Cardiovascular

Question 0

Where do berry (cerebral) aneurysms occur?

Answer 0

Branches of internal carotid arteries

Question 1

What is a mycotic aneurysm?

Answer 1

One caused by infection

Question 2

At what diameter does an aneurysm become significant enough to consider surgery?

Answer 2

5cm

Question 3

What is cardiac tamponade?

Answer 3

Fluid accumulation in the pericardium

Question 4

What are the three in Virchow’s Triad?

Answer 4

Alterations to blood flow
Alterations in vessel wall
Alterations in coagulability of blood

Question 5

What are the two types of atheromatous aneurysms?

Answer 5

Fusiform and saccular

Question 6

What are the four factors that affect pharmacoKINETICS?

Answer 6

Absorption, distribution, metabolism and excretion

Question 7

What six factors contribute to the venous return?

Answer 7

Gravity, thoracic pump, muscle pump, co-localisation, venomotor tone and blood volume

Question 8

What does the Fick principle say?

Answer 8

In a closed system at equilibrium if a substance x is neither synthesised nor broken down then the rate at which x enters the system must be equal to the rate at which it leaves.

Question 9

Which two sub-endothelial proteins activate platelets?

Answer 9

Von willebrand factor and collagen

Question 10

What is Cor Pulmonale?

Answer 10

Right sided heart failure from COPD, hard because SOB would appear to indicate left sided, but in fact it is from respiratory problems.

Question 11

Why does the compensatory increase in HR after SNS stimulation not last long?

Answer 11

With overstimulation the B1 receptors are down regulated.

Question 12

How does a fall in BP stimulate vasopressin release?

Answer 12

Detected by central baroreceptors which stimulate hypothalamus which produces vasopressin which is released by the pituitary gland.

Question 13

What is the alternative name for ADH?

Answer 13

Vasopressin

Question 14

Name three endothelium-derived vasodilators and one vasoconstrictor stimulated in heart failure.

Answer 14

Vasodilators - NO, bradykinin and prostacyclin

Vasoconstrictor - endothelin I

Question 15

What do natriuretic peptides do?

Answer 15

Increase excretion of Na into urine.

Question 16

What are five symptoms and three physical signs of LV failure?

Answer 16

Symptoms - dyspnoea, PND, orthopnoea, cough, haemoptysis

Physical signs - basal lung crackles, tachycardia, s3 gallop,

Question 17

Name five symptoms and four physical signs of RV failure

Answer 17

Symptoms - abdominal pain, anorexia, nausea, bloating, swelling
Physical signs - jugular venous distension, peripheral oedema, hepatomegaly, ascites

Question 18

What are four clinical uses of positive inotropes?

Answer 18

Congestive HF, cardiogenic shock, septic shock, cardiomyopathies

Question 19

Give two examples of phosphodiesterase III inhibitors used in heart failure

Answer 19

Milrinone, amirinone

Question 20

How does digoxin work as a positive inotrope?

Answer 20

Inhibits Na/K ATPase pump so reduces conc gradient so increases intracellular Ca so increases contraction.

Question 21

Name a factor Xa inhibitor

Answer 21

Rivaroxaban

Question 22

Where do oligosaccharides such as fondaparinux act?

Answer 22

Bind to and inhibit ATIII

Question 23

What four main things can arteritis cause?

Answer 23

Changes in vessels due to inflammation of walls
Ischaemia of territory supplied
Aneurysm or haemorrhage due to wall weakening
Systemic symptoms due to circulating cytokines

Question 24

What is ANCA and what is its relevance in vasculitis?

Answer 24

Antineutrophil Cytoplasmic Antibody - deposition in walls activates macrophages, NK cells, neutrophils and complement (inflammation). Serum levels measured clinically

Question 25

What do fast twitch muscles rely upon to regenerate ATP?

Answer 25

Creatine phosphate

Question 26

What is a general definition of shock?

Answer 26

Failure of circulatory system resulting in inadequate perfusion of tissue and hypoxia.

Question 27

What are four causes of cardiogenic shock?

Answer 27

MI, myocarditis, cardiac tamponade and P.E.

Question 28

What are four causes of hypovolaemic shock?

Answer 28

Haemorrhage, diarrhoea, dehydration and burns

Question 29

What is the type of infarct that occurs at the boundary of two adjacent arterial territories?

Answer 29

Watershed infarct

Question 30

What condition occurs when blood vessels twist, constricting blood flow?

Answer 30

Torsion

Question 31

How long does it take before necrosis becomes clinically visible?

Answer 31

6-8 hours

Question 32

What serum test is used to measure extent of membrane damage in infarction?

Answer 32

Troponin T

Question 33

Name two anti platelet drugs that are gpIIb/IIIa antagonists and one which reduces its expression.

Answer 33

Abciximab and tirofiban

Clopidogrel

Question 34

What dose is used for low dose aspirin?

Answer 34

75mg daily

Question 35

Name six specialised functions of vascular endothelium.

Answer 35

Express adhesion molecules
Secrete vasodilators (eg NO, prostacyclin)
Secrete vasoconstrictors (eg endothelin, ACE)
Secrete anticoagulants (eg thrombomodulin)
Secrete coagulation promoters (eg vWF)
Secrete immune modulators (eg interleukins)

Question 36

What is the Bayliss Myogenic Response?

Answer 36

If a smooth muscle in a blood vessel is stretched it responds by contracting

Question 37

Give four possible complications of subendothelial MI?

Answer 37

Arrhythmia, ventricular rupture, aneurysm, chronic pump failure, papillary muscle rupture

Question 38

What is the other name for isotonic exercise?

Answer 38

Dynamic

Question 39

What is the other name for static exercise?

Answer 39

Isometric

Question 40

What are the three sources that muscle uses to replenish ATP pool during exercise?

Answer 40

Cellular respiration, creating phosphate and glycogen stores