First Aid: Cardiovascular

Question 1

Which drug is used to help close a patent ductus arteriosum?

Answer 1

Indomethacin.

Question 2

Which prostaglandins keep the PDA open?

Answer 2

PGE1 and PGE2

Question 3

What is the only murmur that increases with a Valsalva?

Answer 3

Hypertrophic Cardiomyopathy

Question 4

What is T-wave inversion a sign of?

Answer 4

Recent MI

Question 5

What is a U wave a sign of?

Answer 5

Hypokalemia or bradycardia

Question 6

Which drugs can prolong QT?

Answer 6

Sotalol
Risperidone (antipsychotics)
Macrolides
Chloriquine
Protease inhibitors
Quinidine (class Ia and class III)
Thiazide
(Some Risky Meds Can Prolong QT)

Question 7

What can cause Torsades de Pointes? What is the treatment?

Answer 7

Drugs, low K+, low Mg2+. It is treated with Magnesium Sulfate.

Question 8

Describe the two congenital long QT syndromes? Names, genetics, and associated symptoms.

Answer 8

Romano-Ward Syndrome is autosomal dominant and it causes long QT only.
Jervell and Lange-Nielsen Syndrome is autosomal recessive and it causes long QT and sensorineural deafness.

Question 9

Describe the reason behind the ECG finding in Wolff-Parkinson-White syndrome?

Answer 9

The delta wave (early sloping R wave) is due to accessory conduction that parallels the AV node. Bundle of kent. Can become a supra ventricular tachycardia.

Question 10

Describe the different types of AV block?

Answer 10

1st Degree = Long PR intervals (>200ms)
2nd Degree Type I = Irregular PR and dropped beats
2nd Degree Type II = Regular PR with dropped beats (2:1)
3rd Degree = Completely independent
The last two require pacemakers.

Question 11

What are the effects of ANP on the nephron?

Answer 11

Afferent dilation. Efferent constriction. Decrease Na+ reabsorption in the collecting tubule. It also causes systemic vasodilation.

Question 12

Describe the Cushing Reaction?

Answer 12

Increased intracranial pressure requires more pressure for perfusion (hypertension). This causes a reflex decrease in heart rate (bradycardia) and respiration (tachypnea)

Question 13

What are the 5 right to left shunts?

Answer 13

Truncus Arteriosus
Transposition
Tricuspid atresia
Tetralogyof Fallot
TAPVR

Question 14

What heart defect is associated with congenital hyperglycemia? (GD or DM)

Answer 14

Transposition of the great vessels.

Question 15

What is the histologic appearance of hypertensive nephropathy?

Answer 15

Arterial Hyalinosis (This is also considered Hayline Arteriolosclerosis, seen in small arteries due to HTN)

Question 16

What is Dressler Syndrome?

Answer 16

Post-MI (several weeks) autoimmune pericarditis

Question 17

What are the two types of cardiac tumors?

Answer 17

Myxomas (adults, atrial 90%) and Rhabdomyomas (children, assc. w/ tuberous sclerosis)

Question 18

What is Kussmal Sign?

Answer 18

In any disease that doesn’t allow the heart to expand on inspiration the expansion of the VC causes paradoxical increase in JVP.