Cardiovascular Review Flashcards
Which of the following isNOT apart of the Tetralogy of Fallot?
* Overriding aorta
* Stenosis of mitral valve
* Right ventricular hypertrophy
* Ventricular septal defect
* Pulmonary valve stenosis
Stenosis of mitral valve
What structural change of the heart is most commonly associated with aortic stenosis?
* Left ventricular hypotrophy
* Left atrial hypertrophy
* Right ventricular hypotrophy
* Left ventricular hypertrophy
* Right atrial hypotrophy
Left ventricular hypertrophy
Which type of cardiomyopathy is associated with sudden cardiac death in athletes?
* Dilated cardiomyopathy
* Hypertrophic cardiomyopathy
* Restrictive cardiomyopathy
* Arrhythmogenic right ventricular cardiomyopathy (ARVC)
* Stress Induced cardiomyopathy
Hypertrophic cardiomyopathy
Which of the following is the major criteria to diagnose infective endocarditis using the Modified Duke’s Criteria?
* Predisposing factor e.g. IV drug abuse
* Vascular phenomenon e.g.major arterial emboli
* Temperature > 38C
* Echocardiographic evidence e.g abscess on valves
Echocardiographic evidence e.g abscess on valves
The following graph shows the distribution of oxygen to various tissues during exercise. Which of the following statement is the true description of the take home message from the graph?
Fig1: Cardiac output and distribution of cardiac output to skeletal muscle (muscle), heart, visceral tissues, and other tissues of miniature swine as a function of exercise intensity, reflected in measurements of oxygen consumption.
- with increasing intensity of exercise, the portion of cardiac output distributed to skeletal muscles decreases, whereas the amount of cardiac output distributed to viscera increases.
- with increasing intensity of exercise, the portion of cardiac output distributed to skeletal muscle increases, whereas the amount of cardiac output distributed to viscera decreases.
- with increasing intensity of exercise, the portion of cardiac output distributed to skeletal muscle and viscera increases
- with increasing intensity of exercise, the portion of cardiac output distributed to skeletal muscle stays the same, whereas the amount of cardiac output distributed to viscera decreases.
with increasing intensity of exercise, the portion of cardiac output distributed to skeletal muscle increases, whereas the amount of cardiac output distributed to viscera decreases.
A 70-year-old woman who referred to the ED with the sole complaint of dyspnea. The patient did not mention any history of thrombotic events or significant diseases, except for diabetes. Laboratory assessments showed a white blood cell (WBC) count of 9000 per ml and C-reactive protein (CRP) of 193 mg/L. PCR of the nasopharyngeal swab samples yielded a positive result for COVID-19 and X ray shows signs of Pneumonia. On physical examination, the patient showed asymmetry in size of her forelegs’ circumference. Doppler ultrasound exam was consistent with deep vein thrombosis (DVT) in the right femoral and popliteal veins. Subsequent D-dimer and troponin I (TPI) measurements revealed high levels of 700 ng/mL and 12 ng/mL respectively, which confirmed the diagnosis of DVT. What would be the most likely cause of thrombotic event in this patient based on the history?
* Diabetes leading to atherosclerosis and eventually DVT
* Sars Cov2 infection leading to cytokine storm, endothelial dysfunction and thus switching on the procoagulant switch
* Hospital acquired emboli due to being bed ridden for long periods of time
* Thrombosis secondary to sepsis caused by Pneumonia
Sars Cov2 infection leading to cytokine storm, endothelial dysfunction and thus switching on the procoagulant switch
A 4 years old child presents to you accompanied by his parents complaining of on and off fever for 8 days accompanied with feeling of cold and shakiness. The family has recently returened from a trip to Asia. On examination he was sweaty and pale. Investigations reveal Hb 8g/dl and platelets 112x 109 per liter and increase in bilirubin level. The thick and thin blood films have been sent which came positive for a parasite. The most likely cause of the anaemia & fever in the child based upon the history is:
* Typhoid due to non hygienice food and water intake during travel
* Hemophilia A
* Dengue fever
* Anaemia due to malarial parasite
Anaemia due to malarial parasite
After suffering a streptococcal throat infection, a 12-year-old boy develops cardiac symptoms that are attributed to rheumatic fever. Years later, at the age of 34 he is admitted to the hospital with pulmonary edema. Further examination reveals a diastolic murmur at the apex and echocardiography shows thickening of the mitral valve cusps; enlargement of the LA, with a normal or small LV; and a reduction in the size of the mitral valve orifice. What is the most likely diagnosis based upon these findings which has led to these findings?
* Aortic regurgitation
* Pulmonary hypertension
* Mitra regurgitation
* Mitral Stenosis
* Congestive heart failure
Mitral Stenosis
What are the indications for the immediate replacement of a valve in aortic regurgitation?
* Asymptomatic but chronic illness
* Symptomatic with normal LV function
* If patient shows symptoms of decompensation, heart failure, fluid in legs and lungs
* AR with wide pulse pressure
If patient shows symptoms of decompensation, heart failure, fluid in legs and lungs
A study of atherogenesis is performed. There is a propensity for atheromas to form at muscular arterial branch points, such as the carotid and aortic bifurcations. Which of the following events in the arteries at these locations is most likely to initiate atherogenesis?
* Collagen synthesis
* Lactic acidosis
* Cholesterol breakdown
* Hypoxaemia
* Endothelial dysfunction
Endothelial dysfunction
A 34-year-old man sought medical care at the hospital due to severe chest pain lasting for 24 hours. The patient was aware of being hypertensive and was a smoker. Without any prior symptoms, he started to have severe chest pain with nausea and diaphoresis and sought emergency medical care after about 24 hours, due to pain persistence. An ECG is performed.
Explain the findings on the ECG and what is your diagnosis based upon these findings. What will be your first line management based upon the diagnosis?
- There is ST segment elevation in leads I, aVL & V6
- There is also ST depression in the leads III and aVF (Reciprocal changes)
- This suggests lateral STEMI in the circumflex artery
- The first line of treatment is antiplatelet medication (i.e. Warfarin) and anticoagulant treatment
A 52-year-old woman with a history of illicit drug use and a family history of premature heart disease presented with episodes of chest pain not relieved by rest. An ECG has been performed.
What is the diagnosis based upon ECG? Explain the pathological and clinical differences between Unstable Angina and NSTEMI and what is the management of both?
- ST depression lead II & lead III + T wave inversions (inferior view right coronary artery)
- These suggest NSTEMI / Unstable Angina
- Need troponins measurement to differentiate
- Unstable angina has enough lumen to meet the demands in rest
- Treatment is anticoagulants (aspirin, clopidogeral, heparin) & b-blockers
