Cardiovascular

Question 1

What is SAN?

Answer 1

dominant pacemaker with intrinsic rate of 60-100 bpm

Question 2

What is the fastest depolarising tissue?

Answer 2

SAN

Question 3

What are ventricular cells?

Answer 3

back-up pacemaker with intrinsic rate of 20-45 bpm

Question 4

ECG: what does one small box represent (horizontally)

Answer 4

0.04s

Question 5

ECG: what does one large box represent (horizontally)

Answer 5

0.2s

Question 6

ECG: what does one large box represent (vertically)

Answer 6

0.5mV

Question 7

Heart sounds: S1?

Answer 7

mitral + tricuspid valve closure

Question 8

Heart sounds: S2?

Answer 8

aortic + pulmonary valve closure

Question 9

Heart sounds: S3?

Answer 9

In early diastole during rapid ventricular filling.
Normal in children + pregnant women.
Associated with mitral regurgitation + heart failure.

Question 10

Heart sounds: S4?

Answer 10

‘Gallop’, in late diastole.
Produced by blood being forced into a stiff hypertrophic ventricle.
Associated with LV hypertrophy.

Question 11

Where is the left ventricle (apex beat) palpated?

Answer 11

5th intercostal space at midclavicular line

Question 12

Define preload

Answer 12

Volume of blood in LV which stretches cardiac myocytes before LV contraction; how much blood is in ventricles before it pumps (EDV)

Question 13

Define afterload

Answer 13

Pressure LV must overcome to eject blood during contraction

Question 14

Define elasticity

Answer 14

Myocardial ability to recover normal shape after systolic stress

Question 15

Define diastolic distensibility

Answer 15

Pressure required to fill ventricle to same diastolic volume

Question 16

Define aneurysm

Answer 16

if there is a permanent dilatation of the artery to TWICE the normal diameter (normal = 2cm)

Question 17

List arteries from aorta –> peroneal

Answer 17

aorta –> common iliac –> external iliac –> internal iliac –> common femoral –> superficial femoral –> popliteal –> anterior tibial / posterior tibial / peroneal

Question 18

Give an example of an alpha-1 adrenreceptor blocker

Answer 18

Doxazosin

Question 19

Give an example of a centrally acting antihypertensive

Answer 19

Methyldopa

Question 20

Give an example of a direct renin inhibitor

Answer 20

Aliskiren

Question 21

Equation summarising BP control?

Answer 21

CO x peripheral resistance = BP

Question 22

What are Class 1 anti-arrhytmics?

Answer 22

sodium channel blockers (e.g. Flecainide)

Question 23

What are Class 2 anti-arrhytmics?

Answer 23

non-selective beta-blockers (e.g. Propanolol)
selective beta-1 blockers (e.g. Bisoprolol)

Question 24

What are Class 3 anti-arrhytmics?

Answer 24

prolong action potential (e.g. Amiodarone, Sotalol)

Question 25

What are Class 4 anti-arrhytmics?

Answer 25

CCBs (e.g. Amlodipine, Verapamil, Diazepam)

Question 26

MOA of Digoxin?

Answer 26

inhibits Na/K pump

Question 27

Outline the Vaughan Williams classification of anti-arrhythmics

Answer 27

Classes 1 + 3 = RHYTHM control Classes 2 + 4 = RATE control

Question 28

State the 2 types of cardiac natriuretic peptides

Answer 28

Atrial natriuretic peptide (ANP) B-(brain) natriuretic peptide (BNP)

Question 29

What are cardiac natriuretic peptides metabolised by?

Answer 29

neutral endopeptidase (NEP)

Question 30

State 3 drugs that inhibit NEP (to increase levels of cardiac natriuretic peptides)

Answer 30

Sacubitril, Valsartan, Entresto

Question 31

State 2 nitrate medications

Answer 31

Isosorbide mononitrate GTN (spray/infusion)