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USMLE Preparation > Cardiovascular > Flashcards

Cardiovascular Flashcards

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USMLE® Step 1 flashcards
1
Q

Allantois -> urachus becomes…

A

Median umbilical ligament

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2
Q

Ductus arteriosus becomes…

A

Ligamentum arteriosum

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3
Q

Ductus venosus becomes…

A

Ligamentum venosum

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4
Q

Notochord becomes…

A

Nucleus pulposus

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5
Q

Umbilical arteries become…

A

Medial umbilical ligaments

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6
Q

Umbilical vein becomes…

A

Ligamentum teres hepatis (round l. of the liver)

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7
Q

Most posterior part of the heart =

Enlargement may cause…

A

LA

Dysphagia due to esophageal compression; hoarseness due to recurrent laryngeal n. damage

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8
Q

Most anterior part of the heart =

Of all heart chambers, it is most likely to be injured due to…

A

RV

Trauma

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9
Q

What are the 3 layers of the pericardium (outer to inner)?

Where is the pericardial cavity?

What innervates the pericardium?

A

Fibrous pericardium
Parietal layer of serous pericardium
Visceral layer of serous pericardium

Between the parietal and visceral layers

Phrenic n.

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10
Q

Right dominant circulation (85%) =

Left dominant circulation (8%) =

Codominant circulation (7%) =

A

PDA arises from RCA

PDA arises from LCX

PDA arises from both RCA and LCX

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11
Q

What is supplied by the LAD? (3)

A

Anterior 2/3 of the IV septum
Anterolateral papillary m.
Anterior surface of the LV

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12
Q

What is supplied by the PDA? (4)

A

AV node
Posterior 1/3 of the IV septum
Posterior 2/3 walls of the ventricles
Posteromedial papillary m.

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13
Q

What is supplied by the right marginal artery? (1)

A

RV

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14
Q

What is supplied by the RCA? (1)

A

SA node

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15
Q

What is supplied by the LCX? (1)

A

Lateral part of the LV

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16
Q

How does stroke volume change with increased preload vs. increased afterload?

A

Increased preload - increased SV

Increased afterload - decreased SV

17
Q

What decreases contractility (and SV)? (4)

A

B1-blockers (decreased cAMP)
Acidosis
Hypoxia/hypercapnia
CCBs

18
Q

What is used to approximate afterload?

What is the effect on afterload of the following:

  • Arterial vasodilators
  • ACEIs/ARBs
  • HTN
A

MAP

  • Arterial vasodilators: decreases afterload (and preload)
  • ACEIs/ARBs: decreases afterload (and preload)
  • HTN: increases afterload
19
Q

Myocardial oxygen demand is increased by… (4)

A

Increased:

  • contractility
  • afterload
  • HR
  • diameter of ventricle
20
Q

a wave

c wave

v wave

y descent

A

a - Atrial contraction (absent in Afib)

c - RV contraction (closed tricuspid valve)

v - increase in RA filling against a closed tricuspid valve

y - RA emptying into the RA (+ in constrictive pericarditis, - in cardiac tamponade)

21
Q

Crescendo-decrescendo murmur and soft S2 (+/- ejection click) =

It can cause what symptoms?

A

Aortic stenosis

Syncope, angina and DOE (SAD)

22
Q

Holosystolic, high-pitched “blowing” murmur that radiates toward axilla =

Holosystolic, high-pitched “blowing” murmur loudest in tricuspid area =

A

Mitral regurgitation - ischemic heart disease, MVP, LV dilation

Tricuspid regurgitation - RV dilation

23
Q

“Midsystolic click” =

A

MVP - RHD/IE, myxomatous degeneration (Marfan or Ehler-Danlos diseases)

24
Q

“Opening snap” =

This condition, if chronic, can cause…

A

Mitral stenosis - RHD

LA dilation leading to hoarseness/dysphagia due to compression

25
Q

Myocardial action potential phases:

0
1
2
3
4
A

0 - rapid upstroke; VG Na+ channels open

1 - inactivation of VG Na+ channels; VG K+ channels begin to open

2 - plateau; Ca++ influx through VG Ca++ channels balances K+ efflux

3 - rapid repolarization; massive K+ efflux due to opening of VG K+ channels and closure of VG Ca++ channels

4 - resting potential; high K+ permeability through K+ channels

4

26
Q

Pacemaker action potential phases:

0
3
4

A

0 - upstroke; opening of VG Ca++ channels

3 - repolarization; inactivation of Ca++ channels and activation of K+ channels (efflux)

4 - slow spontaneous Na+ influx via funny channels

27
Q

AP conduction pathway

A

SA node -> atria -> bundle of His -> right and left bundle branches -> Purkinje fibers -> ventricles

28
Q

Greatest speed of conduction =

Greatest pacemaker rate =

A

Purkinje fibers

SA node

29
Q

Drugs that cause Torsades de Pointes (5)

A

ABCDE

A - anti-arrhythmics (class IA, III)
B - antibiotics (macrolides)
C - anti-Cychotics (Haldol)
D - anti-depressants (TCAs)

30
Q

What are the 2 congenital Long QT syndromes?

A

Romano-Ward syndrome - AD, pure cardiac phenotype

Jervell and Lange-Nielsen syndrome - AR, sensorineural hearing loss

USMLE Preparation (7 decks)

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