CR EOYS7 Flashcards

1
Q

What type of drug would be in a inhaler to initially reduce inflammatory response in asthma? [1]

A

Steroids inhaler: reduce inflammatory response

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2
Q

Why does a the lung look like this with uncontrolled asthma? [3]

A

Goblet cells causes secretion of too much mucous: plugs the airways. Causes collapse of alveoli: atelectasis

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3
Q

Eosinophil accumulation is triggered by chemotactic factors released from which cells in asthmatics? [2]
Eosinophil accumulation is triggered by which IL in asthmatics? [1]

A

Eosinophils are attracted by chemotactic factors released by mast cells and by the chemokine eotaxin, produced by bronchial epithelial cells.

Eosinophil accumulation is also favored by IL-5, a T-cell derived cytokine.

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4
Q

What role do eosinophils play in causing tissue damage?

A

The major basic protein of eosinophils causes epithelial damage and shedding.

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5
Q

Explain changes in cell types due to smoking xx [3]

A
  • loss pseudostratified epitheluim, with transition into a fully squamous epithelium and expression of early markers of carcinogenesis.
  • change to squamous = metaplastic change (reversible)
  • change to squamous that is irreversible = dysplastic
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6
Q

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with left ventricular hypertrophy?

A
B
C
D

A

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with left ventricular hypertrophy?

A
B
C
D

Left ventricular hypertrophy results in a thickening of the cardiac muscle. The increase in mass increases the magnitude of the depolarisation wave on the left side of the heart. This causes the left axis deviation.

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7
Q

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with normal heart?

A
B
C
D

A

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with normal heart?

A : normal heart axis = -30 to 90 degrees
B
C
D

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8
Q

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with right ventricular hypertrophy?

A
B
C
D

A

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with right ventricular hypertrophy?

A
B
C
D = 90 to 180 degrees

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9
Q

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with extreme axis deviation?

A
B
C
D

A

Based on the quadrant diagram shown, which region would you expect the mean electrical axis to deviate towards in a patient with extreme axis deviation?

A
B
C
D

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10
Q

If found a Q wave is found in an ECG, which leads would indicate that it is pathological? [1]

A

Pathological: V1-V3

Pathological Q waves usually indicate current or prior myocardial infarction.

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11
Q

Absent Q waves in V5-6 is most commonly due to:

LBBB
Mobitz type 1 AV block
RBBB
Wolff-Parkinson-White (WPW)
Mobitz type 2 AV block

A

Absent Q waves in V5-6 is most commonly due to:

LBBB
Mobitz type 1 AV block
RBBB
Wolff-Parkinson-White (WPW)
Mobitz type 2 AV block

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12
Q

Name this sign [1]

A

Xanthelesma

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13
Q

Name this sign [1]

A

arcus lipoides - sign of high cholesterol in young people; normal in older

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14
Q

What is the axis deviation of a healthy heart? [1]
Right axis deviation ranges between which degrees? [1]
Left axis deviation ranges between which degrees? [1]

A

Normal: -30° and +90º

Right axis deviation: +90º and +180º

Left axis deviation: -30° and -90°.

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15
Q

Which lead would you expect to see the biggest negative deflection in a healthy heart?

avL
avF
avR
Lead I
Lead II

A

Which lead would you expect to see the biggest negative deflection in a healthy heart?

avL
avF
avR
Lead I
Lead II

This is due to aVR looking at the heart in the opposite direction.

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16
Q

State the most common cause of a heart axis deviation between +90º and +180º [1]

Explain why this occurs

A

+90º and +180º: RAD. Most common cause is right ventricular hypertrophy

Extra right ventricular tissue results in a stronger electrical signal being generated by the right side of the heart.

17
Q

Describe the changes in ECG leads seen cardiac in right axis deviation [2]

A

Deflection in lead I to become negative
Deflection in lead aVF/III to be more positive.

18
Q

Describe the changes in ECG leads seen cardiac in left axis deviation [2]

A

Deflection of lead III becoming negative (this is only considered significant if the deflection of lead II also becomes negative).

19
Q

Name 3 reasons left axis deviation may occur [3]

A

left anterior hemiblock
left bundle branch block
inferior myocardial infarction
Wolff-Parkinson-White syndrome- right-sided accessory pathway
hyperkalaemia
congenital: ostium primum ASD, tricuspid atresia
minor LAD in obese people

20
Q

Name 3 reasons right axis deviation may occur [3]

A

right ventricular hypertrophy
left posterior hemiblock
lateral myocardial infarction
chronic lung disease → cor pulmonale
pulmonary embolism
ostium secundum ASD
Wolff-Parkinson-White syndrome- left-sided accessory pathway
normal in infant < 1 years old
minor RAD in tall people

21
Q

Left axis deviation would occur from an MI in which part of the heart?

Septal
Anterior
Inferior
Lateral

A

Left axis deviation would occur from an MI in which part of the heart?

Septal
Anterior
Inferior
Lateral

22
Q

Cold peripheries are caused by:

Beta blockers
Loop diuretics
ACE inhibitors
Thiazide-like diuretics

A

Cold peripheries are caused by:

Beta blockers
Loop diuretics
ACE inhibitors
Thiazide-like diuretics

23
Q

Which of the following is most associated with ACE inhbitors

Hypokalaemia
Dry mouth
Cough
Bradycardia
Fluid retention

A

Which of the following is most associated with ACE inhbitors

Hypokalaemia
Dry mouth
Cough
Bradycardia
Fluid retention

24
Q

Name 4 causes of systolic dysfunction [4]

A

Ischaemic heart disease
Dilated cardiomyopathy
Myocarditis
Arrhythmias

25
Q

Name 5 causes of diastolic dysfunction [5]

A

Hypertrophic obstructive cardiomyopathy
Restrictive cardiomyopathy
Cardiac tamponade
Constrictive pericarditis

26
Q

Name a common side effect of statin use [1]

A

myalgia

27
Q

Eosinophil accumulation is also favored by:

IL-1
IL-2
IL-3
IL-4
IL-5

A

Eosinophil accumulation is also favored by:

IL-1
IL-2
IL-3
IL-4
IL-5

28
Q

Which of these is not a cause of systolic heart failure

Ischaemic heart disease
Dilated cardiomyopathy
Myocarditis
Arrhythmias
Cardiac tamponade

A

Which of these is not a cause of systolic heart failure

Ischaemic heart disease
Dilated cardiomyopathy
Myocarditis
Arrhythmias
Cardiac tamponade - diastolic failure