Cardiology

Question 1

What is the cause of TOF? of Transposition of great vessels? truncus arteriosus?

Answer 1

TOF due to anteriorsuperior displacement of the infundibular septum

Transposition due to linear vs spiral development of aortopulmonary septum

Truncus arteriosus due to incomplete development of aortopulmonary septum

Question 2

What are the derivatives of each aortic arch 1-6?

Answer 2

1. Trigeminal, maxillary artery
2. Facial, nothing
3. Glossopharyngeal, carotid
4. Vagus, aortic arch, subclavian
5. Nothing
6. Recurrent vagus, pulmonary arteries and ductus arteriosus

Question 3

What conditions are associated with infantile and adult coarctation of the aorta?

Answer 3

Infantile: associated with PDA and Turners syndrome

Adult: associated with bicuspid aortic valve, berry aneurysms that can rupture, endocariditis, HTN can lead to HF

Question 4

What are the common complications 3-14 days after an acute MI?

Answer 4

Free wall rupture resulting in cardiac tamponade

Papillary muscle rupture (posteriomedial papillary muscle most susceptible to damage due to single blood supply from posterior descending artery) resulting in mitral regurgitation

Interventricular septal rupture due to macrophage mediated structural degradation resulting in a new holosystolic murmur and stepped up oxygen level between right atrium and ventricle

LV pseudoaneurysm

Question 5

Where in the aorta is blunt aortic injury from trauma found?

What would be seen on xray?

Answer 5

Traumatic aortic rupture is usually seen due to sudden deceleration that results in extreme stretching and torsional forces affecting the heart and aorta. Injury most often occurs at the aortic isthmus, which is tethered by the ligamentum arteriosum and is relatively fixed and immobile compared to the rest of the adjacent descending aorta

A widened mediastinum may be seen on X ray

Question 6

What heart conditions are found most commonly in Turner syndrome? what are the clinical findings of Turner syndrome?

Answer 6

Turner Syndrome= XO
Short stature, short and thick neck, broad chest, shortened 4th metacarapls

Cardiac: bicuspid aortic valve most common. coarction of the aorta also seen

Question 7

Where are the leads in an electronic pacemaker placed?

Answer 7

First two placed in right atrium and right ventricle.
Third lead placed in left ventricle. This third lead is placed by going through the right atrium, into the coronary sinus (which resides in the atrioventricular groove on the posterior side of the heart)… and then finally advanced into one of the lateral venous tributaries

Question 8

What arteries does polyarteritis nodosa spare?

Answer 8

Pulmonary arteries.

Typically involves the renal and visceral vessels

Question 9

What are the arteries most susceptible to developing atherosclerotic plaques?

Answer 9

Abdominal, coronary, popliteal, carotid

Question 10

What is seen on histology in hypertrophic cardiomyopathy?

Answer 10

Extreme myofiber disarray with interstitial fibrosis

Question 11

What is hereditary hemorrhagic telangiectasia?

What is it also known as?

Answer 11

Autosomal dominant inherited disorder of blood vessels. Branching skin lesions (telangiectasias), recurrent nose bleeds skin discolorations, AVMs, GI bleeding, hematuria.

Also known as Osler Weber Rendu syndrome