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Term 2 - CVS and Resp > Formative/Practice Questions > Flashcards

Formative/Practice Questions Flashcards

1
Q

The right atrium possesses

A

an opening for the coronary sinus

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2
Q

The tricuspid valve is located between

A

right atrium and right ventricle

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3
Q

The azygous vein empties into the

A

SVC

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4
Q

The internal jugular vein and subclavian veins form from the

A

brachiocephalic vein

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5
Q

The brachiocephalic vein becomes the

A

SVC

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6
Q

Fossa ovalis is a depression in the

A

right atrium

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7
Q

Fossa ovalis is a remnant of

A

thing fibrous sheet that covered the foramen ovals during foetal development

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8
Q

Gap junctions are found in

A

cardiac muscle

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9
Q

Action potential is short in _____ and long in ______

A

skeletal

cardiac

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10
Q

Skeletal muscle can exhibit

A

tetanus

cardiac refractory period is too long so it cant

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11
Q

Skeletal muscle RMP is

A

very stable

depolarises in response to activation by motorneurone

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12
Q

Cardiac muscle RMP is

A

very unstable
randomly depolarise
are pacemakers

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13
Q

In development, which pair of arches give rise to the common carotid arteries/arch?

A

3rd pair of aortic arches

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14
Q

The 1st and 2nd pair of aortic arches =

A

disappear early

1st one forms arch of maxillary aa.

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15
Q

4th left aortic arch =

A

arch of aorta

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16
Q

4th right aortic arch =

A

right subclavian

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17
Q

5th aortic arch =

A

disappears on both sides

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18
Q

6th aortic arches form the

A

pulmonary arteries

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19
Q

Arterioles function as resistance vessels because

A

they have a narrow lumen and strong muscular wall

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20
Q

In the heart, the fast depolarising phase of the cardiac action potential is caused by

A

influx of Na+

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21
Q

the P wave shows

A

the depolarisation of atria

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22
Q

the QRS complex shows

A

ventricular depolarisation

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23
Q

the T wave shows

A

ventricular repolarisation

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24
Q

atrial repolarisation signal is swamped by

A

QRS complex

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25
Q

The second heart sound is when

A

semilunar valves close

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26
Q

The first heart sound is when

A

atrio-ventricular valves close

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27
Q

A HR in excess pf 150bpm is likely to

A

decrease preload

decrease SV

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28
Q

Activation of B1-adrenoreceptors on cardiac myocytes will

A

increase contractility

increase SV

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29
Q

Most significant features of pulmonary circulation =

A

pulmonary arterioles constrict in response to local hypoxia

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30
Q

During exercise, venous pressure (+ venous return to heart) may be increased by

A

increase in systemic filling pressure
contraction of smooth muscle around veins
increased rate and depth of respiration
rhythmic contraction of skeletal muscle

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31
Q

intermittent rapid regular palpitations terminated by the valsalva manoeuvre is most likely to be

A

supraventricular tachycardia

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32
Q

the valsalva manoeuvre increases

A

vagal (parasymp) tone

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33
Q 
sudden severe breathlessness
PND
tachycardia
elevated JVP
lung crackles
peripheral oedema 
SIGNS OF .......
TREATMENT =
A

heart failure

IV diuretic

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34
Q

exertional angina treated with

A

beta blockers

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35
Q

beta blockers

A

reduced workload of heart
reduce O2 requirements
less pain

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36
Q

most useful investigation for severe ‘white coat’ hypertension

A

24 hour ambulatory blood pressure recording

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37
Q

in the first trimester of pregnancy, what can be used to treat a DVT?

A

low molecular weight heparin

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38
Q

warfarin is teratogenic in which trimester?

A

1st

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39
Q

coarctation of aorta
short stature
neck webbing
gondal dysgenesis

= ????

A

Turner Syndrome

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40
Q

Downs syndrome causes

A

atrioventricular septal defects
hypotonic baby
reduced tone

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41
Q

Noonan syndrome causes

A

pulmonary stenosis

septal defects

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42
Q

Shprintzen syndrome is associated with

A

teratology of Fallot

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43
Q

Williams syndrome cause

A

supravalvular aortic stenosis

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44
Q

calf pain on exertion =

A

intermittent claudication

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45
Q

22q11 micro deletion leads to

A

DiGeorge syndrome

associated with teratology of Fallot

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46
Q

FAS mainly associated with

A

neurological, craniofacial defects

some atrial/ventricular septal defects

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47
Q

ulcer on leg
sleep interrupted by severe lower limb pain
MOST LIKELY TO BE ???

A

critical limb ischaemia

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48
Q

Marfan syndrome signs

A 
tall
joint mobility
pneumothorax
myopic
stretch marks
systolic murmur
49
Q

a chest x-ray in marfan’s would show

A

apical blebs

50
Q

an ECG in marfan’s is to assess

A

aortic root diameter at sinus of valsalva

clarify reason for murmur

51
Q

pelvic x-ray in marinas would show

A

protrusio acetabulae

52
Q

MRI scan of lumbar spine in marina’s would show

A

dural ectasia

53
Q

Family history needed in Marfan’s patient

A 
fathers details
cause of death in father's brother
did uncle have features?
paternal grandparents
signs of marina's in them all
54
Q

signs of systolic murmur

A

dyspnoea (worsening)

55
Q

causes of systolic murmur

A

aortic sclerosis
aortic stenosis
mitral regurgitation

56
Q

mitral regurgitation clinical signs

A

loudest at apex
radiates to axilla
pan systolic murmur
maximal on expiration

57
Q

aortic stenosis clinical signs

A

rising upstroke in pulse waveform
low output pulse
murmur radiating to carotid

58
Q

aortic sclerosis clinical signs

A

does not radiate to carotids

59
Q

investigations for systolic murmur

A

FBC
ECG
CXR
biochemical screen + thyroid function

60
Q

severe aortic stenosis is fixed with

A

surgical aortic valve replacement

61
Q

Vital capacity =

A

maximum volume of air that can be exhaled following a maximum inspiration

62
Q

Expiratory reserve volume =

A

volume of air that can be voluntarily forcibly exhaled after normal expiration

63
Q

Function residual capacity =

A

volume left in lungs after normal respiration

ERV + RV

64
Q

Residual volume =

A

volume of air in lungs that cannot be voluntarily expired

65
Q

Tidal volume =

A

volume of air breathed in or out at rest

66
Q

Air flows into the lungs during respiration because

A

external intercostals and diaphragm contract

thoracic volume increases

67
Q

Alveolar ventilation =

A

(TV - DS) x RR

68
Q

the partial pressure of oxygen in mixed venous blood is usually

A

40mmHg (5.3 kPa)

69
Q

Arterial blood pressure of oxygen will be reduced in

A

pulmonary oedema

70
Q

What do the following conditions have in common?

anaemia (iron deficiency)
anemia (vitamin B12 deficiency) 
blood loss (child birth)
CO poisoning
A

decrease in total oxygen content due to lack of O2 binding to Hb or loss of Hb
O2 in solution in plasma unaffected

71
Q

In chronic lung disease, arterial PCO2 levels are

A

elevated due to poor alveolar ventilation

72
Q

In chronic lung disease, is NO safe to use? Why?

A

No

Blunts peripheral chemoreceptor response to falling O2 levels, hypoxic drive, no control over ventilation

73
Q

In chronic lung disease, patients are on _______ because _______

A

hypoxic drive

chronic elevation of PCO2 blunts central response to CO2

74
Q

In chronic lung disease patients have

A

decreased sensitivity to PCO2

rely on peripheral chemoreceptors for ventilation

75
Q

Shunt describes when

A

perfusion exceeds ventilation in L/min

76
Q

Hypothermia causes the haem-ox curve to shift ________ causing ________

A

to the left

difficulty to offload oxygen to peripheral tissues

77
Q

Hypothermia is a decrease in

A

body temperature

78
Q

Presence of foetal haemoglobin shifts to haem-ox curve

A

left

higher affinity for oxygen than adult haemoglobin

79
Q

Respiratory alkalosis shifts the haem-ox curve left because

A

decrease in [H+] pulls CO2 equilibrium to right, reducing PCO2

80
Q

Running a marathon shifts the haem-ox curve right because

A

increase in body temp, CO2, lactic acid

oxygen extraction in peripheral tissues easier, increases oxygen delivery

81
Q

Voluntary hyperventilation causes the haem-ox curve to go left because

A

decreases PCO2

82
Q

At the costovertebral joints, the head of the 9th rib joins with the body of which vertebra(e)?

A

T8 and T9

same number and one above it

83
Q

The cardiac notch is located

A

anterior border of left lung

84
Q

All lung fissures contain

A

visceral pleura

85
Q

The right lung has 2 fissures called

A

oblique

transverse

86
Q

The left lung has a ______ fissure

A

oblique

87
Q

The right lung contains what extra structure? Why?

A

eparterial bronchus in its hilum

it has three lobes

88
Q

The lobes in the left lung are separated by

A

the oblique fissure

89
Q

To investigate a patient with squamous carcinoma, abdominal pain, constipation and confusion, you should carry out a

A

serum calcium test

90
Q

Squamous cell lung cancer is associated with

A

hypercalcaemia due to parathyroid hormone related protein

91
Q

In a patient with a peripheral speculated opacity and an enlarged lymph node (supraclavicular) you should investigate with:

A

fine needle aspiration of the lymph node
to get sample of cancer type
easy access

92
Q

If a patient has daytime somnolence but can sleep for 9 hours a night on holiday, this shows

A

poor sleep hygiene

93
Q

The most likely organism infecting CF lungs is

A

pseudomonas aeruginosa

94
Q

The most likely cause of lobar pneumonia is

A

streptococcus pneumoniae

95
Q

normal blood Ph values =

A

7.37 - 7.43

96
Q

normal PaO2 values are

A

11 - 15 kPa

97
Q

normal PaCO2 values are

A

4.6 - 6.4 kPa

98
Q

low pH, low PaO2, high PaCO2 is most likely

A

a severe exacerbation of asthma (too tired to do a peak flow)

99
Q

A patient with new asthma who is waking up at night because of it should be treated with

A

inhaled CCS and beta-2-agonist

100
Q

A healthy person with sudden severe chest pain, SOB is most likely a

A

primary pneumothorax

101
Q

A patient recovering rom severe pneumonia develops rigors, poor appetite and SOB on exertion. What is wrong now?

A

Empyema thoracis

102
Q

What is empyema thoracis?

A

thick-walled lung abscess = pus in pleural space

103
Q

Typical cause of empyema thoracic is

A

consolidation of pneumonia

104
Q

What do the following values show?

PaO2 = 7.8 kPa
PaCO2 = 8.6kPa
A

Type II Resp failure

105
Q

What treatment should be used in Type II rest failure?

A

Nebulised beta-2-agonist

106
Q

Coughing up blood is also called

A

haemoptysis

107
Q

haemoptysis is most likely to show signs of

A

lung cancer

108
Q

what are the clinical signs of lung cancer in hands?

A

finger clubbing

109
Q

what are the clinical signs of lung cancer felt in the abdomen?

A

hepatomegaly

110
Q

signs of lung cancer found in the neck =

A

lymphadenopathy
SVC obstruction
tracheal deviation

111
Q

imaging techniques used to view the extent of a lesion are

A

chest radiograph
CT
MRI

112
Q

other than imagine, how else can lung cancer be investigated?

A

biopsy

bronchoscopy

113
Q

4 main types of lung cancer

A 
small cell
non-small cell:
- squamous
- adenocarcinoma
- large cell
114
Q

where else does lung cancer commonly spread?

A 
lymph nodes
adrenal gland
lung
liver
brain
bone
115
Q

List signs of left lower lobe pneumonia

A 
tachypnoea
tachycardia
fever
cyanosis
reduced expansion of left chest
dullness at left base
bronchial breathing at left base
crackles
increased vocal resonance
116
Q

In a healthy person, what can cause pneumonia?

A 
chlamydia psittaci
streptococcus pneumoniae
mycoplasma pnemoniae
staph. aureus
haemophilus influenza
117
Q

Investigations for pneumonia =

A 
CXR
sputum/blood culture
acute + convalescent serology
mycoplasma IgM
atypical serology
FBC
ESR/CRP
legionella/pneumococcal urinary antigen
118
Q

What two classes of drugs can be used to treat pneumonia?

A

beta-lactams

macrolides

119
Q 
A patient has these measurements:
temp 38
RR 20bpm
BP 98/60mmHg
HR 120bpm
oxygen sats 90%

How do you manage them in hospital?

A

supplemental oxygen
analgesia
intravenous fluids
anti-pyretics

Term 2 - CVS and Resp (8 decks)

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