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Question 1

What is the most common cause of acute infectious endocarditis?

Answer 1

Staph Aureus

Question 2

What will result in predominately right sided heart failure?

Answer 2

Pulmonary Disease (COPD)

Question 3

What drug can affect HR without direct actions on the heart?

Answer 3

Phenylephrine (vasoconstricts vessels = autoregulatory drop in HR)

Question 4

What is true about Metropolol vs Atenolol?

Answer 4

Metropolol has a higher lipid solubility than Atenolol (Atenolol IS NOT lipid soluble)

Question 5

Which effect would be observed with ganglionic blockers?

Answer 5

Hypotension

Question 6

Which statin would be used in a patient with CKD?

Answer 6

Atorvastatin

Question 7

What is the MOA of phentolamine?

Answer 7

Non-selective alpha block with a decrease in HTN

Question 8

What does the bainbridge reflex do?

Answer 8

Increases HR as a result of increased RA pressure

Question 9

What drug should you give to patient for post DC cardioversion of A-Fib.

Answer 9

Amiodarone

Question 10

A woman works two night shifts back to back, and is standing on her feet a lot, she gets swelling in her ankles, what is most likely the mechanism behind this?

Answer 10

Increased venous congestion

Question 11

An otherwise healthy middle aged woman develops sudden shortness of breath, and orthopnea. A loud pancystolic murmur is heard on auscultation….

Answer 11

A floppy valve (Mitral valve prolapse)

Question 12

Which of the following is responsible for the findings in Non Infective Thrombotic Endocarditis?

Answer 12

Procoagulant effects from Mucin Secreting Tumors

Question 13

Which one of the following would you be able to discern from a patients lab values, who is currently taking fenofibrate?

Answer 13

Decreased triglycerides

Question 14

Fatty streaks in a child can be seen where?

Answer 14

Smooth muscle cells

Question 15

Which one of the following congenital defects is responsible for the development of cyanosis in a newborn, 4 days post delivery?

Answer 15

Transposition of the great vessels (with assumed concomitant heart defect, will not cause immediate death, baby will be cyanotic)

Question 16

Which of the following is responsible for setting of the unfortunate series of events with tetralogy of fallot?

Answer 16

Failure to form spiral septum

Question 17

Which of the following aids in localization of hemostats?

Answer 17

TPA

Question 18

High school football player drops dead on the field?

Answer 18

Hypertrophic Cardiomyopathy

Question 19

Patient develops a midsystolic crescendo-decrescendo?

Answer 19

Concentric Hypertrophy (Due to aortic stenosis)

Question 20

Which site verapamil most specific to?

Answer 20

AV node

Question 21

What is responsible for the heart sound over LSB in a patient ASD?

Answer 21

Relative pulmonary stenosis from increased pulmonary flow

Question 22

Which of the following regarding ischemic therapy is true (anti-anginal)?

Answer 22

THe effects of nitroglycerin may become tolerant with long term treatment

Question 23

Patient presents with 6/10 dull chest pain, SOB, diaphoretic, EKG shows ST elevation…

Answer 23

Acute MI

Question 24

Which of the following would be seen on autopsy 1 hour after a man dies to a heart attack?

Answer 24

Atherosclerotic lesions of the coronary arteries

Question 25

Which of the following regarding atherosclerosis risk is true?

Answer 25

Post menopausal women are at an increased risk of MI than pre-menopausal

Question 26

Which of the following drugs has been shown to exhibit fetal toxicity in the first trimester?

Answer 26

ACEI

Question 27

A man comes in with aortic stenosis (murmur maybe described), which of the following should be considered if he should have valve replacement?

Answer 27

Gradient between aorta and LV

Question 28

For re-entry to occur, what must be present?

Answer 28

An alternative conduction pathway must exist and a slower conduction velocity present

Question 29

For automaticity to occur, what must be present?

Answer 29

Alteration in phase 4 diastolic depolarization of the AP

Question 30

Which of the following regarding parasympathetics (?) is true?

Answer 30

ACH slows heart rate by decreasing conductance of the If Na channels in nodal tissue

Question 31

A man comes into the ER with cocaine overdose and tachycardia, BP is 200s/100s, the nurse wants to give metropolol to treat his tachycardia, what are you concerned about?

Answer 31

Hypertension????? hypotension?

Question 32

Question about guy who gets increased angina chest pain when running on a treadmill?

Answer 32

Decrease his systolic BP with drugs

Question 33

Someone stabbed in the chest, and present with diminished heart sounds. Two different pulses…. what is the reason?

Answer 33

Encroachment of the IV septum into the LV, decreasing the CO/preload = pulsus paradoxis

Question 34

Picture of a heart with an extremely dilated LA, most common condition observed in this patient?

Answer 34

Pulmonary congestion

Question 35

Question about a woman who asks about cutting out salt from diet?

Answer 35

Tell her that cutting cooking/dietary isnt enough, possible question about you need to eat a diet rich in other fruits/vegetables to get other things like K, Mg, Ca, etc

Question 36

Question about eating salmon?

Answer 36

Increase omega 3 fatty acids

Question 37

Question about framingham?

Answer 37

It was a multigenerational study, longitudinal study, involving only a caucasian population of people in Mass, that looked at the risks/development of CVD

Question 38

Question about a whole bunch of people who were on a nonrestrictive fat diet and a low trans fat diet and relative risk of 1.5 in patients (nonrestrictive) who developed atherosclerosis vs those who didnt?

Answer 38

Means that those patients have a 50% increased likelihood of developing atherosclerosis

Question 39

Question about a giant cohort study where 50,000 patients were surveyed, then followed over time to see if their diet affected their morbidity outcomes or not. COD was determined by blinded physicians, what was the limit?

Answer 39

Recall bias

Question 40

Which was true, lipids lecture

Answer 40

Familial combined hyperlipidemia is a problem with both VLDL and ApoB

Question 41

Which causes Torsade de Pointe?

Answer 41

Change in K+ conductance (K+ blockers, class 3 antiarrhythmics

Question 42

Patient comes in with a thrombus blocking CA, which causes MI, undergoes fibrinolysis and developed left sided weakness, confusion, etc. Etiology?

Answer 42

Thromboembolism

Question 43

A woman has been treated (and noncompliant) for HTN for 5 years, she ends up developing aortic dissection with a dilated mediastinum, aortic insufficiency, etc, and dies. What was her most likely risk factor?

Answer 43

HTN

Question 44

Got em? Good, now go do schneider, and go look at a muscular artery and a venule.

Answer 44

Good Luck.