Cardio Disease HY

Question 1

Cardiac Dysrhythmias:

Physiologic basis for normal ECG tracing

Answer 1

P Wave - Atrial Depolarization
QRS Complex - Ventricular Depolarization
T Wave Ventricular Depolarization

Cardiac Dysrhythmias:
Physiologic basis for normal ECG tracing

Question 2

Cardiac Dysrhythmias:

Master pacemaker of the heart

Answer 2

Sino atrial SA node

Cardiac Dysrhythmias:
Master pacemaker of the heart

Question 3

Cardiac Dysrhythmias:

Causes depolarization of the SA node

Answer 3

Calcium INflux
(Na influx brings potential closer to threshold, not depolarization; Na determines heart rate)

Cardiac Dysrhythmias:
Causes depolarization of the SA node

Question 4

Cardiac Dysrhythmias:

Chronotropic incompetence

Answer 4

Failure to INC heart rate during exercise, alternatively defined as:

• Unable to achieve 85% of predicted maximal HR at peak exercise
• Unable to achieve a HR >100 bpm with exercise

Maximal HR with exercise

Question 5

Cardiac Dysrhythmias:

ONLY electrical connection between the atria and ventricles

Answer 5

AV Node

Cardiac Dysrhythmias:
ONLY electrical connection between the atria and ventricles

Question 6

Cardiac Dysrhythmias:

Most common arrhythmia mechanism

Answer 6

Re entry

Cardiac Dysrhythmias:
Most common arrhythmia mechanism

Question 7

Cardiac Dysrhythmias:

Only reliable therapy for symptomatic bradycardia in the absence of extrinsic and reversible etiologies

Answer 7

Permanent pacemaking

Cardiac Dysrhythmias:
Only reliable therapy for symptomatic bradycardia in the absence of extrinsic and reversible etiologies

Question 8

Cardiac Dysrhythmias:

Most rapid conduction in the heart

Answer 8

HIS Bundle and bundle branches

Cardiac Dysrhythmias:
Most rapid conduction in the heart

Question 9

Cardiac Dysrhythmias:

Most expeditious technique in the management of AV conduction block

Answer 9

Trans-cutaneous pacing

Cardiac Dysrhythmias:
Most expeditious technique in the management of AV conduction block

Question 10

Cardiac Dysrhythmias:

Most common arrhythmia ID-ed during extended ECG monitoring

Answer 10

Atrial Premature complex

Cardiac Dysrhythmias:
Most common arrhythmia ID-ed during extended ECG monitoring

Question 11

Cardiac Dysrhythmias:

Most common sustained arrhythmia

Answer 11

Atrial fibrillation

Cardiac Dysrhythmias:
Most common sustained arrhythmia

Question 12

Cardiac Dysrhythmias:

Mobitz Type I

Answer 12

• Prolongation of PR interval before dropped QRS complex
• Mneumonic: Think Roman Numeral I that gets taller –> PR prolongation in Mobitz I

Cardiac Dysrhythmias:
Mobitz Type I

Question 13

Cardiac Dysrhythmias:

Mobitz Type II

Answer 13

NO PR prolongation of PR interval before dropped QRS complex.

Mneumonic: Roman numeral II with equal height between the two letters –> NO PR prolongation in Mobitz II

Cardiac Dysrhythmias:
Mobitz Type II

Question 14

Cardiac Dysrhythmias:

Duration that distinguishes sustained from non-sustained ventricular tachycardia

Answer 14

> 30 seconds

Cardiac Dysrhythmias:
Duration that distinguishes sustained from non-sustained ventricular tachycardia

Question 15

Cardiac Dysrhythmias:

Most common arrhythmia post-MI

Answer 15

Premature Ventricular Contraction (PVC)

Cardiac Dysrhythmias:
Most common arrhythmia post-MI

Question 16

Cardiac Dysrhythmias:

Most common LETHAL arrhythmia post-MI

Answer 16

Ventricular fibrillation

Cardiac Dysrhythmias:
Most common LETHAL arrhythmia post-MI

Question 17

Heart Failure:

Most common cause of systolic dysfunction that leads to L sided HF

Answer 17

Coronary artery disease (CAD)

Heart Failure:
Most common cause of systolic dysfunction that leads to L sided HF

Question 18

Heart Failure:

Most common cause of diastolic dysfunction that leads to L sided HF

Answer 18

Concentric LVH (d/t HTN)

Heart Failure:
Most common cause of diastolic dysfunction that leads to L sided HF

Question 19

Heart Failure:

Most common cause of R sided HF

Answer 19

L sided HF

Heart Failure:
Most common cause of R sided HF

Question 20

Heart Failure:

Earliest cardinal symptom of L sided HF

Answer 20

Dyspnea

Heart Failure:
Earliest cardinal symptom of L sided HF

Question 21

Heart Failure:

Earliest cardinal sign of L sided HF

Answer 21

L sided S3

Heart Failure:
Earliest cardinal sign of L sided HF

Question 22

Heart Failure:

Presentation of L sided HF

Answer 22

Dyspnea, L sided S3, PND, orthopnea, Mitral regurg, INC Brain natriuretic peptide (BNP), Siderophages (hemosiderin-laden macrophages or HF cells), pulmonary edema (septal edema, peribronchiolalr edema)

Heart Failure:
Earliest cardinal sign of L sided HF

Question 23

Heart Failure:

Presentation of R sided HF

Answer 23

Peripheral ankle edema (Hallmark), Native valve endocarditis (NVE), tricuspid regurg, ascites, chronic passive congestion of the liver (nutmeg), cardiac cirrhosis

Heart Failure:
Presentation of R sided HF

Question 24

Heart Failure:

Most sensitive index of cardiac function

Answer 24

Ejection Fraction

Heart Failure:
Most sensitive index of cardiac function

Question 25

Heart Failure:

Single most important beside measurement to estimate volume status

Answer 25

JVP (Internal jugular vein is preferred)

Heart Failure:
Single most important beside measurement to estimate volume status

Question 26

Heart Failure:

Cardinal symptoms of HF

Answer 26

Fatigue and Shortness of Breath

Heart Failure:
Cardinal symptoms of HF

Question 27

Heart Failure:

Most important mechanism of dyspnea in HF

Answer 27

Pulmonary congestion with accumulation of interstitial or intra-alveolar fluid, which activates juxtacapillary J receptors

Heart Failure:
Most important mechanism of dyspnea in HF

Question 28

Heart Failure:

Only pharmacologic agents that can adequately control fluid retention in advanced HF

Answer 28

Diuretics

Heart Failure:
Only pharmacologic agents that can adequately control fluid retention in advanced HF

Question 29

Heart Failure:

Major problem of Aldosterone Antagonists

Answer 29

Development of life-threatening hyperkalemia (HYPER K)

Heart Failure:
Major problem of Aldosterone Antagonists

Question 30

Heart Failure:

Cornerstones of modern therapy for HF with a depressed EF

Answer 30

ACE-I / ARBs / Beta Blockers

Heart Failure:
Cornerstones of modern therapy for HF with a depressed EF

Question 31

Heart Failure:

MC side effect of all vaso-dilating agents

Answer 31

Hypotension

Heart Failure:
MC side effect of all vaso-dilating agents

Question 32

Heart Failure:

MC used inotropic agent for acute HF

Answer 32

Dobutamine

Heart Failure:
MC used inotropic agent for acute HF