

Question 29

endogenous pulmonary vasodilators

Answer 29

dilators: acetylcholine, badykinin PGE E1,E2,I2 (vowels = open), iNO
constrictors: ATII, Leukotrienes, PGE F2, thromboxane A2, serotonin

Question 30

mesalamine puts you at risk for

Answer 30

myopericarditis (seen in kids with ulcerative colitis)

Question 31

ectopia cordis asociated with which cardiac abnormalities? other defects? survival?

Answer 31

conotruncal
midline defects
10% survival to 1 year

Question 32

levosimendan MOA
way to remember
benefits?

Answer 32

Calcium sensitizer: binds troponin C< inc sensitivity to calcium, also open K channels in smoothe muscle, reducing afterload via vasdilation
LEVER - C - MEN : Leverages calcium MEN

No data to support benefits in adults or KIDS.

Question 33

early vs late HLHS formation

Answer 33

early: superior aspect of septum primum deviates anterior and leftward, causes restrictive atrial septum, limits LV preload
late: aortic valve issue (endocardial cusion)

Question 34

marked drop in impedence of a pacemaker lead

Answer 34

insulation breach - prevented by axillary placement

subclavian crush as lead passes between first rib and clavicle

Question 35

most common presenting symptom of coronary cameral fistula

Answer 35

left to right shunt