Passmed Cardiology

Question 1

Which part of the heart has the slowest rate of conduction?

Answer 1

AV node conduction
Atrial conduction
Ventricular conduction -> fastest due to purkinje fibres

Question 2

What is the feature of the S4 heart sound?

Answer 2

Caused by atria contracting forcefully to overcome a stiff ventricle. It coincides with the P wave and is in late diastole.

Question 3

Which pathologies are the S4 heart sound heard?

Answer 3

Aortic stenosis
Hypertension
Hypertrophic cardiomyoapthy

Question 4

What are the features of S3 heart sound?

Answer 4

Caused by rapid diastolic filling of the ventricle, which occurs early in diastole.

Question 5

What pathologies are related to the S3 heart sound?

Answer 5

Left ventricular failure such as dilated cardiomyoapthy
Mitral regurgitation
Constrictive pericarditis

Question 6

Which artery commonly supplies the SA and AV node

Answer 6

Right coronary artery

Question 7

Where do the coronary arteries drain?

Answer 7

Via the coronary sinus into the right atrium

Question 8

Which pathology of the heart worsens afterload?

Answer 8

Ventricular dilatation, as there are less myocytes which are weaker and require more force to eject the same amount of blood.

Question 9

How does mitral valve stenosis affect preload?

Answer 9

Reduces left ventiruclar filling that reduces preload.

Question 10

What is the most important aspect of the CHADS-VASCULAR score?

Answer 10

Age
Prior stroke, TIA or thromboembolism

Question 11

What are the components of the CAHDS2-score?

Answer 11

CHADS-2 VaSc score:

Congestive heart failure
Hypertension
Age over 75 years -> high weight
Age 65-74
Diabetes
Stroke TIA or thromboembolism -> high weight
Vascular disease
Sex female

Question 12

What are the features of the ORBIT score?

Answer 12

Low haemoglobin
Age over 74
Bleeding history
Renal impairment with GFR below 60
Treatment with antiplatelet agents

Question 13

What is a low risk ORBIT score?

Answer 13

0-2

Question 14

What is a medium risk ORBIT score?

Answer 14

3

Question 15

What is a high risk ORBIT score?

Answer 15

4-7

Question 16

Why is aspirin not reccomended for stroke risk?

Answer 16

It can prevent clot-related stroke, however it increases the risk of haemorrhagic stroke.

Question 17

What causes rapid depolarisaiton in cardiac action potential?

Answer 17

Sodium influx

Question 18

How is left ventiruclar ejection fraction calculated?

Answer 18

Stroke volume/ EDV x 100

Question 19

How is stroke volume calculated?

Answer 19

EDV of left ventricle - ESV of Left ventricle

Question 20

How is systemic vascular resistance calculated?

Answer 20

Mean arterial pressure/ cardiac output

Question 21

What is a complication of ventiruclar septal defect?

Answer 21

Aortic regurgitation, as the high velocity flow of blood through the ventricular septal defect can cause damage to aortic valve cusps, leading to relapse and subsequent regurgitation.