Cardiovascular

Question 1

Starling’s Law

Answer 1

increasing preload (aka venous return) increases stroke volume

Question 2

Coronary territories

Answer 2

Anteroseptal leads - left anterior descending artery
Inferior leads - right coronary artery
Lateral leads - circumflex artery
Posterior leads - posterior descending artery, usually arising from RCA

Question 3

Virchow’s triad

Answer 3

Hypercoagulability
Endothelial injury
Circulatory stasis

Question 4

‘type I’ and ‘type II’ MIs?

Answer 4

Type I relates to coronary artery occlusion, due to thrombosis, plaque rupture, arterial dissection or vasospasm e.g. due to cocaine

Type II relates to an alternative underlying pathology, such as sepsis, severe anaemia, hypoxia or hypovolaemia

Question 5

Complications of MI?

Answer 5

(‘DARTH VADER’):

Death (cardiogenic shock)
Arrhythmias (esp. ventricular)
Rupture (ventricular / septal / papillary muscle)
Tamponade (due to wall rupture)
Heart failure (chronic/acute)
Valve disease (esp. flail MR)
Aneurysm (ventricular)
Dressler’s syndrome (fever, pleuritic pain, pericarditis and pericardial effusion secondary to an MI, typically occurring 2-5 weeks later. Treat with NSAIDS/steroids)
Embolism (of mural thrombus)
Recurrence of MI

Question 6

Myocardial infarction - complications
from treatment?

Answer 6

Reperfusion injury (following PCI)
Haemorrhage (due to procedures or from antiplatelet/anticoagulant)

Question 7

’lipid profile’?

Answer 7

total cholesterol, triglycerides, HDL, LDL, non-HDL cholesterol and the HDL:LDL ratio

Question 8

QRISK score?

Answer 8

quantify risk of stroke/MI in next 10 years (NB not if already have established IHD)

Question 9

Primary disorder of lipid metabolism?

Answer 9

familial hypercholesterolaemia (LDLR/PCSK9 mutation)