Cardiology 2

Question 0

Thiazide

Answer 0

Diuretic

Question 1

Diuretics

Answer 1

Inhibit sodium and water retention, this reduces plasma volume which decreases preload and decreases wall stress

Question 2

Loop

Answer 2

Diruretic

Question 3

Glyceryl trinitrate

Answer 3

Vasodilator
\+++ veins
\+ arteries
Big decrease in preload
Small decreases in aftelaod

Question 4

Sodium nitroprusside

Answer 4

Vasodilator

Breaks up into nitric oxide automatically- large effect on veins and arteries. Large decreases in pre and after loads

Question 5

Ace inhibitor

Answer 5

Vasodilator
Blocks formation of angiotensin 2

Medium effect on veins and arteries, medium effect on pre and afterload

Question 6

ARB angiotensin receptor blocker

Answer 6

Vasodilator

Med effect on veins and arteries
Med effect on pre and afterload

Question 7

Phosphodiesterase inhibitor

Answer 7

Vasodilator

Med effect on veins and arteries
Med effect on pre and afterload

Question 8

Hydralazine

Answer 8

Vasodilator

Also inhibits superoxide formation, very effective when given with isosorbide dimitrate

Question 9

Digoxen

Answer 9

Inhibits sodium potassium pump

Muscle tension is proportional to intracellular sodium levels

75% absorption normally
10% in patients with digoxin inactivating bacteria
Co treatment with antibiotics and lead to toxcity
2/3 elimination unchanged in kidney

Renal failure can lead to toxicity

Question 10

Glycoside in order of longest to shortest acting

Answer 10

Digitoxin, digoxin, ouabain

Question 11

Digitoxin ionic interactions

Answer 11

Potassium inhibits digoxin binding to ATP ase

Calcium potentiates digoxin effects

Magnesium attenuates digoxin effects

Question 12

Metroplol

Answer 12

Cardio selective beta blocker

Beta 1 antagonist

Question 13

Carvedilol

Answer 13

Beta blocker for both beta 1 and 2 receptors

Question 14

Cardiomegely

Answer 14

Enlarged heart

Question 15

Hypokalemia

Answer 15

Low potassium

Question 16

Vitelline vein

Answer 16

Drains deoxygenated blood from the yolk sac

Enters the venous end of sinus venosus

Fate: left Vitelline regresses
Right forms hepatic portal system

Question 17

Common cardinal veins

Answer 17

Anterior and posterior cardinal veins fuse to form the common cardinal vein.

These veins drain the blood of the body wall

Question 18

Umbilical veins

Answer 18

Carry oxygenated blood from placenta to baby

Turns in ligementum teres hepatis

Question 19

Order of sections of primitive heart

Answer 19

Sinus venosus
Atrium
Ventricle
Bulbous cordis
Truncus arteriousus

Question 20

Bulboventricular loop

Answer 20

Loop formed when ventricle and bulbus chordis grow faster than other parts of the heart

Question 21

Path of blood through primitive heart

Answer 21

Sinus venosus
Atria
Ventricle
Bulbus cordis
Truncus arteriousus 
Aortic sac
Pharyngeal branches
Dorsal aorta

Question 22

Endocardial cushions

Answer 22

Fuse to form two atrioventricular canals

They develop from specialized extra cellular matrix or cardiac jelly

Question 23

Catheterization

Answer 23

Gold standard for obstructive coronary disease or hemodynamic assessment

Con: invasive, may require anti coagulants, requires contrast- bad for those with renal failure, radiation exposure

Question 24

Nuclear cardiology

Answer 24

Pro: powerful prognostic and risk stratification, ability to assess different aspect of myocardium- ischemia, viability, hibernation Cons: high radiation exposure, high cost, imperfect accuracy can lead to false positives

Question 25

Chest x ray

Answer 25

Pros Fast, cheap, portable Diagnostic for pneumothorax Cons: radiation exposure, limited resolution of 3d, cannot differentiate various fluids,

Question 26

Echo

Answer 26

Pro Portable, fast Gold standard for endocarditis Can combine imagine with stress to look for ischemia, hibernating or scar Con: imaging can be difficult in critically Ill patients Misdiagnosis

Question 27

Cardiac CT

Answer 27

Can visualize calcified plaque, including extra luminal plaque Can detect mild to moderate disease non invasivly, can detect non cardiac reasons for symptoms Con: Radiation exposure. Contrast is bad for those with renal failure Not ideal for patients with fast or irregular heartbeats Difficult to overcome artifacts such as stents or calcium Difficult to tell if a lesion is hemodynamic significant

Question 28

Cardiac MR

Answer 28

Pro Best assessment of ventricular volumes and function Best in Vivo imaging to characterize aspects of myocardium- scar, infiltrative disease) Gold standard for viability of myocardium for revascularization Con: Long imaging time in a small tube, cannot image patients with metallic implants can be bad for patients with kidney disease