Cardiac 1

Question 0

Hallmark of Stable angina on EKG

Answer 0

ST segment depression

Question 1

Stable Angina only when atherosclerosis is ____ (number)

Answer 1

> 70% stenosis (from atherosclerosis) of coronary arteries

Question 2

Definition of Unstable Angina

Answer 2

Chest pain at rest

due to rupture of atherosclerotic plaque with thrombosis and incomplete occlusion of coronary artery

Question 3

Prinzemetal Angina is

Answer 3

Vasospasm of coronary artery

episodes of chest pain unrelated to exertion

Question 4

Possible causes of Myocardial Infarction

Answer 4

rupture of atherosclerotic plaque with thrombosis and COMPLETE occlusion leading to necrosis of myocytes

Prinzemetal vasospasm for greater than 20 minutes
Embolism
Vasculitis (inflammation > thrombus)

Question 5

Marker for MI

Answer 5

Troponin I

rises 2-4hr after infarction
peaks @ 24hrs
returns to normal by 7-10 days

Question 6

What marker is useful for detecting re-infarction a couple days after initial episode?

Answer 6

CK-MB

rises 4-6hrs after infarction
but returns to normal by 72hrs unlike Troponin I

Question 7

Treatments for MI

Answer 7

ASA/heparin
supplemental O2
Nitrates (reduces preload)
Beta blocker (prevents arrhythmia)
ACE inhibitor (prevents water retention)

Question 8

Fibrinolysis or angioplasty can cause Contraction Band necrosis. What is it?

Answer 8

Sudden repurfusion introduces Ca++ which causes contraction of necrotic tissue. Histologically, it’s bands in myocytes

Question 9

Symptoms of pulmonary congestion

Answer 9

Edema 
Dyspnea
Orthopnea 
Paroxymal nocturnal dyspnea 
Orthopnea 
Crackles

Question 10

What causes Heart Failure Cells

Answer 10

Left sided heart failure leads to excess blood in pulmonary circulation. Rupture of capillaries leads to blood in alveoli air sacks. Macrophages consume that blood and will become HEMOSIDERIN LADEN MACROPHAGES aka Heart Failure Cells

Question 11

Cor Pulmonale is…

Due to

Answer 11

Right sided heart failure due to pulmonary blood vessels constricting due to hypoxia in the lungs.

Question 12

Jugular Vein Distention due to

Answer 12

Right side heart failure

Question 13

Cardiac congestion symptoms

Answer 13

JVD
Hepatosplenomegaly (painful)
Cardiac Cirrhosis
Pitting Edema

Question 14

Most common type of Atrial Septal Defect

Answer 14

Ostium Secundum

Question 15

What is paradoxical embolism?

Answer 15

Emboli in the Vena Cava would usually travel into the pulmonic circulation and lodge there. But in ATRAIL SEPTAL DEFECT it would travel through the the septum into the left atrium, then ventrical, and lodge elsewhere in the body, such as the brain.

Question 16

Patent Ductus Arteriosis associated with

Answer 16

Congenital Rubella

Question 17

Patent Ductus Arteriosis links what with what?

Answer 17

Pulmonary Artery with Aorta (below major upper body arteries)

Pulmonary hypertension will result in shunting of blue blood from pulmonary circulation into aorta, which results in lower body cyanosis.

Question 18

What is Eisenmenger syndrome?

Answer 18

Reversal of a Left to Right shunt due to pulmonary hypertension

Question 19

Treatment for PDA (patent ductus arteriosis)

Answer 19

Indomethacin

Decreases Prostaglandin E, which is what keeps the duct open
Closes the PDA

Question 20

Boot shaped heart associated with

Answer 20

Tetralogy of Fallot

Question 21

Transposition of Great Vessels associated with

Answer 21

Maternal diabetes

Question 22

Coarctation of the Aorta is…

associated with ____

Answer 22

Narrowing of aorta distal to aortic arch but proximal to PDA
presents with lower extremity cyanosis
associated with Turner Syndrome

Question 23

Coarctation in adults results in

Answer 23

Since no patent duct, results in
Hypertension in upper extremities
Hypotension in lower extremities
Collateral circulations develop across intercostal arteries results in
NOTCHING of BONE (on xray)