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CVS Flashcards

1
Q

A pregnant lady came with mitral stenosis and atrial fibrillation what will you give?

A

IV heparin

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2
Q

Myxoid degeneration is most likely associated with?

A

Mitral Valve prolapse

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3
Q

Women with mitral stenosis at 28 weeks of gestation, her dyspnea worsens due to?

A

Pulmonary HTN

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4
Q

Maximum entry of calcium during ventricular myocytes depolarisation shown as?

A

ST segment

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5
Q

U wave in ECG is due to?

A

slow repolarisation of papillary muscles

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6
Q

AV nodal delay is caused by which phase of cardiac cycle?

A

Ventricular filling

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7
Q

54 years old male, palpitations and light headedness, heart rate 200bpm, bp75/40mmHg, what adjustment occurred in cardiac cycle

A

Systolic time has decreased proportionately more than the diastolic time

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8
Q

The right bundle branch is supplied by?

A

Left coronary artery

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9
Q

Tall QRS complex in lead II on ECG shows?

A

Hypertrophied ventricle

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10
Q

Increase in JVP due to increase in?

A

Resistance

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11
Q

Absent P waves on ECG occurs in?

A

Nodal Rhythm

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12
Q

What will occur in the myocardium of a patient with MI who is being treated with fibrinolytic agents?

A

Free Radical Formation

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13
Q

Plateau phase of ventricles on ECG shown by?

A

ST segment

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14
Q

ECG recording is done during?

A

partly depolarisation partly repolarisation

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15
Q

Aortic insufficiency is seen in which disease?

A

Ankylosing spondylitis

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16
Q

A 25yrs old female patient with SOB on exertion, palpitation, and atypical chest pain. O/E BP was 130/90mmHg, pulse 90bpm and a grade 2 systolic murmur in the 4th intercostal space with normal ECG and CXR, diagnosis?

A

Normal Heart

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17
Q

23yrs old, stabbed in bar fight, blade enters at 5th intercostal space, just lateral to sternum, pierces depth of 4cm, structure damaged?

A

Pericardium

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18
Q

Artery most likely to be damaged in close proximity of phrenic nerve?

A

pericardiophrenic artery

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19
Q

Cardiac plexus in the superior mediastinum receives input from?

A

left vagus

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20
Q

Epicardium gets its blood supply from?

A

coronary artery

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21
Q

RBB is supplied by?

A

LCA

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22
Q

If RCA gets blocked after giving marginal artery branch, which portion of the heart will be affected?

A

AV node

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23
Q

Blood supply of posterior surface of heart is supplied by?

A

RCA

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24
Q

What is the blood supply of heart?

A

Two coronary, auricular, atrioventricular, septal

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25
Q

In inferior wall MI which artery is likely to be blocked?

A

right marginal

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26
Q

60 years old male with IHD with palpitation, syncope, dyspnea and sinking of heart. QRS rate 140 to 200 per minute. best treatment?

A

Lidocaine

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27
Q

ECG of patient shows 3:1 ratio of P to QRS. diagnosis?

A

Mobitz 2

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28
Q

During inspiration JVP drops due to?

A

increase venous return

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29
Q

A direct consequence of severe magnesium deficiency would be?

A

Hypokalemia

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30
Q

Wave of depolarisation from endocardium to epicardium represented on ECG as?

A

QRS complex

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31
Q

Normal length of PR interval and QRS complex?

A

PR interval 120-200msec QRS<100msec

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32
Q

Maximum flow pressure in coronary vessels occurs at?

A

Beginning of diastole

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33
Q

Aortic valve opens in left ventricle at what pressure?

A

80mmHg

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34
Q

The maximum left ventricular pressure is during? how much in healthy adult?

A

rapid ejection phase 120mmHg

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35
Q

The audible heart sounds lie in the range of?

A

40-500 cycles per second

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36
Q

During exercise there is decreased blood flow to?

A

Kidneys > splanchnic

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37
Q

Patient with HTN, started on ACE inhibitors, BP controlled but complains of dizziness. Most likely cause of decreased blood supply to brain is?

A

Decreased sympathetic response

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38
Q

Which event occurs just before aortic valve opening?

A

beginning of systole

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39
Q

During which phase calcium will be entering ventricular cells via slow channels?

A

Rapid ejection phase

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40
Q

Patient with murmur, QRS complex +180 axis deviation, diagnosis?

A

RBBB

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41
Q

What is increased in AR?

A

Preload and EDV

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42
Q

75yrs old hx of stable angina presents with SOB, creat 10, urea 200, auscultation reveal a pericardial friction rub and signs of effusion, diagnosis?

A

Uremic pericarditis

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43
Q

Patient with pericardial frictional rub with deranged RFT, urea was increased, creatinine was 8, cause of pericarditis?

A

Fibrinous

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44
Q

Best marker for monitoring the heart in patient with ESRD?

A

Trop I

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45
Q

Superificial cardiac plexus is made of?

A

left vagus

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46
Q

Infarction of apex of heart, vessel thrombosed will be?

A

LAD

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47
Q

Drug to prevent tachy-disarrythmias in patient with Wolf-parkinson-white syndrome?

A

Droperidol

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48
Q

Patient with SVT should be given?

A

Adenosine > Verapamil

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49
Q

A woman usually feels tachycardia during exercise and stress, which settles down at rest, cause?

A

Sinus Tachycardia

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50
Q

In ventricular ECG, changes appeared and ventricles beat slower than atria, diagnosis?

A

2nd degree heart block

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51
Q

Atrial fibrillation leads to?

A

embolus

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52
Q

Massive transfusions cause? Repeated or multiple transfusions cause?

A

hypocalcemia Hemosiderosis/Hemochromatosis or hyperkalemia

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53
Q

Onset of ventricular systole coincides with the peak of?

A

R wave in ECG

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54
Q

Most important cause of low amplitude QRS complex?

A

Old MI

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55
Q

What is higher in peripheral arteries than in the aorta?

A

pulse pressure

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56
Q

Pressure of right ventricle which opens the pulmonary valve?

A

8mmHg

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57
Q

First heart sound is variable in?

A

Atrial fibrillation

58
Q

in cardiac cycle, QRS complex begins prior to?

A

ventricular systole

59
Q

Which heart sound produced by hypervolemia?

60
Q

when does the first heart sound become louder?

A

P-R interval less than normal

61
Q

What is most commonly present along with PDA?

62
Q

Bicuspid aortic valve association?
Turner syndrome associated with?

A

Coarctation of aorta

63
Q

The venous pO2 will be close to 70mmHg in which condition?

A

Left to right shunt

64
Q

Which is most common large vessel disease?
common condition in premature infants?

65
Q

DURING extra systole what occurs?

A

Decrease in pulse pressure due to decreased SV

66
Q

AFTER extra systole what occurs?

A

Increase in pulse pressure due to increased contractility

67
Q

SV increased but neither TPR nor diastolic pressure increased, what will be the effect?

A

Pulse pressure and MAP will raise

68
Q

During rest in well trained athlete,what decreases?

What increases

69
Q

Maximum resistance in arteries then aorta, what will be the effect?

A

Pulse pressure will increase

70
Q

Regarding pulse pressure decrease when there is decreased?

A

systemic pressure

71
Q

Pulse wave velocity is used to?

A

Detect blood flow to the extremity

72
Q

If heart, after pumping were to be stopped to ensure that circulatory system becomes static, the pressure measured in the rest of the body is?

A

Mean systemic filling pressure

73
Q

The cardiac output of the right side of the heart is what percentage of the cardiac output of the left side of the heart?

74
Q

A person took stairs to 4th floor, increase in cardiac output will be due to?

A

Increase preload

75
Q

The best index of after load is?

76
Q

Keep the end diastolic length constant, how can the Cardiac Output be increased?

A

By increasing HR

77
Q

Dye used during indicator dilution method to measure cardiac output is?

A

Cardio green

78
Q

Verapamil MOA on heart?

A

Increases AV nodal delay

79
Q

Characteristic of right ventricle?

A

Gives rise to pulmonary trunk

80
Q

If absent p waves and normal QRS complex and T wave, where is the pacemaker?

81
Q

Patient with HR of 25 and wide QRS complexes, where is the pacemaker?

A

Purkinje fibre

82
Q

SA node acts as a pacemaker of heart because? 4 reasons

A
  1. Generates impulses at a faster rate
  2. phase 4 depolarisation
  3. inward Na+ current
  4. highest firing rate
83
Q

in defective conductive tissue damage of heart, an artificial pacemaker is to be placed in?

A

Moderator band

84
Q

In person with 3rd degree AV conduction block, where shall the pacemaker electrodes to be placed?

A

right ventricle

85
Q

Parasympathetic causes decrease HR by causing what at SA node?

A

decrease Na influx

86
Q

Vagal stimulation of myocardium acts predominantly at?

87
Q

Difference of increase hydrostatic pressure of kidney from heart is?

A

increased osmotic pressure along capillary flow

88
Q

Most common complication of HTN?

89
Q

50yrs old lady with DM/HTN on diuretic presented with hyperkalemia and unconscious and normal RBS, cause is?

90
Q

Patient with both rheumatic fever and endocarditis, long term prophylaxis to prevent recurrence?

A

Benzithine penicillin

91
Q

Most common cause of death in rheumatic fever?

A

Myocarditis

92
Q

Most common organism causing infective endocarditis?

A

Strep. viridian’s

93
Q

Mortality of:
staph aureus
viridian’s?

94
Q

Valves involved in Libman sac endocarditis?

A

Aortic and Mitral

95
Q

School teacher who after death was diagnosed with endocarditis and lymphocytic infiltration of cardiac tissues, organism?

A

Coxsackie virus

96
Q

Diagnostic test for infective endocarditis is?

A

blood culture

97
Q

A 20 yrs old with rheumatic valvular disease with low grade fever for last 2 weeks, pansystolic murmur, splenomegaly, clubbing, treatment should commence with?

A

inj. penicillin and gentamycin

98
Q

Large friable vegetations are seen in?

A

infective endocarditis

99
Q

Female patient with known vascular heart disease, wants to insert IUCD, bacteria that could cause infective endocarditis?

A

Enterococcus faecalis

100
Q

A morbidly obese woman died from heart failure. on autopsy heart was 900gm when normally it is 400g. on histology adipose tissues were intermixed with cardiac cells, this is an example of?

A

Fatty infiltration

101
Q

HF patient, B/L pleural effusion. In pleural tap what will be seen considering its transudative?

A

2-3% lymphocytes

102
Q

In which condition mannitol is given with caution? and why?

A

given in heart failure with caution because can precipitate pulmonary edema

103
Q

In CHF captopril works because?

A

increases cardiac output

104
Q

Mechanism of edema in CHF?

A

increase capillary hydrostatic pressure

105
Q

65yrs old with AST and ALT raised, pitting edema grade 2 bilaterally and JVP raised, diagnosis?

A

heart failure

106
Q

LVH with chest pain and mild SOB, BP 90/70 and pulse 90. What shall be given for pain?

107
Q

Female with fever, suddenly collapsed. On autopsy there is dilated heart, pericardial effusion, lymphocytes and necrosis, cause is?

A

Coxackie B

108
Q

Pt with SOB and pink fluid with no RBC and WBC in alveoli occurs in?

109
Q

bronchus, diagnosis?
Pt with recent MI, after which he develops SOB upon lying and decrease urine output. O/E pedal edema, distended jugular pressure, basal crepts, tender liver and shifting dullness, diagnosis?

110
Q

A HTN woman, On standing from sitting his BP decreases from 120/80 to 90/60 and her HR increases from 70 to 120. The mechanism of increased HR is?

A

decrease firing from the baroreceptors

111
Q

Unconscious pt pale with cold clammy skin, rapid thready pulse, MAP 50mmHg, which parameter will decrease to increase BP?

A

firing from baroreceptors

112
Q

What is present in the adventitia of large arteries?

A

baroreceptors

113
Q

Nerve taking afferents from baroreceptors?

A

Glossopharyngeal

114
Q

Pt with hemorrhage in RTA, unreportable BP, receptors in aortic and carotid detect?

A

decrease pO2

115
Q

Pt brought to ER for massive haemorrhage because of trauma and leaded hypotension baroreceptor compensation lead to?

A

dec. venous compliance

116
Q

Pt with decrease MAP from 100 to 70, change would be?

A

increased cardiac sympathetic efferent activity

117
Q

BP recording of 2 males, a HTN with bp 180/110 and a normal with bp 120/80. If 10mmHg is added to mean BP of both, how will the response in both males vary?

A

increase parasympathetic activity in HTN pt.

118
Q

p-ANCA granulomatosis vasculitis is associated with?

A

Hep B

(Hep B seropositivity seen in polyarteritis nodosa as well)

119
Q

Pt with low cardiac reserve, performs exercise tolerance test, what will be observed?

A

failure of cardiac output to raise in order to meet the demand of acitvity

120
Q

Increased arterial pressure with decrease TPR in?

121
Q

After stress or exercise what will be different in left and right systolic and diastolic duration?

A

increase systolic, decrease diastolic

122
Q

In exercise blood flow is increased to?

A

skeletal muscles

123
Q

During regular exercise, factor that increases respiratory rate?

A

proprioceptors

124
Q

If GFR increases proximal tubular reabsorption of salt and water increase by process called Glomerulotubular balance. Most likely contribution to this process would be?

A

increase in peritubular oncotic pressure

125
Q

Formation of interstitial fluid increase with decreased?

A

plasma colloid osmotic pressure

126
Q

A lady drowned, saved and resuscitated develops ARDS, mechanism is?

A

pulmonary interstitial edema

127
Q

Factors that do not cause increase in edema?

A

arteriolar constriction

128
Q

Neurogenic shock? associated with?

A

due to loss of vasomotor tone and associated with decrease systemic filling pressure

129
Q

Vasodilation and hypotension are features of which shock?

130
Q

Best parameter for fluid resuscitation in hypovolemic shock patient is?

A

increase in urine output

131
Q

Patient with accidental bruises on thigh, that is foul smelling and Pt is hypotensive, diagnosis?

A

toxic shock syndrome

132
Q

Boy developed fever, hypotension and erythematous patches all over trunk, toxin involved?

A

erythrogenic shock/toxic shock syndrome/scarlet fever

133
Q

DIC is caused by which type of toxin

134
Q

Which drug increases chronotropic and ionotropic effect on the heart?

135
Q

30yr old male brought to emergency in state of cardiogenic shock/ failing heart, what drug would you use first?

136
Q

Patient brought to ER in state of shock (unrecordable BP) with heart failure, which neurotransmitter drug should be given?

A

norepinephrine

137
Q

The vascular smooth muscle of the circulatory structure is controlled almost exclusively by the nervous system is?

138
Q

Increase in both renal blood flow and GFR caused by?

A

dilatation of afferent arterioles

139
Q

Pressure in the glomerular capillaries is higher than the other capillaries because?

A

afferent arterioles are short

140
Q

What is associated with increased risk of death in cardiac patient pt with positive familial hyperlipidemia?

141
Q

Factor inhibiting fibrinolysis related to coronary artery disease?

FCPS (7 decks)

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