Hemodynamic Disorder Lecture 3

Question 1

Why is infective endocarditis so important?

Answer 1

it is 100% fatal if unDx and unTx and 20% fatal id Dx and Tx appropriately

Question 2

Right sided infective endocarditis embolus always goes to ____

Answer 2

lung

Question 3

myocardial abscess

Answer 3

forms when infective embolus goes to CA

Question 4

What is a normal QT interval corrected for HE, QTc?

Answer 4

<440 miliseconds ***

Question 5

What are causes of long QT

Answer 5

ischemic heart disease
low K, Ca, or Mg
channelopathy
many other things

Question 6

What is the risk of early afterdepolairzations (aka long QT)

Answer 6

ventricular tachycardia

Question 7

What is the risk of ventricualr tachycardia?

What is the preventative treatment for ventricular tachycardia?

Answer 7

sudden death

defibrillator

Question 8

loss of fucntion in repolarizing outward K channel, I-KS

Answer 8

LQT1 (prolongation of phase 2)

Question 9

inactivating mutation in Na channel

Answer 9

LQT3 (prolong phase 3)

Question 10

loss of fucntion in repolarizing outward K channel, I-KR

Answer 10

LQT2

Question 11

the type of polymorphic ventricular tachycardia typical of congenital LQT syndromes is called

Answer 11

torsades de pointes

Question 12

What is life saving preventative Tx for torsades de pointes

Answer 12

defibrillator

Question 13

group of channelopathies causing shorted cardiac myocyte APs –> ventricular tachycardia –> sudden death

Answer 13

brugada syndrome

Question 14

brugada syndrome is most common in what age/race/gender

Answer 14

young asian males

Question 15

persistently elevation of ST segments (>2 mm) descending with an upward convexity to an inverted T wave in leads V1-V3
(AT REST)

Answer 15

brugada pattern

Question 16

Tx of brugada syndrome

Answer 16

defibrillator

Question 17

mutations in ryanodine receptor

Answer 17

catecholaminergic

polymorphic ventricular tachycardia

Question 18

What triggers arrhythmias?

Answer 18

high intracell Ca causing delayed afterpolarizations

Question 19

Life saving-preventative treatment for arrythmias

Answer 19

Beta blockade or defibrillator

Question 20

how many babies, children, and young adults die of cahnnelopathies each year

Answer 20

4,000

Question 21

recognizing EKG signs of a _______ could save the life of a young person

Answer 21

channelopathy

Question 22

Gross: pale mottled flabby dilated heart

Answer 22

viral myocarditis

Question 23

pale septum

Answer 23

viral myocarditis

Question 24

muations in genese encofding desomsomal proteins or myocyte adhesion; probably with a 2nd hit

Answer 24

RT ventricular cardiomyopahty

Question 25

What does right ventricular cardiomyopathy cause?

Answer 25

re-entrant ventricular tachycardia

Question 26

disease possibly assc with enteric viral infection of the right heart

Answer 26

Rt ventricualr cardiomyopathy

Question 27

fatty replacement of myocytes frequently with lyphocytic inflitationd and later fibrous scarring

Answer 27

Rt ventricular cardiomyopathy

Question 28

notch in terminal part of QRS is called ____ and can be a manifestation of ____

Answer 28

epsilon wave

Rt ventricular cardiomyopathy

Question 29

life saving preventative treatment Rt ventricualr cardiomyopathy

Answer 29

defibrillator

Question 30

describe the cardiac AP in the left ventricle, what channels are open and what/where ions move

Answer 30

phase 4 (-90): I-K1 moves K+ out of cells
Phase 0 (+10mV): I-Na moves Na+ into cells
Phase 1: I-to1,2 moves K+ out and Cl- out
phase 2: I-Ca-L and I-KS move Ca in and K+ out (at equal rates)
phase 3: I-KS, KR, K1 move K+ out (back to -90mV)

Question 31

ST segment convex to top

Answer 31

Type 1 ECG brugada sign

Question 32

ST segment downward straight

Answer 32

Type 1 ECG brugada sign

Question 33

ventricular tachycardia or ventricular fibrillation during emotional or physical stress from a mutation in SR Ca release channel

Answer 33

familial catecholaminergic

polymorphic ventricular tachycardia

Question 34

Microscopic: multifocal inflammation, intersitial, usually mononuclear and is assc with myocyte injury and necrosis

*predominant cells are lymphocytes and macrophages

Answer 34

viral myocarditis