[qwiz style=”width: auto !important; min-height: auto !important; border-width: 4px !important; border-color: #0099cc !important; ” align=”center”]
[h] Cardiovascular System Flashcards
[i] Master this session in just 2 Hours.
[q] Complete septation of the ……… does not occur until birth.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGF0cmlhLg==[Qq]
[q] ………. is caused by failure of septum primum and septum secundum to fuse after birth; most are left untreated. Can lead to …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhdGVudCBmb3JhbWVuIG92YWxlLiBwYXJhZG94aWNhbCBlbWJvbGlzbS4=
Cg==Cg==[Qq][q] The fully developed interventricular septum is formed by two components: mostly by a thick ………. part and a thin ……… part at the superior end.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG11c2N1bGFyLCBtZW1icmFub3VzLg==
Cg==Cg==[Qq][q] Defects in the development of ……….. result in three significant cyanotic congenital heart defects at birth (Transposition of great vessels, Tetralogy of Fallot, Persistent truncus arteriosus).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBhb3J0aWNvcHVsbW9uYXJ5IHNlcHR1bS4=
Cg==Cg==[Qq][q] Failure of ………. to develop in a spiral fashion results in the aorta arising from the right ventricle and the pulmonary trunk arising from the left ventricle (Transposition of the great vessels).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFvcnRpY29wdWxtb25hcnkgc2VwdHVtLg==
Cg==Cg==[Qq][q] ……… is an embryonic structure that give rise to Ascending aorta and pulmonary trunk.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRydW5jdXMgYXJ0ZXJpb3N1cy4=[Qq]
[q] ……… is an embryonic structure that give rise to Smooth parts of left and right Ventricles.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJ1bGJ1cyBjb3JkaXMu[Qq]
[q] ……… is an embryonic structure that give rise to Trabeculated part of left and right ventricles.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByaW1pdGl2ZSB2ZW50cmljbGUu[Qq]
[q] ……… is an embryonic structure that give rise to Atrial septum, membranous interventricular septum; atrioventricular (Mitral/tricuspid) and semilunar valves (Aortic/pulmonary).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVuZG9jYXJkaWFsIGN1c2hpb24u[Qq]
[q] ……… is an embryonic structure that give rise to Trabeculated part of left and right atria.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByaW1pdGl2ZSBhdHJpdW0u[Qq]
[q] ……… is an embryonic structure that give rise to Smooth part of atrium and Coronary sinus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHNpbnVzIHZlbm9zdXMu[Qq]
[q] ……… is an embryonic structure that give rise to Superior vena cava (SVC).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZ2h0IGNvbW1vbiBjYXJkaW5hbCB2ZWluIGFuZCByaWdodCBhbnRlcmlvciBjYXJkaW5hbCB2ZWluLg==
Cg==Cg==[Qq][q] Posterior cardinal vein is an embryonic structure that give rise to ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmVyaW9yIHZlbmEgY2F2YSAoSVZDKS4=
Cg==Cg==[Qq][q] Oxygenated blood from the placenta is delivered to the fetus via ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSB1bWJpbGljYWwgdmVpbi4=
Cg==Cg==[Qq][q] ……… has the highest oxygen content in the fetal circulation
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSB1bWJpbGljYWwgdmVpbi4=
Cg==Cg==[Qq][q] Blood from the umbilical vein is first delivered to the liver, where it bypasses the hepatic circulation via ……. and enters the inferior vena cava (IVC).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBkdWN0dXMgdmVub3N1cy4=
Cg==Cg==[Qq][q] Most of the highly oxygenated blood reaching the heart via the IVC is directed through ……… and pumped into the aorta to supply the head and body.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBmb3JhbWVuIG92YWxlLg==
Cg==Cg==[Qq][q] 3. Deoxygenated blood from the SVC passes through the RA –> RV —> main pulmonary artery –> ………. —> descending aorta; shunt is due to high fetal pulmonary artery resistance.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGR1Y3R1cyBhcnRlcmlvc3VzLg==
Cg==Cg==[Qq][q] ……… is an embryonic structure that give rise to Ligamentum arteriosum as a postnatal derivative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IER1Y3R1cyBhcnRlcmlvc3VzLg==
Cg==Cg==[Qq][q] ……… is an embryonic structure that give rise to Ligamentum venosum as a postnatal derivative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IER1Y3R1cyB2ZW5vc3VzLg==
Cg==Cg==[Qq][q] …….. is an embryonic structure that give rise to Fossa ovalis as a postnatal derivative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZvcmFtZW4gb3ZhbGUu[Qq]
[q] …….. is an embryonic structure that give rise to Ligamentum teres hepatis (Contained in falciform ligament) as a postnatal derivative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVtYmlsaWNhbCB2ZWluLg==
Cg==Cg==[Qq][q] …….. is an embryonic structure that give rise to 2 MediaL umbilical ligaments as a postnatal derivative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVtYmlMaWNhbCBhcnRlcmllcy4=
Cg==Cg==[Qq][q] …….. is an embryonic structure that give rise to MediaN umbilical ligament as a postnatal derivative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFsbGFOdG9pcy4=
Cg==Cg==[Qq][q] ……… can be used to close a PDA, while …….. infusions can be used to maintain patency of this structure in cases of congenital heart disease requiring a patent left-to-right shunt in order to maintain oxygenation (Tetralogy of Fallot, Transposition).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGxuZG9tZXRoYWNpbiAocHJvc3RhZ2xhbmRpbiBpbmhpYml0b3IpLCBQR0UyIChQcm9zdGFnbGFuZGlucyA=RQ==MSBhbmQgRQ==MiBr[Qq]EEp PDA open).
[q] ………. is the aortic arch that give rise to Part of maxillary artery (branch of external carotid).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDFzdCBhb3J0aWMgYXJjaC4gMXN0IGFyY2ggaXMgbWF4aW1hbC4=[Qq]
[q] ………. is the aortic arch that give rise to Stapedial artery and hyoid artery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDJuZCBhb3J0aWMgYXJjaC4gUw==ZWNvbmQgPSA=Uw==[Qq]tapedial.
[q] ………. is the aortic arch that give rise to Common Carotid artery and proximal part of internal Carotid artery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDNyZCBhb3J0aWMgYXJjaC4gQyBpcyAzcmQgbGV0dGVyIG9mIGFscGhhYmV0Lg==
Cg==Cg==[Qq][q] ………. is the aortic arch that give rise to aortic arch on the left, and proximal part of right subclavian artery on the right.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDR0aCBhb3J0aWMgYXJjaC4gNHRoIGFyY2ggKDQgbGltYnMpID0gc3lzdGVtaWMu
Cg==Cg==[Qq][q] ………. is the aortic arch that give rise to Proximal part of pulmonary arteries and (on left only) ductus arteriosus..
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDZ0aCBhb3J0aWMgYXJjaC4gNnRoIGFyY2ggPSBwdWxtb25hcnkgYW5kIHRoZSBwdWxtb25hcnktdG8gc3lzdGVtaWMgc2h1bnQgKGR1Y3R1cyBhcnRlcmlvc3VzKS4=
Cg==Cg==[Qq][q] The right border of the heart is formed by ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSByaWdodCBhdHJpdW0u
Cg==Cg==[Qq]
[q] The left border of the heart is formed by ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGxlZnQgdmVudHJpY2xlLg==
Cg==Cg==[Qq]
[q] The anterior (sternocostal) surface is formed primarily by the ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHJpZ2h0IHZlbnRyaWNsZS4=
Cg==Cg==[Qq]
[q] The posterior surface of the heart is formed primarily by …..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZWZ0IGF0cml1bS4=
Cg==Cg==[Qq]
[q] The inferior (diaphragmatic) surface of the heart is formed primarily by ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZWZ0IHZlbnRyaWNsZS4=
Cg==Cg==[Qq][q] The apex of the heart is the tip of the left ventricle and is found in ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZWZ0IGZpZnRoIGludGVyY29zdGFsIHNwYWNlLg==
Cg==Cg==[Qq][q] Left atrium, atrial septum, and mitral valve can be particularly well visualized on TEE if we make the probe face …….., but clear visualization of the descending aorta by transesophageal echocardiography can be done if the probe was rotated so that it faces ……….., allowing for the detection of abnormalities such as dissection or aneurysm.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFudGVyaW9ybHksIHBvc3Rlcmlvcmx5Lg==
Cg==Cg==[Qq][q] Conditions that result in ……… can cause dysphagia through external compression of the esophagus or hoarseness (due to compression of the left recurrent laryngeal nerve, a branch of the vagus).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGxlZnQgYXRyaWFsIGVubGFyZ2VtZW50IChhdHJpYWwgZmlicmlsbGF0aW9uLCBtaXRyYWwgc3Rlbm9zaXMpLg==
Cg==Cg==[Qq][q] ……… is the serous sac covering the heart and is the only one of the 3 serous membranes that has 3 layers (an outer fibrous layer and a double-layered parietal and visceral serous layers).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBwZXJpY2FyZGl1bS4=
Cg==Cg==[Qq][q] A pericardiocentesis is performed with a needle at ……… through the cardiac notch of the left lung to remove the fluid.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZWZ0IGluZnJhc3Rlcm5hbCBhbmdsZS4=
Cg==Cg==[Qq][q] Superficial Penetrating injury involving the fifth intercostal space at the left midclavicular line would most likely injure ……..?. Penetration of the left lung at this location could lead to injury of ……… as well, if the wound were deep enough.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZWZ0IGx1bmcsIHRoZSBhcGV4IG9mIHRoZSBoZWFydCAobGVmdCB2ZW50cmljbGUpLg==
Cg==Cg==[Qq][q] A penetrating injury at the left sternal border in the fourth intercostal space along the left sternal border will injure the …..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZ2h0IHZlbnRyaWN1bGFyIG15b2NhcmRpdW0uIFRoZSBsZWZ0IGx1bmcgd291bGQgbm90IGJlIHB1bmN0dXJlZCBieSBhIHN0YWIgd291bmQgaW4gdGhpcyBsb2NhdGlvbiBiZWNhdXNlIHRoZXJlIGlzIG5vIG1pZGRsZSBsb2JlIG9uIHRoZSBsZWZ0IHNpZGUsIGFuZCB0aGUgc3VwZXJpb3IgbG9iZSBvZiB0aGUgbGVmdCBsdW5nIGlzIGRpc3BsYWNlZCBsYXRlcmFsbHkgYnkgdGhlIGNhcmRpYWMgaW1wcmVzc2lvbi4=
Cg==Cg==[Qq][q] A motor vehicle accident with sudden deceleration can cause different rates of deceleration between the heart (in a fixed position) and the aorta. The most common site of injury is ……, which is the connection between the ascending and descending aorta distal to where the left subclavian artery branches off the aorta.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBhb3J0aWMgaXN0aG11cy4=
Cg==Cg==[Qq][q] The blood supply to the myocardium is provided by branches of the right and left coronary arteries. These 2 arteries are the only branches of …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBhc2NlbmRpbmcgYW9ydGEu
Cg==Cg==[Qq][q] Blood flow enters the coronary arteries during (diastole or systole)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpYXN0b2xlLg==[Qq]
[q] ………. is the terminal distribution of the right coronary artery and courses in the posterior interventricular sulcus to supply parts of the right and left ventricles and, importantly, the posterior third of the interventricular septum. It also supplies most of the inferior wall of the left ventricle, which forms the diaphragmatic surface of the heart. It also supplies blood to the atrioventricular (AV) node via the AV nodal artery (dependent on dominance):
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBwb3N0ZXJpb3IgZGVzY2VuZGluZyBhcnRlcnkgKFBEQSku
Cg==Cg==[Qq][q] ……… is a branch of Left main coronary artery and descends in the anterior interventricular sulcus and provides branches to the anterior left ventricle wall, anterior two-thirds of the interventricular septum, bundle of His, and apex.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZnQgYW50ZXJpb3IgZGVzY2VuZGluZyAoTEFEKS4=
Cg==Cg==[Qq][q] …….. is a branch of Left main coronary artery and courses around the left border of the heart in the coronary sulcus and supplies the left border of the heart and ends on the posterior aspect of the left ventricle and supplies the posterior-inferior left ventricular wall.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBjaXJjdW1mbGV4IGFydGVyeSAoTENYKS4=
Cg==Cg==[Qq][q] Coronary dominance is determined by the coronary artery supplying ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBwb3N0ZXJpb3IgZGVzY2VuZGluZyBhcnRlcnkgKFBEQSku[Qq]
[q] Because the AV nodal artery usually arises from the posterior descending artery (dependent on dominance), in case of AV nodal artery atherosclerotic occlusion:
– In left dominant coronary circulation: the atherosclerotic lesion is most likely in ……..?
– In right dominant coronary circulation: the atherosclerotic lesion is most likely in ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZWZ0IGNpcmN1bWZsZXggYXJ0ZXJ5LCB0aGUgcmlnaHQgY29yb25hcnkgYXJ0ZXJ5Lg==[Qq]
[q] The coronary sinus communicates freely with the right atrium and therefore may become dilated secondary to any factor that causes right atrial dilatation. The most common such factor is ……….., which leads to elevated right heart pressures.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHB1bG1vbmFyeSBhcnRlcnkgaHlwZXJ0ZW5zaW9uLg==[Qq]
[q] Myocardial oxygen extraction exceeds that of any other tissue or organ; therefore, the cardiac venous blood in ……… is the most deoxygenated blood in the body.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBjb3JvbmFyeSBzaW51cy4=
Cg==Cg==[Qq][q] The third lead of Biventricular pacemaker that paces the left ventricle is the most difficult one. The preferred transvenous approach involves passing the left ventricular pacing lead from the right atrium into …………, which resides in the posterior atrioventricular groove on the posterior aspect of the heart.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBjb3JvbmFyeSBzaW51cy4=
Cg==Cg==[Qq]
[q] When cannulating the common femoral artery during cardiac catheterization, the optimal entry site is the middle below ……….?. Arterial puncture above the inguinal ligament increases the risk of ……….. as the area is directly over the retroperitoneal space.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBpbmd1aW5hbCBsaWdhbWVudCwgcmV0cm9wZXJpdG9uZWFsIGhlbW9ycmhhZ2Uu
Cg==Cg==[Qq][q] To access the left side of the heart through right heart catheter, cardiac venous catheters must cross ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBpbnRlcmF0cmlhbCBzZXB0dW0gYXQgdGhlIHNpdGUgb2YgdGhlIGZvcmFtZW4gb3ZhbGUu
Cg==Cg==[Qq][q] IVC and right phrenic nerve perforate diaphragm at the level of ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFQ4Lg==
Cg==Cg==[Qq][q] Esophagus and vagus nerve perforate diaphragm at the level of ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFQxMC4=
Cg==Cg==[Qq][q] aorta, thoracic duct, and azygos vein perforate diaphragm at the level of ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFQxMi4=
Cg==Cg==[Qq][q] The common carotid bifourcates at …… level.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEM0Lg==[Qq]
[q] The trachea bifourcates at ……. level.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFQ0Lg==[Qq]
[q] The abdominal aorta bifourcates at …….. level.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEw0Lg==[Qq]
[q] Name the following labels:
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==MS4gRXNvcGhhZ3VzLg==
Cg==Mi4gVHJhY2hlYS4=
[Qq]3. Left subclavian artery.
4. Left common carotid artery.
5. Brachiocephalic artery.
6. Left brachiocephalic vein.
7. Right Brachiocephalic vein.
[q] Name the following labels:
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==MS4gRXNvcGhhZ3VzLg==
CjIuIFRyYWNoZWEu
Cg==[Qq]3. Aortic Arch.
4. Superior Vena Cava.
[q] Name the following labels:
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==MS4gRXNvcGhhZ3VzLg==
CjIuIE1haW5zdGVtIEJyb25jaGku
Cg==[Qq]3. Ascending Aorta.
4. Descending Aorta.
5. Pulmonary Trunk.
6. Superior Vena Cava.
[q] Name the following labels:
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==MS4gRXNvcGhhZ3VzLg==
Cg==Mi4gRGVzY2VuZGluZyBBb3J0YS4=
[Qq]3. Left Atrium.
4. Right atrium.
5. Left Ventricle.
6. Right Ventricle.
[q] ………. is the amount of blood pumped by each ventricle per beat. It equals the difference between end-diastolic volume (EDV) and End-Systolic volume (ESV).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cm9rZSB2b2x1bWUgKFNWKS4=
Cg==U1YgPSBFbmQtZGlhc3RvbGljIHZvbHVtZSAoRURWKSDiiJIgRW5kLXN5c3RvbGljIHZvbHVtZSAoRVNWKQ==[Qq]
[q] ……….. is the amount of blood pumped by each ventricle per minute.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmRpYWMgb3V0cHV0IChDTyku
Cg==wqAgwqAgwqAgwqAgwqAgwqAgwqAgwqAgwqAgwqAgwqAgwqAgwqAgwqAgQ08gPSBTdHJva2Ugdm9sdW1lIChTVikgWCBoZWFydCByYXRl[Qq]
[q] ……… can be determined by measuring the amount of O2 consumed by the body in a given time and dividing this by the A-V difference across the lungs.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENPLg==
Cg==Q08gPSAocmF0ZSBvZiBPMiBjb25zdW1wdGlvbikvKGFydGVyaWFsIE8yIGNvbnRlbnQtdmVub3VzIE8yIGNvbnRlbnQp[Qq]
[q] During the early stages of exercise, CO is maintained by …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IOKGkSBIUiBhbmQg4oaRIFNWLg==[Qq]
[q] During the late stages of exercise, CO is maintained by …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IOKGkSBIUiBvbmx5IChTViBwbGF0ZWF1cyku[Qq]
[q] Despite the sympathetic nervous system activation in response to exercise, the mean arterial pressure typically increases only 20-40 mmHg during full body exercise. The mean arterial pressure remains fairly stable during exercise due to an adaptive decrease in …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBzeXN0ZW1pYyB2YXNjdWxhciByZXNpc3RhbmNlIChTVlIpLg==
Cg==Cg==[Qq][q] …….. is directly proportional to the vessel radius raised to the fourth power (F α r4).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJsb29kIGZsb3cu
Cg==Cg==[Qq][q] The total resistance for a group of vessels arranged in ……. is equal to one divided by the sum of the inverse values for resistance of each of the contributing vessels.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBhcmFsbGVsLg==[Qq]
[q] What is the effect of Removal of organs in parallel arrangement (nephrectomy or amputation) on TPR and CO?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluY3JlYXNlIFRQUiBhbmQgZGVjcmVhc2UgQ08u[Qq]
[q]…….. has smallest cross-sectional area and highest velocity.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFvcnRhLg==
Cg==Cg==[Qq][q] ……… have highest total cross-sectional area and lowest flow velocity. The low velocity in it facilitates the exchange of nutrients and gases with the tissues.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcGlsbGFyaWVzLg==
Cg==Cg==[Qq][q] ………. is the peak pressure in a systemic artery during the cardiac cycle. The most important factor determining it is the stroke volume (SV).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN5c3RvbGljIEJsb29kIFByZXNzdXJlIChTUCku
Cg==Cg==[Qq][q] ………. is the lowest pressure in a systemic artery during the cardiac cycle. The most important factor determining it is the resistance of the arterioles (TPR).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpYXN0b2xpYyBCbG9vZCBQcmVzc3VyZS4=
Cg==Cg==[Qq][q] ………. is the difference between systolic and diastolic blood pressures.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]wqBQdWxzZSBwcmVzc3VyZS4=
Cg==wqAgwqAgwqAgwqAgwqAgUHVsc2UgcHJlc3N1cmUgPSBzeXN0b2xpYyBwcmVzc3VyZSDigJMgZGlhc3RvbGljIHByZXNzdXJl
Cg==[Qq]
[q] ……… is the average pressure in the artery over the complete cardiac cycle. Its equal to 2⁄3 diastolic pressure + 1⁄3 systolic pressure or DBP + 1/3 PP.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1BUC4=
Cg==Cg==[Qq][q] ……….. is the amount of blood loaded into left ventricle prior to each contraction. It’s approximated by ventricular EDV and depends on venous tone and circulating blood volume.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByZWxvYWQu[Qq]
[q] ……… is the forces resisting flow out of left ventricle. It increases when Blood pressure is high (↑ TPR) or in cases of Outflow obstruction (Aortic stenosis, HOCM).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFmdGVybG9hZC4=[Qq]
[q] ……… is usually presented as the percentage of the ventricular volume ejected during systole. It’s considered an index of ventricular contractility; normal is ≥ 55%.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVqZWN0aW9uIGZyYWN0aW9uLg==[Qq]
[q] ……… is the artery with the greatest wall tension (greatest pressure and radius).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBhb3J0YS4=[Qq]
[q] Name the following labels:
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==MS4gQ29udHJhY3RpbGl0eSDihpEgd2l0aCBjYXRlY2hvbGFtaW5lcywgcG9zaXRpdmUgaW5vdHJvcGVzIChkaWdveGluKS4=
Cg==Mi4gQ29udHJhY3RpbGl0eSDihpMgd2l0aCBsb3NzIG9mIG15b2NhcmRpdW0gKE1JKSwgzrItYmxvY2tlcnMgKGFjdXRlbHkpLCBub24tZGloeWRyb3B5cmlkaW5lIENhIGNoYW5uZWwgYmxvY2tlcnMsIEhlYXJ0IGZhaWx1cmUu
[Qq]3. Heart failure + Digoxin or Normal heart + Beta Blockers/CCB.
[q] Name the following labels:
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==MS4g4oqVIENvbnRyYWN0aWxpdHk6IENhdGVjaG9sYW1pbmVzLCBkaWdveGluLg==
CjIuIOKKnSBDb250cmFjdGlsaXR5OiBVbmNvbXBlbnNhdGVkIEhGLCBuYXJjb3RpYyBvdmVyZG9zZS4=
Cg==[Qq]3. ⊕ volume or venous tone: Fluid infusion, sympathetic activity.
4. ⊝ volume or venous tone: Acute hemorrhage, spinal anesthesia.
5. ⊕ TPR: Vasopressors.
6. ⊝ TPR: Exercise, AV shunt.
[q] Which on of these 2 curves describes what happen in chronic arteriovenous shunt?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDIu
Cg==74KnIEFjdXRlbHksIGFuIGFydGVyaW92ZW5vdXMgZmlzdHVsYSBjYXVzZXMgYSBkZWNyZWFzZSBpbiBUUFIgKGluY3JlYXNlZCBzbG9wZSBvZiBib3RoIHRoZSBjYXJkaWFjIGZ1bmN0aW9uIGN1cnZlIGFuZCB0aGUgdmVub3VzIHJldHVybiBjdXJ2ZSksIHdoaWNoIHJlc3VsdHMgaW4gYW4gaW5jcmVhc2VkIGNhcmRpYWMgb3V0cHV0IGFuZCBhbiBpbmNyZWFzZWQgdmVub3VzIHJldHVybi4gSG93ZXZlciwgdGhlIHZlbm91cyByZXR1cm4gY3VydmUgZG9lcyBub3QgaW1tZWRpYXRlbHkgc2hpZnQgYWxvbmcgdGhlIHgtYXhpcy4=
Cu+CpyBPdmVyIHRpbWUsIHRoZSBzeW1wYXRoZXRpYyBuZXJ2b3VzIHN5c3RlbSBhbmQga2lkbmV5cyB3aWxsIGJlZ2luIHRvIGNvbXBlbnNhdGUgZm9yIGEgY2hyb25pYyBmaXN0dWxhIGJ5IGluY3JlYXNpbmcgY2FyZGlhYyBjb250cmFjdGlsaXR5LCB2YXNjdWxhciB0b25lLCBhbmQgY2lyY3VsYXRpbmcgYmxvb2Qgdm9sdW1lLiBUaGVzZSBjaGFuZ2VzIGZ1cnRoZXIgaW5jcmVhc2UgdGhlIGNhcmRpYWMgZnVuY3Rpb24gY3VydmUgYXMgd2VsbCBhcyBpbmNyZWFzZSB0aGUgbWVhbiBzeXN0ZW1pYyBwcmVzc3VyZSwgcmVzdWx0aW5nIGluIGEgcmlnaHR3YXJkIHNoaWZ0IG9mIHRoZSB2ZW5vdXMgcmV0dXJuIGN1cnZlIG9uIHRoZSB4LWF4aXMu[Qq]
[q] Which of the following points coincides with Aortic valve opening?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEIu
Cg==Cg==[Qq][q] Which of the following points coincides with Mitral valve opening?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEQu
Cg==Cg==[Qq][q] Which of the following points coincides with Second heart sound?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEMu
Cg==Cg==[Qq][q] ……… is the major limiting factor for coronary blood supply to the left ventricular myocardium during periods of tachycardia (exercise)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNob3J0ZXIgZHVyYXRpb24gb2YgZGlhc3RvbGUu
Cg==Cg==[Qq][q] During right heart catheter, swan Ganz catheter recorded a systolic pressure 25 mmgh and diastolic pressure of 5 mmgh. This reading was obtained from ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZ2h0IHZlbnRyaWNsZS4=
Cg==Cg==[Qq][q] Wide splitting of second heart sound is considered an exaggeration of normal splitting, it is seen in conditions that delay ………. like ………… or ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJWIGVtcHR5aW5nLCBwdWxtb25pYyBzdGVub3NpcywgcmlnaHQgYnVuZGxlIGJyYW5jaCBibG9jay4=
Cg==Cg==[Qq][q] Fixed splitting of second heart sound can be heard during inspiration and expiration, it occurs due to …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFTRC4=
Cg==Cg==[Qq][q] Paradoxical splitting of second heart sound is heard in conditions that delay ………. like ………… or ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExWIEVtcHR5aW5nLCBhb3J0aWMgc3Rlbm9zaXMsIGxlZnQgYnVuZGxlIGJyYW5jaCBibG9jayku
Cg==Cg==[Qq][q] ………… is often associated with a volume-overloaded ventricle (mitral regurgitation, aortic regurgitation, HF). It occurs during the rapid filling of a very compliant ventricle.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoaXJkIGhlYXJ0IHNvdW5kLg==[Qq]
[q] ………… present in any condition that causes reduced ventricular compliance (hypertensive heart disease, aortic stenosis, hypertrophic cardiomyopathy). It coincides with atrial contraction against a stiff ventricle.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZvdXJ0aCBoZWFydCBzb3VuZC4=[Qq]
[q] Left ventricular gallops (S3 and/or S4) are best heard with the (Bell or Diaphragm?) of the stethoscope over the cardiac apex while the patient is in the left lateral decubitus position. Listening at end (Inspiration or expiration?) makes the sound even more audible.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJlbGwsIGV4cGlyYXRpb24gKGJ5IGRlY3JlYXNpbmcgbHVuZyB2b2x1bWUgYW5kIGJyaW5naW5nIHRoZSBoZWFydCBjbG9zZXIgdG8gdGhlIGNoZXN0IHdhbGwpLg==[Qq]
[q] ………. cause wide and fixed splitting of S2 and can facilitate paradoxical embolism due to periods of transient shunt reversal (during straining or coughing).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFTRC4=[Qq]
[q] The ……… wave is generated by atrial contraction and will be absent in ……….., the ……… wave is caused by bulging of the tricuspid valve into the right atrium in early systole, and the ….. wave reflects the passive increase in pressure and volume of the right atrium as it fills in late systole and early diastole.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGEsIGF0cmlhbCBmaWJyaWxsYXRpb24sIGMsIHYu
Cg==Cg==[Qq][q] Prominent A wave is produced by atrial contraction against high resistance as ………. or high right ventricular pressure due to ………. or ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRyaWN1c3BpZCBzdGVub3NpcywgcHVsbW9uaWMgc3Rlbm9zaXMgb3IgcHVsbW9uYXJ5IGh5cGVydGVuc2lvbi4=
Cg==Cg==[Qq][q] ……… waves are produced by atrial systole against a closed tricuspid valve (third degree AV block). The atria and ventricles are contracting separately and out of coordination with each other.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhbm5vbiBBLg==
Cg==Cg==[Qq][q] ………… cause absent x descend and prominent v wave.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyaWN1c3BpZCByZWd1cmdpdGF0aW9uLg==
Cg==Cg==[Qq][q] The y-descent represents the abrupt decrease in right atrial pressure during early diastole after the tricuspid valve opens and the right ventricle begins to passively fill. It becomes prominent in …………, and absent in ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNvbnN0cmljdGl2ZSBwZXJpY2FyZGl0aXMsIGNhcmRpYWMgdGFtcG9uYWRlLg==
Cg==Cg==[Qq][q] The dashed loop reflects an increase in stroke volume due to increase of ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmRpYWMgY29udHJhY3RpbGl0eS4=[Qq]
[q] The dashed loop reflects an increase in stroke volume due to increase of preload and decrease in TPR. This can happen in cases of ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFWIHNodW50cy4=[Qq]
[q] The red loop reflects effect of drug on patient with heart failure. This drug produce the same stroke volume in lower pressure and volume. This drug is most probably ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5pdHJvcHJ1c3NpZGUgaXMgYSBzaG9ydC1hY3RpbmcgYmFsYW5jZWQgdmVub3VzIGFuZCBhcnRlcmlhbCB2YXNvZGlsYXRvci4=[Qq]
[q] The red loop reflects ………. which can explained by ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRlY3JlYXNlZCB2ZW50cmljdWxhciBjb21wbGlhbmNlLMKgIGluZmlsdHJhdGl2ZSBkaXNvcmRlcnMgKHRyYW5zdGh5cmV0aW4tcmVsYXRlZCBhbXlsb2lkb3Npcywgc2FyY29pZG9zaXMpLg==[Qq]
[q] Because there is no significant blood flow towards the left atrium (LA) beyond this point of occlusion, the pressure at the tip of the “wedged” pulmonary artery catheter becomes nearly equal to ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBMQSBwcmVzc3VyZS4=
Cg==Cg==[Qq][q] ……….. is a valvular lesion that may occur due to due to ischemic heart disease (post-MI), MVP, LV dilatation, Rheumatic fever and infective endocarditis. It causes holosystolic (pansystolic) high-pitched “blowing murmur” Loudest at apex and radiates toward axilla.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pdHJhbCBSZWd1cmdpdGF0aW9uLg==
Cg==Cg==[Qq][q] These hemodynamic changes can be explained by ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pdHJhbCBSZWd1cmdpdGF0aW9uLg==
Cg==Cg==[Qq][q] Among auscultatory findings, the best indicator of severe MR with left ventricular volume overload is the presence of …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFMzIGdhbGxvcCAodm9sdW1lIG92ZXJsb2FkKS4=[Qq]
[q] Decompensated heart failure is a common cause of secondary (functional) mitral valve regurgitation. Treatment with ……….. can improve heart failure-induced MR.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpdXJldGljcyBhbmQgdmFzb2RpbGF0b3JzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
65 years old patient presenting with multiple episodes of Syncope, Angina, and Dyspnea on exertion + Crescendo-decrescendo systolic ejection murmur (Early ejection click may be present) with soft S2 at the 2nd right intercostal space radiating to the carotid?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFvcnRpYyBTdGVub3Npcy4=
Cg==Cg==[Qq][q] The most defining characteristic of ………. is that left ventricular systolic pressure is significantly higher than aortic systolic pressure.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFTLg==
Cg==Cg==[Qq][q] These hemodynamic changes can be explained by ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFvcnRpYyBTdGVub3Npcy4=
Cg==Cg==[Qq][q] 1. Aortic stenosis most commonly results from ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFnZS1yZWxhdGVkIGNhbGNpZmljIGFvcnRpYyB2YWx2ZSBkaXNlYXNlIChDQVZEKS4gRmlicm9ibGFzdHMgZGlmZmVyZW50aWF0ZSBpbnRvIG9zdGVvYmxhc3QtbGlrZSBjZWxscyBhbmQgZGVwb3NpdCBib25lIG1hdHJpeCwgbGVhZGluZyB0byBwcm9ncmVzc2l2ZSB2YWx2dWxhciBjYWxjaWZpY2F0aW9uIGFuZCBzdGVub3Npcy4=[Qq]
[q] Premature aortic stenosis that develops on average around age 50 is most commonly due to …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpY3VzcGlkIGFvcnRpYyB2YWx2ZXMu
Cg==Cg==[Qq][q] ………….. is indicated for acute atrial fibrillation in patients with severe AS?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmRpb3ZlcnNpb24u
Cg==Cg==[Qq][q] ………….. is caused by myxomatous degeneration (1° or 2° to connective tissue disease such as Marfan or Ehlers-Danlos syndrome), rheumatic fever, chordae rupture (Post-MI Complication). It causes Late systolic crescendo murmur with midsystolic click (MC) in mitral area.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pdHJhbCBWYWx2ZSBQcm9sYXBzZS4=
Cg==Cg==[Qq][q] A significant increase in blood oxygen saturation between 2 right-sided vessels or chambers indicates the presence of ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZTRCAobGVmdC10by1yaWdodCBzaHVudCku[Qq]
[q] What is the most likely diagnosis?
34 Years old patient who was diagnosed with infective endocarditis presenting with bounding femoral, carotid pulsations with head popping + High-pitched “blowing” early diastolic decrescendo murmur at the left sternal border?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFvcnRpYyBSZWd1cmdpdGF0aW9uLg==
Cg==Cg==[Qq][q] These hemodynamic changes can be explained by ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFvcnRpYyBSZWd1cmdpdGF0aW9uLg==
Cg==Cg==[Qq]
[q] What is the most likely diagnosis?
23 years old patient with history of rheumatic fever presenting with dysphagia and hoarseness + mid-diastolic rumbling murmur after opening snap with presystolic accentuation at the mitral area?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pdHJhbCBTdGVub3Npcy4=
Cg==Cg==[Qq][q] These hemodynamic changes can be explained by ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pdHJhbCBTdGVub3Npcy4=
Cg==Cg==[Qq][q] Diastolic pressure in the left ventricle is usually near normal or even decreased with severe mitral stenosis. Elevated diastolic pressure in left ventricle raises your suspicion about ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRvdWJsZSBtaXRyYWwgbGVzaW9uIG9yIGNvbmNvbWl0YW50IGFvcnRpYyBzdGVub3Npcy4=[Qq]
[q] On auscultation, the best indicator of mitral stenosis (MS) severity is ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZW5ndGggb2YgdGltZSBiZXR3ZWVuIFMyIChzcGVjaWZpY2FsbHkgdGhlIEEyIGNvbXBvbmVudCwgY2F1c2VkIGJ5IGFvcnRpYyB2YWx2ZSBjbG9zdXJlKSBhbmQgdGhlIG9wZW5pbmcgc25hcCAoT1MpLg==
Cg==IA==
[Qq][q] If cardiac catheterization reveals a LA end-diastolic pressure (LAEDP) that is significantly greater than the LVEDP. This abnormal pressure gradient implies ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluY3JlYXNlZCByZXNpc3RhbmNlIHRvIGZsb3cgYmV0d2VlbiB0aGUgTEEgYW5kIExWLCBhcyBvY2N1cnMgaW4gbWl0cmFsIHN0ZW5vc2lzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
Premature infant presenting with Continuous machine-like murmur Loudest at S2?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhdGVudCBEdWN0dXMgQXJ0ZXJpb3N1cy4=
Cg==Cg==[Qq][q] Sitting up and leaning forward accentuates and increases the intensity of ……………, and left lateral decubitus increseses the intensity of ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFvcnRpYyByZWd1cmdpdGF0aW9uIG11cm11ciwgbWl0cmFsIHN0ZW5vc2lzIG11cm11ci4=[Qq]
[q] Rapid squatting, Supine position with leg elevated, and handgrip (increase or decrease?) intensity of most murmurs except hypertrophic cardiomyopathy murmur and MVP.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluY3JlYXNlLg==[Qq]
[q] Valsalva, standing up, amyl nitrate (increase or decrease?) intensity of most murmurs except hypertrophic cardiomyopathy murmur and MVP.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRlY3JlYXNlLg==[Qq]
[q] Regarding Baroreceptors, Aortic arch transmits via ……… to solitary nucleus of medulla and Carotid sinus transmits via ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZhZ3VzIG5lcnZlLCBnbG9zc29waGFyeW5nZWFsIG5lcnZlLg==
Cg==Cg==[Qq][q] Triad of hypertension, bradycardia, and irregular respiration in patient with high intracranial pressure is called ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEN1c2hpbmcgcmVhY3Rpb24u[Qq]
[q] ………… is released from atrial myocytes in response to ↑ blood volume and atrial pressure, while ………….. is released from ventricular myocytes.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBuYXRyaXVyZXRpYyBwZXB0aWRlLA==[Qq]
[q] ………. blood test used for diagnosing HF (very good negative predictive value). It is available in recombinant form (nesiritide) for treatment of HF.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEIgdHlwZSAoYnJhaW4pIG5hdHJpdXJldGljIHBlcHRpZGUu[Qq]
[q] In the kidney, natriuretic peptides promote afferent glomerular arteriolar ………. and efferent arteriolar ………, causing ………. glomerular filtration rate; this leads to ……….. natriuresis (sodium excretion) and diuresis (fluid excretion).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZhc29kaWxhdGlvbiwgY29uc3RyaWN0aW9uLCBpbmNyZWFzZWQsIGluY3JlYXNlZC4=
Cg==Cg==[Qq][q] The pulmonary vasculature is unique in that hypoxia causes …………. so that only well-ventilated areas are perfused. In other organs, hypoxia causes ……………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZhc29jb25zdHJpY3Rpb24sIHZhc29kaWxhdGlvbi4=[Qq]
[q] ………… and ………. are the most important factors involved in coronary blood flow autoregulation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFkZW5vc2luZSBhbmQgbml0cmljIG94aWRlIChOTyku[Qq]
[q] The sinoatrial node consists of specialized pacemaker cells located at the junction of ……… and ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSByaWdodCBhdHJpdW0gYW5kIHN1cGVyaW9yIHZlbmEgY2F2YS4=
Cg==Cg==[Qq][q] The AV node is located on the endocardial surface of the right atrium, near the insertion of the septal leaflet of the tricuspid valve and ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBvcmlmaWNlIG9mIHRoZSBjb3JvbmFyeSBzaW51cy4=
Cg==Cg==[Qq][q] AV nodal cells can become pacemaker of the ventricles when conduction between the SA and AV nodes is impaired. This can occur in cases of ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNvbXBsZXRlICh0aGlyZC1kZWdyZWUpIGF0cmlvdmVudHJpY3VsYXIgKEFWKSBibG9jay4=[Qq]
[q] The slowest conduction velocity of the heart occurs in ……… and the fastest conduction occurs in ………..?. The conduction speed of the atrial muscle is …….. than that of the ventricular muscle.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBBViBub2RlLCB0aGUgUHVya2luamUgc3lzdGVtLCBoaWdoZXIu
Cg==Cg==[Qq][q] Phase 4 of ventricular action potential is called ……….. and is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlc3RpbmcgbWVtYnJhbmUgcG90ZW50aWFsLCBIaWdoIEsgcGVybWVhYmlsaXR5IHRocm91Z2ggbGVha3kgSyBjaGFubmVscy4=
Cg==Cg==[Qq][q] Phase 0 of ventricular action potential is called ……….. and is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRlcG9sYXJpemF0aW9uLCBWb2x0YWdlLWdhdGVkIE5hIGNoYW5uZWxzIG9wZW4u
Cg==Cg==[Qq][q] Phase 1 of ventricular action potential is called ……….. and is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluaXRpYWwgcmVwb2xhcml6YXRpb24swqBWb2x0YWdlLWdhdGVkIEsgY2hhbm5lbHMgYmVnaW4gdG8gb3Blbi4=
Cg==Cg==[Qq][q] Phase 2 of ventricular action potential is called ……….. and is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBsYXRlYXUswqBDYSBpbmZsdXggdGhyb3VnaCB2b2x0YWdlLWdhdGVkIENhIGNoYW5uZWxzIGJhbGFuY2VzIEsgZWZmbHV4Lg==
Cg==Cg==[Qq][q] Phase 3 of ventricular action potential is called ……….. and is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJhcGlkIHJlcG9sYXJpemF0aW9uLCBNYXNzaXZlIEsgZWZmbHV4IGR1ZSB0byBvcGVuaW5nIG9mIHZvbHRhZ2UtZ2F0ZWQgc2xvdyBLIGNoYW5uZWxzIGFuZCBjbG9zdXJlIG9mIHZvbHRhZ2UtZ2F0ZWQgQ2EgY2hhbm5lbHMu
Cg==Cg==[Qq][q] ………. is a period that begins at threshold and continues until the cell has almost completely repolarized. During this period, a second action potential cannot be generated, no matter how strong the stimulus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVmZmVjdGl2ZSByZWZyYWN0b3J5IHBlcmlvZC4=
Cg==Cg==[Qq][q] Phase 4 of nodal action potential is called ……….. and is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNsb3cgc3BvbnRhbmVvdXMgZGlhc3RvbGljIGRlcG9sYXJpemF0aW9uLCB0aGUgZWFybGllciBwYXJ0IGlzIGR1ZSB0byBmdW5ueSBpbndhcmQgTmEgY3VycmVudCwgYW5kIHRoZSBsYXR0ZXIgcGFydCBpcyBkdWUgdG8gJiM4MjExOyBULXR5cGUgKHRyYW5zaWVudCkgQ2EgY2hhbm5lbHMu
Cg==Cg==[Qq][q] Phase 0 of nodal action potential is called ……….. and is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVwc3Ryb2tlIGRlcG9sYXJpemF0aW9uLMKgT3BlbmluZyBvZiB2b2x0YWdlLWdhdGVkIENhIGNoYW5uZWxzLg==[Qq]
[q] Phase 0 of the non-pacemaker action potential is mediated by rapid ………. influx, in contrast to the slower calcium-mediated depolarization of pacemaker cells.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHNvZGl1bS4=
Cg==Cg==[Qq][q] ……… is the only drug that slows heart rate (negative chronotropic effect) with no effect on cardiac contractility (inotropy) and/or relaxation (lusitropy).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEl2YWJyYWRpbmUu
Cg==Cg==[Qq][q] By blocking SA and AV node calcium channels, ………. slows the depolarization that occurs in phase 0 and the latter part of phase 4. This decreases the rate of SA node firing and slows AV node conduction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZlcmFwYW1pbC4=
Cg==Cg==[Qq][q] ……… interacts with receptors on the surface of cardiac cells, activating potassium channels and increasing potassium conductance, causing the membrane potential to remain negative for a longer period. It also inhibits L-type Ca channels, further prolonging the depolarization time.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFkZW5vc2luZS4=[Qq]
[q] “What is the most likely diagnosis?”
Patient with history of Mitral stenosis presenting with palpitation + ECG shows an absence of P waves and irregularly irregular rhythm with varying R-R intervals?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBmaWJyaWxsYXRpb24u
Cg==Cg==[Qq][q] …………. is chaotic and erratic baseline ecg with no discrete P waves in between irregularly spaced QRS complexes. with Irregularly irregular heartbeat. It can lead to thromboembolic events, particularly stroke.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBmaWJyaWxsYXRpb24u
Cg==Cg==[Qq][q] The most common trigger of ………….. is aberrant electrical foci in the pulmonary veins near their ostia into the left atrium; therefore, catheter ablation of pulmonary vein trigger sites (pulmonary vein isolation) is used for the treatment of symptomatic cases.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBmaWJyaWxsYXRpb24u
Cg==Cg==[Qq][q] The severity of atrial fibrillation is dependent on …………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZlbnRyaWN1bGFyIHJlc3BvbnNlICh0aGUgdHJhbnNtaXNzaW9uIG9mIGFibm9ybWFsIGF0cmlhbCBpbXB1bHNlcyB0aHJvdWdoIHRoZSBhdHJpb3ZlbnRyaWN1bGFyIG5vZGUpLg==[Qq]
[q] ……………. is a small saclike structure in the left atrium that is particularly susceptible to thrombus formation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBsZWZ0IGF0cmlhbCBhcHBlbmRhZ2UgKExBQSku
Cg==Cg==[Qq][q] “What is the most likely diagnosis?”
Patient with history of Mitral stenosis presenting with palpitation + ECG shows absent p waves and replaced with sawtooth pattern with regular rythm?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBmbHV0dGVyLiBUcmVhdCBsaWtlIGF0cmlhbCBmaWJyaWxsYXRpb24u
Cg==Cg==[Qq][q] …………. is a rapid succession of identical, back-to-back atrial depolarization waves with “sawtooth” appearance on ECG?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBmbHV0dGVyLg==
Cg==Cg==[Qq][q] “What is the most likely diagnosis?”
Young female presenting with palpitation with abrupt onset and offset + ECG shows absent p waves, no fibrillatory waves, no flutter waves, very regular rhythm?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhcm94eXNtYWwgU3VwcmF2ZW50cmljdWxhciBUYWNoeWNhcmRpYS4=
Cg==Cg==[Qq][q] The best initial treatment of Paroxysmal Supraventricular Tachycardia is ….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZhZ2FsIG1hbmV1dmVycyAoY2Fyb3RpZCBzaW51cyBtYXNzYWdlLCBWYWxzYWx2YSBtYW5ldXZlciwgZXllYmFsbCBwcmVzc3VyZSkgaW5jcmVhc2UgcGFyYXN5bXBhdGhldGljIHRvbmUgaW4gdGhlIGhlYXJ0IGFuZCByZXN1bHQgaW4gYSB0ZW1wb3Jhcnkgc2xvd2luZyBvZiBjb25kdWN0aW9uIGluIHRoZSBBViBub2RlIGFuZCBhbiBpbmNyZWFzZSBpbiB0aGUgQVYgbm9kZSByZWZyYWN0b3J5IHBlcmlvZC4=[Qq]
[q] The drug of choice for Paroxysmal Supraventricular Tachycardia is ….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFkZW5vc2luZS4gQmV0YSBibG9ja2VycyAobWV0b3Byb2xvbCksIGNhbGNpdW0gY2hhbm5lbCBibG9ja2VycyAoZGlsdGlhemVtKSwgb3IgZGlnb3hpbiBpZiBhZGVub3NpbmUgaXMgbm90IGVmZmVjdGl2ZS4=[Qq]
[q] “What is the most likely diagnosis?”
Patient with history of COPD presenting with tachycardia (heart rate > 100 beats/min) + ECG shows polymorphic P waves (3 morphologically distinct P waves)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11bHRpZm9jYWwgQXRyaWFsIFRhY2h5Y2FyZGlhIChNQVQpLiBUcmVhdCBNQVQgYXMgeW91IHdvdWxkIGF0cmlhbCBmaWJyaWxsYXRpb24sIGJ1dCBhdm9pZCBiZXRhIGJsb2NrZXJzIGJlY2F1c2Ugb2YgdGhlIGx1bmcgZGlzZWFzZS4=
Cg==Cg==[Qq][q] …… is indicated if sinus bradycardia is asymptomatic?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vIHRyZWF0bWVudC4=[Qq]
[q] Patients with symptomatic sinus bradycardia should be treated initially with ….., and …… is “the most effective therapy”.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludHJhdmVub3VzIGF0cm9waW5lLiBQYWNlbWFrZXIu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZpcnN0LURlZ3JlZSBBViBibG9jay4=[Qq]
[q] What is the most likely diagnosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1vYml0eiBJIG9yIFdlbmNrZWJhY2ggQmxvY2su[Qq]
[q] What is the most likely diagnosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1vYml0eiBJSSBCbG9jay4=[Qq]
[q] What is the most likely diagnosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoaXJkIGRlZ3JlZSBBViBCbG9jay4=[Qq]
[q] …………. result from mutations in a K channel protein that contributes to the delayed rectifier current.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmdlbml0YWwgbG9uZyBRVCBzeW5kcm9tZS4=[Qq]
[q] The major cardiac pathophysiological consequence of QT prolongation is ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFuIGluY3JlYXNlZCByaXNrIG9mIGVwaXNvZGljIHBvbHltb3JwaGljIHZlbnRyaWN1bGFyIHRhY2h5Y2FyZGlhLCBpbmNsdWRpbmcgdG9yc2FkZXMgZGUgcG9pbnRlcy4=[Qq]
[q] ………… is an autosomal dominant congenital long QT syndrome with pure cardiac phenotype (no deafness), but ………… is an autosomal recessive congenital long QT syndrome with sensorineural deafness.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJvbWFuby1XYXJkIHN5bmRyb21lLCBqZXJ2ZWxsIGFuZCBMYW5nZS1OaWVsc2VuIHN5bmRyb21lLg==[Qq]
[q] “What is the most likely diagnosis?”
Patient presenting with SVT alternating with ventricular tachycardia.
Patient presenting with SVT that gets worse after diltiazem or digoxin.
ECG shows shortened PR-interval, a delta wave at the start of the QRS complex, and a widened QRS interval.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdvbGZmLVBhcmtpbnNvbi1XaGl0ZSBzeW5kcm9tZS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZlbnRyaWN1bGFyIGZpYnJpbGxhdGlvbiAoVkYp[Qq]
[q] What is the most likely diagnosis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRvcnNhZGVzIGRlIHBvaW50ZXMu[Qq]
[q] “What is the most likely diagnosis?”
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmVyaW9yIHdhbGwgSXNjaGVtaWEu[Qq]
[q] “What is the most likely diagnosis?”
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmVyaW9yIHdhbGwgTXlvY2FyZGlhbCBJbmZhcmN0aW9uLg==[Qq]
[q] “What is the most likely diagnosis?”
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFudGVyb2xhdGVyYWwgd2FsbCBNeW9jYXJkaWFsIEluZmFyY3Rpb24u[Qq]
[q] Two-thirds of lightning-related deaths occur within the first hour after injury, with …………….. and …………. as the most common causes.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGZhdGFsIGFycmh5dGhtaWFzIGFuZCByZXNwaXJhdG9yeSBmYWlsdXJlLg==[Qq]
[q] ……. is Age-related degeneration of the cardiac conduction system with fibrosis of the sinus node leading to bradycardia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNpY2sgc2ludXMgc3luZHJvbWUgKFNTUyku
Cg==Cg==[Qq][q] ………….. occurs because truncus arteriosus fails to divide into pulmonary trunk and aorta due to lack of aorticopulmonary septum formation. Presents with early cyanosis; deoxygenated blood from right ventricle mixes with oxygenated blood from left ventricle before pulmonary and aortic circulations separate. Most patients have accompanying VSD.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBlcnNpc3RlbnQgdHJ1bmN1cyBhcnRlcmlvc3VzLg==
Cg==Cg==[Qq][q] ……….. results from failure of the fetal aorticopulmonary septum to spiral normally during septation of the truncus arteriosus. Associated with maternal diabetes. Echocardiogram shows an aorta lying anterior to and to the right of the pulmonary artery is diagnostic of transposition of the great arteries (TGA). Chest x-ray will show an “egg on a string” due to narrow mediastinum.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEQtdHJhbnNwb3NpdGlvbiBvZiBncmVhdCB2ZXNzZWxzLg==
Cg==Cg==[Qq][q] ……….. can be administered to maintain a PDA in patients with transposition of great vessels until definitive surgical repair is performed.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByb3N0YWdsYW5kaW4gKFBHRSku
Cg==Cg==[Qq][q] ………. is one of the congenital causes of early cyanosis because no outlet from the right atrium to the right ventricle. Associated atrial and ventricular septal defects are necessary for survival, allowing for mixing of oxygenated and deoxygenated blood to provide some oxygenated blood for the systemic circulation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyaWN1c3BpZCBhdHJlc2lhLg==
Cg==Cg==[Qq][q] ………. is the most common cyanotic heart defect in children that result from deviation of the infundibular septum in utero and is characterized by pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect (VSD), overriding aorta. Chest x-ray showing a boot-shaped heart due to right ventricular hypertrophy.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRldHJhbG9neSBvZiBGYWxsb3Qu
Cg==Cg==[Qq][q] ……….. presents with varying degrees of cyanosis depending on the severity of right ventricular outflow tract obstruction. Placement of patients in a knee-chest position (Squatting) during a cyanotic spell increases …………… and improves symptoms and cyanosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRldHJhbG9neSBvZiBGYWxsb3QuIHN5c3RlbWljIHZhc2N1bGFyIHJlc2lzdGFuY2UgYW5kIHB1bG1vbmFyeSBibG9vZCBmbG93Lg==
Cg==Cg==[Qq][q] ………. is one of the congenital causes of early cyanosis because all four pulmonary veins are malpositioned and make anomalous connections to the systemic venous circulation. Associated with ASD and sometimes PDA to allow for right-to-left shunting to maintain CO.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRvdGFsIGFub21hbG91cyBwdWxtb25hcnkgdmVub3VzIHJldHVybi4=
Cg==Cg==[Qq][q] ……… is the most common congenital cardiac defect. It presents with harsh, holosystolic murmur best heard at the left lower sternal border.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZlbnRyaWN1bGFyIHNlcHRhbCBkZWZlY3Qu
Cg==Cg==[Qq][q] ……… is one of the congenital causes of late cyanosis and present with wide, fixed splitting of S2. O2 saturation ↑ in RA, RV, and pulmonary artery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBzZXB0YWwgZGVmZWN0Lg==
Cg==Cg==[Qq][q] Failure of ductus arteriosus to close is associated with …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHByZW1hdHVyaXR5IGFuZCBjb25nZW5pdGFsIHJ1YmVsbGEu
Cg==Cg==[Qq][q] is associated with “Continuous machinery-like” murmur due to constant movement of blood from the high-pressure aorta to the low-pressure pulmonary artery.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBhdGVudCBkdWN0dXMgYXJ0ZXJpb3N1cyAoUERBKS4=
Cg==Cg==[Qq][q] Therapy with ………… successfully closes patent ductus arteriosus (PDA) in the majority of patients, but ………… keeps it open.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluZG9tZXRoYWNpbiwgcHJvc3RhZ2xhbmRpbi4=[Qq]
[q] ………… results from thickening of the tunica media near the junction of ductus arteriosus and the aortic arch. It is associated with a PDA; coarctation lies after (distal to) the aortic arch, but before (proximal to) the PDA. It Presents as lower extremity exercise intolerance in infants. It has a frequent association with Turner syndrome.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmFudGlsZSBmb3JtIChQcmVkdWN0YWwpIENvYXJjdGF0aW9uIG9mIHRoZSBhb3J0YS4=
Cg==Cg==[Qq][q] ……….. results from thickening of the tunica media near the junction of ductus arteriosus and the aortic arch. It is not associated with a PDA; coarctation lies after (distal to) the aortic arch and ligamentum arteriosum. It presents as hypertension in the upper extremities and hypotension with weak pulses in the lower extremities (brachial-femoral delay); classically discovered in adulthood. Chest x-ray usually demonstrates inferior notching of the third to eighth ribs.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFkdWx0IGZvcm0gKFBvc3RkdWN0YWwpIENvYXJjdGF0aW9uIG9mIHRoZSBhb3J0YS4=
Cg==Cg==[Qq][q] Differential clubbing and cyanosis without blood pressure or pulse discrepancy are pathognomonic for ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGEgbGFyZ2UgcGF0ZW50IGR1Y3R1cyBhcnRlcmlvc3VzIGNvbXBsaWNhdGVkIGJ5IEVpc2VubWVuZ2VyIHN5bmRyb21lIChyZXZlcnNhbCBvZiBzaHVudCBmbG93IGZyb20gbGVmdC10by1yaWdodCB0byByaWdodC10by1sZWZ0KS4=[Qq]
[q] ………… is characterized by displacement of tricuspid valve leaflets downward into RV, artificially “atrializing” the ventricle. Can be caused by lithium exposure in utero to female with bipolar disorder.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVic3RlaW4gYW5vbWFseS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
60 years old male patient who is diabetic and heavy smoker presenting with severe hypertension + ultrasound shows left renal artery stenosis with diffuse cortical thinning and atrophy of the left kidney?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlbmFsIGFydGVyeSBzdGVub3Npcy4=
Cg==Cg==[Qq][q] In cases of unilateral renal artery stenosis, morphologic changes in the affected kidney are related to hypoperfusion and include ………….? In contrast, the contralateral nonstenotic kidney is exposed to high blood pressure and therefore demonstrates typical signs of ………………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpZmZ1c2UgY29ydGljYWwgdGhpbm5pbmcgYW5kIGF0cm9waHkuIGh5cGVydGVuc2l2ZSBuZXBocm9zY2xlcm9zaXMgYW5kIGh5YWxpbmUgYXJ0ZXJpb2xvc2NsZXJvc2lzLg==
Cg==Cg==[Qq][q] Severe (≥ 180/≥ 120 mm Hg) hypertension without acute end-organ damage is called ……………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cGVydGVuc2l2ZSB1cmdlbmN5Lg==[Qq]
[q] Severe hypertension with evidence of acute end-organ damage (encephalopathy, stroke, retinal hemorrhages and exudates, papilledema, MI, HF, aortic dissection, kidney injury, microangiopathic hemolytic anemia, eclampsia) is called ……………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cGVydGVuc2l2ZSBlbWVyZ2VuY3ku[Qq]
[q] ……….. is diagnosed when the systolic blood pressure is elevated (>130) with a normal (<80) diastolic blood pressure (DBP) and is caused by age-related decreases in the compliance of the aorta and its proximal major branches (aortic stiffening).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElzb2xhdGVkIHN5c3RvbGljIGh5cGVydGVuc2lvbiAoSVNIKTo=[Qq]
[q] ……………. is characterized by hypotension, pallor, sweating, nausea, and dizziness that occur when a pregnant woman lies supine (on her back) and resolve with sitting, standing up, or when assuming a left lateral decubitus position.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1cGluZSBoeXBvdGVuc2lvbiBzeW5kcm9tZSAob3IgYW9ydG9jYXZhbCBjb21wcmVzc2lvbiBzeW5kcm9tZSku
Cg==Cg==[Qq][q] The pathogenesis of atherosclerotic plaques (atheromas) is thought to begin with ……………, which results in increased endothelial permeability and enhanced leukocyte adhesion.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGVuZG90aGVsaWFsIGNlbGwgaW5qdXJ5Lg==
Cg==Cg==[Qq][q] Platelet-derived growth factor (PDGF) released by locally adherent platelets, dysfunctional endothelial cells, and infiltrating macrophages within the atherosclerotic plaque which promotes migration of …………………… from the media into the intima.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHNtb290aCBtdXNjbGUgY2VsbHMgKFNNQ3MpLg==
Cg==Cg==[Qq][q] Fatty streaks are composed of …………….. whic is derived from macrophages and smooth muscle cells (SMC) that have engulfed lipoprotein (predominantly LDL).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGludGltYWwgbGlwaWQtZmlsbGVkIGZvYW0gY2VsbHMu
Cg==Cg==[Qq][q] High intraplaque activity of …………….. enzymes predisposes the patient to plaque rupture and a consequent acute coronary syndrome, including myocardial infarction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG1ldGFsbG9wcm90ZWluYXNlcy4=
Cg==Cg==[Qq][q] ……………. is caused by proteins leaking into the vessel wall which is typically produced by long-standing nonmalignant hypertension and/or diabetes, producing vascular thickening; proteins are seen as pink hyaline on microscopy. This results in reduced vessel caliber with end-organ ischemia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5YWxpbmUgYXJ0ZXJpb2xvc2NsZXJvc2lzLg==
Cg==Cg==[Qq][q] ……………….. presents as onion-like concentric thickening of the walls of arterioles as a result of laminated smooth muscle cells (SMC) and reduplicated basement membranes due to malignant hypertension. It results in reduced vessel caliber with end-organ ischemia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cGVycGxhc3RpYyBhcnRlcmlvbG9zY2xlcm9zaXMu
Cg==Cg==[Qq][q] ……………is a calcification of the media of muscular (medium-sized) arteries. Not clinically significant because its nonobstructive. It seen as an incidental finding on x-ray or mammography “Pipestem appearance on x-ray”.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1vbmNrZWJlcmcgbWVkaWFsIGNhbGNpZmljIHNjbGVyb3Npcy4=
Cg==Cg==[Qq][q] ……….. are plaques or nodules composed of lipid-laden histiocytes in skin, especially the eyelids.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFhhbnRob21hcyAoeGFudGhlbGFzbWEpLg==
Cg==Cg==[Qq][q] ………………… is lipid deposit in tendon, especially Achilles.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRlbmRpbm91cyB4YW50aG9tYS4=
Cg==Cg==[Qq][q] …………. is lipid deposit in cornea. Common in elderly (arcus senilis) but appears earlier in life in hypercholesterolemia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvcm5lYWwgYXJjdXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
56 years old patient with history of hypertension, DM, and heavy smoker presenting with tearing chest pain of sudden onset, radiating to the back, and markedly unequal BP in arms + CXR shows mediastinal widening + Chest CT is shown below?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFvcnRpYyBkaXNzZWN0aW9uLg==[Qq]
[q] ………………… is initiated by a tear in the aortic intima forming a false lumen.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFvcnRpYyBkaXNzZWN0aW9uLg==
Cg==Cg==[Qq][q]…………… is the single most important risk factor for the development of intimal tears leading to aortic dissection.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cGVydGVuc2lvbi4=
Cg==Cg==[Qq][q] Stanford type (A or B) involves ascending aorta and may extend to aortic arch or descending aorta. The intimal tear usually originates in the sinotubular junction. May result in acute aortic regurgitation or cardiac tamponade?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YW5mb3JkIHR5cGUgQSAocHJveGltYWwpLg==
Cg==Cg==[Qq][q] Stanford type (A or B) involves only descending aorta (Below left subclavian artery). No ascending aorta involvement. The intimal tear usually originates below the origin of the left subclavian artery?
[c]IFNob3cgbWXCoC B0aGUgYW5zd2Vy[Qq]
[f]IFN0YW5mb3JkIHR5cGUgQiAoZGlzdGFsKS4=
Cg==Cg==[Qq][q] The most common cause of death in aortic dissection is ……………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpc3NlY3Rpb24gbWF5IGV4dGVuZCBwcm94aW1hbGx5IGludG8gdGhlIHBlcmljYXJkaXVtLCBsZWFkaW5nIHRvIGxpZmUtdGhyZWF0ZW5pbmcgYWN1dGUgdGFtcG9uYWRlLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
56 years old patient with history of hypertension, DM, and heavy smoker presenting with pain, which is typically localized to the chest and back, dysphagia, hoarseness of the voice. Chest x-ray shows a widened mediastinum, enlarged aortic knob, and tracheal deviation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRob3JhY2ljIGFvcnRpYyBhbmV1cnlzbS4=
Cg==Cg==[Qq][q] The pathogenesis of thoracic aortic aneurysm due to tertiary syphilis begins with ………………….. resulting in inflammation, ischemia, and weakening of the aortic adventitia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZhc2EgdmFzb3J1bSBlbmRhcnRlcml0aXMgYW5kIG9ibGl0ZXJhdGlvbiAoZW5kYXJ0cml0aXMgb2JsaXRlcmFucyku[Qq]
[q] …………….. is characterized by the fragmentation of elastic tissue (“basket weave” pattern, compared to normal) and separation of the elastic and fibromuscular components of the tunica media by small, cleft-like spaces that become filled with amorphous extracellular matrix?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEN5c3RpYyBtZWRpYWwgZGVnZW5lcmF0aW9uLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
66 years old patient with history of hypertension, DM, and heavy smoker presenting with pulsatile abdominal mass that grows with time + Abdominal CT is shown below?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFiZG9taW5hbCBhb3J0aWMgYW5ldXJ5c20u[Qq]
[q] ……………. is characterized by chronic transmural inflammation of the aortic wall.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFiZG9taW5hbCBhb3J0aWMgYW5ldXJ5c20u[Qq]
[q] ………….. should be suspected in patients with abdominal distension, a pulsatile abdominal mass, hypotension, tachcardia, syncope and umbilical/ flank hematoma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHJ1cHR1cmVkIEFiZG9taW5hbCBhb3J0aWMgYW5ldXJ5c20u
Cg==Cg==[Qq][q] ………… is chest pain that arises with exertion or emotional stress due to atherosclerosis of coronary arteries with > 70% stenosis. Presents as chest pain (lasting < 20 minutes) that radiates to the left arm or jaw, diaphoresis, and shortness of breath. EKG shows ST-segment depression due to subendocardial ischemia. Relieved by rest or nitroglycerin.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YWJsZSBhbmdpbmEu[Qq]
[q] ………… is chest pain that occurs at rest. Usually due to rupture of an atherosclerotic plaque with thrombosis and incomplete occlusion of a coronary artery. EKG shows ST-segment depression due to subendocardial ischemia but no cardiac biomarker elevation (unlike NSTEMI). Relieved by nitroglycerin.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVuc3RhYmxlIGFuZ2luYS4=[Qq]
[q] What is the most likely diagnosis?
30 years old heavy smoker female presenting with episodic chest pain unrelated to exertion + EKG shows ST-segment elevation with no elevation in cardiac enzymes +low doses of ergonovine induce coronary spasm, chest pain, and ST-segment elevation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZhcmlhbnQgKFByaW56bWV0YWwpIGFuZ2luYS4=[Qq]
[q] ……….. is the most sensitive provocative diagnostic test for coronary vasospasm in variant (Prinzmetal) angina.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBlcmdvbm92aW5lIHRlc3Qu[Qq]
[q] In …………… angina there is coronary vasospasm which further can be aggravated by beta blockers because by blocking beta receptors, alpha receptors on the vasculature are left unopposed —-> aggravating the vasospasm.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHByaW56bWV0YWwu[Qq]
[q] Drugs like …………and ………… causes vasodilation of coronary arterioles in nonischemic regions. This leads to decreased perfusion pressure within the collateral microvessels supplying the ischemic myocardium, diverting blood flow from ischemic areas to nonischemic areas.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFkZW5vc2luZSBhbmQgZGlweXJpZGFtb2xlLg==
Cg==Cg==[Qq][q] ……….. is the most commonly involved artery in MI (45% of cases) and ………… is the 2nd most common.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExBRCwgUkNBLg==[Qq]
[q] ………… is the type of myocardial infarction that is transmural (full thickness of myocardial wall involved) and shows ST elevation on ECG, Q waves.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNULXNlZ21lbnQgZWxldmF0aW9uIE1JIChTVEVNSSku
Cg==Cg==[Qq][q] ………… is the type of myocardial infarction that is subendocardial (inner 1⁄3) and shows ST depression on ECG.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vbi1TVCBzZWdtZW50IGVsZXZhdGlvbiBNSSAoTlNURU1JKS4=
Cg==Cg==[Qq][q] Reperfusion of irreversibly damaged cells results in calcium influx, leading to ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGh5cGVyY29udHJhY3Rpb24gb2YgbXlvZmlicmlscyAoY29udHJhY3Rpb24gYmFuZCBuZWNyb3Npcyku[Qq]
[q] ……………….. usually occurs after repetitive activity and involves the upper costal cartilage at the costochondral or costosternal junctions. The pain is typically reproduced with palpation and worsened with movement or changes in position.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvc3Rvc3Rlcm5hbCBzeW5kcm9tZSAoYWxzbyBrbm93biBhcyBjb3N0b2Nob25kcml0aXMgb3IgYW50ZXJpb3IgY2hlc3Qgd2FsbCBzeW5kcm9tZSku[Qq]
[q] Within the 1st 4 hours of the myocardial infarction, …………. can be seen as microscopic changes and …………………….. as a possible complication.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vbmUgKE5vcm1hbCBteW9jYXJkaXVtKSwgQ2FyZGlvZ2VuaWMgc2hvY2sgKG1hc3NpdmUgaW5mYXJjdGlvbiksIGNvbmdlc3RpdmUgaGVhcnQgZmFpbHVyZSwgYW5kIGFycmh5dGhtaWEu[Qq]
[q] Within 4-24 hours of the myocardial infarction, …………. can be seen as microscopic changes and …………………….. as a possible complication.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVhcmx5IGNvYWd1bGF0aXZlIG5lY3Jvc2lzLCByZWxlYXNlIG9mIG5lY3JvdGljIGNlbGwgY29udGVudHMgaW50byBibG9vZDsgZWRlbWEsIGhlbW9ycmhhZ2UsIHdhdnkgZmliZXJzLiBDb21wbGljYXRpb25zOiBBcnJoeXRobWlhIGlzIGFuIGltcG9ydGFudCBjYXVzZSBvZiBkZWF0aCBiZWZvcmUgcmVhY2hpbmcgdGhlIGhvc3BpdGFsIGFuZCB3aXRoaW4gdGhlIGZpcnN0IDI0IGhvdXJzIHBvc3QtTUku[Qq]
[q] Within 1-3 Days of the myocardial infarction, …………. can be seen as microscopic changes and …………………….. as a possible complication?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEV4dGVuc2l2ZSBjb2FndWxhdGl2ZSBuZWNyb3Npcy4gVGlzc3VlIHN1cnJvdW5kaW5nIGluZmFyY3Qgc2hvd3MgYWN1dGUgaW5mbGFtbWF0aW9uIHdpdGggbmV1dHJvcGhpbHMu
Cg==Cg==JiM4MjExOyBDb21wbGljYXRpb25zOiBQb3N0aW5mYXJjdGlvbiBmaWJyaW5vdXMgcGVyaWNhcmRpdGlzICh0cmFuc211cmFsIGluZmFyY3Rpb24pLg==[Qq]
[q] Within 4-7 Days of the myocardial infarction, …………. can be seen as microscopic changes and …………………….. as a possible complication?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHJvYnVzdCBwaGFnb2N5dG9zaXMgb2YgZGVhZCBjZWxscyBieSBtYWNyb3BoYWdlcy4=
Cg==Cg==JiM4MjExOyBDb21wbGljYXRpb25zOg==
[Qq]
1. Free wall rupture –> cardiac tamponade. Ventricular free wall rupture is a complication of transmural (ST-elevation) myocardial infarction (Ml) that generally occurs 3 to 7 days after the onset of total ischemia, when coagulative necrosis, neutrophil infiltration, and enzymatic lysis of connective tissue have substantially weakened the infarcted myocardium. Free wall rupture causes cardiac tamponade, which greatly limits ventricular filling during diastole.
2. Papillary muscle rupture –> mitral regurgitation.
3. Interventricular septal rupture due to macrophage-mediated structural degradation –> VSD.
[q] Within 1-2 Weeks of the myocardial infarction, …………. can be seen as microscopic changes and …………………….. as a possible complication?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdlbGwtZGV2ZWxvcGVkIGdyYW51bGF0aW9uIHRpc3N1ZSB3aXRoIG5lb3Zhc2N1bGFyaXphdGlvbi4gwqBEdXJpbmcgdGhlIHNlY29uZCB3ZWVrIGFmdGVyIE1sLCB0aGUgZGFtYWdlZCB0aXNzdWUgaXMgcmVwbGFjZWQgYnkgZ3JhbnVsYXRpb24gdGlzc3VlIGFuZCBuZW92YXNjdWxhcml6YXRpb24gaXMgZm91bmQgaW4gdGhlIGluZmFyY3Qgem9uZS4=
Cg==Cg==JiM4MjExOyBDb21wbGNhdGlvbnM6IEZyZWUgd2FsbCBydXB0dXJlICYjODIxMTsmZ3Q7IGNhcmRpYWMgdGFtcG9uYWRlOyBwYXBpbGxhcnkgbXVzY2xlIHJ1cHR1cmUgJiM4MjExOyZndDsgbWl0cmFsIHJlZ3VyZ2l0YXRpb247IGludGVydmVudHJpY3VsYXIgc2VwdGFsIHJ1cHR1cmUgZHVlIHRvIG1hY3JvcGhhZ2UtbWVkaWF0ZWQgc3RydWN0dXJhbCBkZWdyYWRhdGlvbiAmIzgyMTE7Jmd0OyBWU0Qu[Qq]
[q] Within 2 Weeks to several months of the myocardial infarction, …………. can be seen as microscopic changes and …………………….. as a possible complication?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHByb2dyZXNzaXZlIGNvbGxhZ2VuIGRlcG9zaXRpb24gYW5kIHNjYXIgZm9ybWF0aW9uLg==
Cg==Cg==JiM4MjExOyBDb21wbGljYXRpb25zOg==
[Qq]
1. Aneurysm [Outward bulge with contraction (“dyskinesia”), associated with fibrosis].
2. Mural thrombus.
3. Dressler syndrome (autoimmune inflammatory reaction to myocardial neo-antigens formed as a result of the MI –> autoimmune pericarditis; it takes weeks for antibodies to develop Vs. post-infarction fibrinous pericarditis).
[q] (Early-onset or Late-onset) post-myocardial infarction (Ml) pericarditis develops between days 2 and 4 following a transmural myocardial infarction and represents an inflammatory reaction to cardiac muscle necrosis that occurs in the adjacent visceral and parietal pericardium?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVhcmx5LW9uc2V0Lg==[Qq]
[q] (Early-onset or Late-onset) post-myocardial infarction (Ml) pericarditis begins one week to a few months following the Ml and affects less than 4% of cases and is thought to be an autoimmune polyserositis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExhdGUtb25zZXQgKERyZXNzbGVyJiM4MjE3O3Mgc3luZHJvbWUpLg==[Qq]
[q] ………… rises after 4 hours (peaks at 24 hr) and is ↑ for 7–10 days; more specific than other protein markers.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmRpYWMgdHJvcG9uaW4gSS4=
Cg==Cg==[Qq][q] ……….. rises after 6-12 hours (peaks at 16–24 hr) and is predominantly found in myocardium but can also be released from skeletal muscle. Useful in diagnosing reinfarction following acute MI because levels return to normal after 48 hours.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENLLU1CLg==
Cg==Cg==[Qq][q] Repetitive ischemia of cardiac myocytes or persistent hypoperfusion of myocytes can result in a chronic but reversible loss of contractile function, referred to as ………..?. ………….. is a less severe form of ischemia-induced reversible loss of contractile function but its repetition can result in hibernation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGhpYmVybmF0aW9uLCBNeW9jYXJkaWFsIHN0dW5uaW5nLg==[Qq]
[q] When ischemia lasts less than 30 minutes, restoration of blood flow leads to reversible contractile dysfunction, with contractility gradually returning to normal over the next several hours to days which is called ……….?. However, after about 30 minutes of total ischemia, ischemic injury becomes …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG15b2NhcmRpYWwgc3R1bm5pbmcsIGlycmV2ZXJzaWJsZS4=
Cg==Cg==[Qq][q] Simple mitochondrial swelling is associated with (reversible or irreversible) cellular injury, however, mitochondrial vacuolization is typically a sign of (reversible or irreversible) cell injury?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHJldmVyc2libGUsIGlycmV2ZXJzaWJsZQ==[Qq]
[q] The major determinant of whether or not a coronary artery plaque will cause ischemic myocardial injury is ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSByYXRlIG9mIGdyb3d0aCBhdCB3aGljaCBpdCBvY2NsdWRlcyB0aGUgaW52b2x2ZWQgYXJ0ZXJ5Lg==[Qq]
[q] In 90% of individuals occlusion of the right coronary artery can result in transmural ischemia of ……………., producing ST elevation in leads II, III, and aVF as well as possible sinus node dysfunction —-> Bradycardia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBpbmZlcmlvciB3YWxsIG9mIHRoZSBsZWZ0IHZlbnRyaWNsZS4=[Qq]
[q] Leads I and aVL corresponds to the lateral limb leads on ECG. Therefore, ST elevation or Q waves in these leads are indicative of infarction involving the lateral aspect of the left ventricle, which is supplied by …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBsZWZ0IGNpcmN1bWZsZXggYXJ0ZXJ5Lg==
Cg==Cg==[Qq][q] ………….. typically presents with hypotension and distended jugular veins, and clear lungs after ST elevation MI.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZ2h0LXNpZGVkIGhlYXJ0IGZhaWx1cmUu
Cg==Cg==[Qq][q] …………. is usually the first arrhythmia to appear as the result of acute myocardial ischemia and is the most common cause of lethal cardiac arrest in CAD-related SCD.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZlbnRyaWN1bGFyIGZpYnJpbGxhdGlvbi4=[Qq]
[q] ……………… is the most common form of cardiomyopathy. Often idiopathic or familial (due to mutation of TTN gene encoding the sarcomeric protein titin) and results in systolic dysfunction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpbGF0ZWQgY2FyZGlvbXlvcGF0aHku[Qq]
[q] ………………. is the most common cause of ventricular fibrillation (VF) or ventricular tachycardia that deteriorates to VF in individuals younger than 30 and the most common cause of sudden cardiac death in a young athlete.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cGVydHJvcGhpYyBvYnN0cnVjdGl2ZSBjYXJkaW9teW9wYXRoeSAoSE9DTSku
Cg==Cg==[Qq][q] Almost all cases of HCM are thought to be due to single point missense mutations in the genes for …………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJldGEtbXlvc2luIGhlYXZ5IGNoYWluIGFuZCBteW9zaW4gYmluZGluZyBwcm90ZWluIEMu
Cg==Cg==[Qq][q] Extreme myofiber disarray with interstitial fibrosis on cardiac histology strongly suggests ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGh5cGVydHJvcGhpYyBjYXJkaW9teW9wYXRoeSAoSENNKS4=
Cg==Cg==[Qq][q] Why use of β-blocker or non-dihydropyridine Ca channel blockers (verapamil) is helpful in Hypertrophic obstructive cardiomyopathy (HOCM)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZXkgZGVjcmVhc2UgaGVhcnQgcmF0ZSBhbmQgTFYgY29udHJhY3RpbGl0eSB0byBpbmNyZWFzZSBMViBibG9vZCB2b2x1bWUsIHJlZHVjZSBMViBvdXRmbG93IHRyYWN0IG9ic3RydWN0aW9uLCBhbmQgaW1wcm92ZSBzeW1wdG9tcy4=[Qq]
[q] ………… is decreased compliance of the ventricular endomyocardium that restricts filling during diastole due to postradiation fibrosis, Löffler endocarditis, Endocardial fibroelastosis, Amyloidosis, Sarcoidosis, or Hemochromatosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlc3RyaWN0aXZlL2luZmlsdHJhdGl2ZSBjYXJkaW9teW9wYXRoeS4=[Qq]
[q] ……………. is due to chronic elevation of ventricular pressures during systole, which is usually caused by long-standing hypertension or aortic stenosis (increased LV afterload).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmNlbnRyaWMgaHlwZXJ0cm9waHku
Cg==Cg==[Qq][q] …………. results from the addition of myocardial contractile fibers in series in response to chronic volume overload. Common causes include dilated cardiomyopathy, ischemic heart disease, and chronic aortic or mitral valve regurgitation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVjY2VudHJpYyBoeXBlcnRyb3BoeS4=
Cg==Cg==[Qq][q] ………………… is characterized by hypokinesis of the mid and apical segments and hyperkinesis of the basal segments of the left ventricle, resulting in systolic dysfunction and reduced ejection fraction likely caused by a surge of catecholamines in the setting of physical or emotional stress in postmenopausal women
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVzcy1pbmR1Y2VkICh0YWtvdHN1Ym8pIGNhcmRpb215b3BhdGh5Lg==
Cg==Cg==[Qq][q] Supine dyspnea that is relieved by sitting up, known as orthopnea, is a relatively specific sign of ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFkdmFuY2VkIGxlZnQtc2lkZWQgaGVhcnQgZmFpbHVyZS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
65 years old patient with history of hypertension, DM presenting with dyspnea, paroxysmal nocturnal dyspnea, orthopnea, and lung crackles + Echocardiography shows ejection fraction= 30?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZnQtc2lkZWQgaGVhcnQgZmFpbHVyZS4=
Cg==Cg==[Qq][q] Small, congested capillaries in Left-sided heart failure may burst, leading to intraalveolar hemorrhage and the iron from hemoglobin is converted to hemosiderin; marked by hemosiderin-laden macrophages (heart-failure cells) which can be stained by …………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBydXNzaWFuIGJsdWUgc3RhaW4u
Cg==Cg==[Qq][q] The most common cause of right heart failure is ………………….. Usually present with jugular venous distension, painful hepatosplenomegaly with characteristic ‘nutmeg’ liver, and dependent pitting edema?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZnQtc2lkZWQgaGVhcnQgZmFpbHVyZS4=
Cg==Cg==[Qq][q] Decreased perfusion of peripheral tissues in heart failure induces a number of neuroendocrine compensatory mechanisms like ………………….. and …………… which exacerbate heart failure by making it more difficult for the failing heart to pump blood to the tissues
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlbmluLWFuZ2lvdGVuc2luLWFsZG9zdGVyb25lIGFjdGl2YXRpb24gYW5kIGluY3JlYXNlZCBzeW1wYXRoZXRpYyBvdXRwdXQu
Cg==Cg==[Qq][q] Prominent pulmonary vessels, patchy bilateral airspace opacities (red arrows), blunting of the costophrenic angles (pleural effusions [yellow arrows]), and a fissure sign (created by fluid trapped between the right upper and middle lobe [blue arrow]) are consistent with …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIHB1bG1vbmFyeSBlZGVtYSBkdWUgdG8gZGVjb21wZW5zYXRlZCBoZWFydCBmYWlsdXJlLg==[Qq]
[q] ………… is caused by hemorrhage, dehydration, burns and is characterised by Cold, clammy skin, ↓↓ PCWP (Preload), ↓ CO, ↑ SVR (Afterload) and is treated with IV fluids.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh5cG92b2xlbWljIHNob2NrLg==
Cg==Cg==[Qq][q] ………… is caused by Acute MI, HF, valvular dysfunction, arrhythmia
and is characterised by Cold, clammy skin, ↑ PCWP (Preload), ↓ CO, ↑ SVR (Afterload) and is treated with Inotropes, diuresis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmRpb2dlbmljIHNob2NrLg==
Cg==Cg==[Qq][q] ………… is caused by cardiac tamponade, pulmonary embolism, Tension pneumothorax and is characterised by Cold, clammy skin, ↓ PCWP (Preload), ↓ CO, ↑ SVR (Afterload) and is treated with relieving the obstruction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9ic3RydWN0aXZlIHNob2NrLg==
Cg==Cg==[Qq][q] ……….. is caused by sepsis, anaphylaxis and is characterised by warm skin, ↓ PCWP (Preload), ↑ CO, ↓ SVR (Afterload) and is treated with relieving the obstruction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpc3RyaWJ1dGl2ZSAoU2VwdGljKSBzaG9jay4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
14 years old patient presenting with fever, Swelling and pain in knee joint with a similar attack in the ankle joint a week ago, annular, nonpruritic rash with erythematous borders in the trunk, and elevated ESR/CPR?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJoZXVtYXRpYyBmZXZlci4=
Cg==Cg==[Qq][q] ………….. is considered a systemic complication of pharyngitis due to group A β-hemolytic streptococci due to molecular mimicry (cross-reactivity of antibodies against bacterial and host antigens); bacterial M protein resembles proteins in human tissue.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIHJoZXVtYXRpYyBmZXZlci4=
Cg==Cg==[Qq][q] …………… is the most common cause of death during the acute rheumatic fever.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE15b2NhcmRpdGlzLg==
Cg==Cg==[Qq][q] Myocarditis in acute rheumatic fever that are characterized by foci of chronic inflammation, reactive histiocytes with slender, wavy nuclei (Anitschkow cells), giant cells, and fibrinoid material
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFzY2hvdGYgYm9kaWVzLg==
Cg==Cg==[Qq][q] ……………….. presents with involuntary, rapid, irregular jerking movements involving the face, arms, and legs. It is caused by a delayed onset autoimmune reaction involving anti-streptococcal antibodies that cross-react with the basal ganglia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN5ZGVuaGFtIGNob3JlYS4=
Cg==Cg==[Qq][q] Fibrous thickening and fusion of the valve leaflets in chronic rheumatic heart disease following acute rheumatic fever is the most common cause of ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pdHJhbCBTdGVub3Npcy4=
Cg==Cg==[Qq][q] Chronic valvular inflammation and scarring associated with rheumatic heart disease predispose to an increased risk of ……………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluZmVjdGl2ZSBlbmRvY2FyZGl0aXMu[Qq]
[q] Treatment and prophylaxis of choice for patients with acute rheumatic fever is ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExvbmcgYWN0aW5nIHBlbmljaWxsaW4u[Qq]
[q] What is the most likely diagnosis?
31 years old patient presenting with fever, new onset murmur, nontender macular, erythematous lesions on the soles and subungual splinter haemorrhage + Blood culture is positive for S.aureus + Echocardiography shows vegetation in the mitral valve + multiple syringe marks in his arm?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGluZmVjdGl2ZSBlbmRvY2FyZGl0aXMu
Cg==Cg==[Qq][q] ………………. is the most common predisposing condition for native valve infective endocarditis (IE) in developed nations.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pdHJhbCB2YWx2ZSBwcm9sYXBzZSAod2l0aCBvciB3aXRob3V0IG1pdHJhbCByZWd1cmdpdGF0aW9uKS4=[Qq]
[q] ……………. typically colonize the oral mucosa and are the most common cause of infective endocarditis (IE) following dental procedures.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZpcmlkYW5zIGdyb3VwIHN0cmVwdG9jb2NjaSAoU3RyZXB0b2NvY2N1cyBzYW5ndWluaXMpLg==[Qq]
[q] …………….. is the most common cause of invective endocarditis in IV drug abusers and ………. is the most common valve to be affected?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoeWxvY29jY3VzIGF1cmV1cy4=[Qq]
[q] ……………. is associated with endocarditis in patients with underlying colorectal carcinoma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgYm92aXMgKGdhbGxvbHl0aWN1cyku[Qq]
[q] …………. is a nontender macular, and erythematous lesions typically located on the palms and soles due to septic embolization of skin vessels from valvular vegetations (vascular phenomenon).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEphbmV3YXkgbGVzaW9ucy4=
Cg==Cg==[Qq][q] Roth spots are round white spots on retina surrounded by hemorrhage and are considered (vascular or immunologic) manifestation of infective endocarditis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGltbXVub2xvZ2ljLg==
Cg==Cg==[Qq][q] Osler nodes are ouchy raised lesions on finger or toe pads due to …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGltbXVuZSBjb21wbGV4IGRlcG9zaXRpb24u
Cg==Cg==[Qq][q] ……………. is due to sterile vegetations that arise in association with SLE. Vegetations are present on the surface and undersurface of the mitral valve and result in mitral regurgitation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExpYm1hbi1TYWNrcyBlbmRvY2FyZGl0aXMu[Qq]
[q] ………………. is due to sterile vegetations that arise in association with a hypercoagulable state or malignancy (underlying adenocarcinoma). Vegetations arise on the mitral valve along lines of closure and result in mitral regurgitation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vbmJhY3RlcmlhbCB0aHJvbWJvdGljIGVuZG9jYXJkaXRpcy4=[Qq]
[q] Viral infection with …………. cause lymphocytic infiltrate with focal necrosis leading to viral myocarditis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNveHNhY2tpZSBCLg==[Qq]
[q] What is the most likely diagnosis?
34 years old female with history of systemic lupus presenting with sharp chest pain that changes in intensity with respiration (pleuritic) as well as the position of the body (positional), the pain is worsened by lying flat and improved by sitting up, high pitched, leathery, and scratchy sound heared through stethoscope + EKG shows ST segment elevation in all leads and PR segment depression?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIHBlcmljYXJkaXRpcy4=[Qq]
[q] …………. is a chronic condition in which the normal pericardial space is replaced by a thick, fibrous calcified shell that restricts ventricular volumes and eventually causes heart failure with increased jugular venous pressure and often results in a positive Kussmaul sign.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbnN0cmljdGl2ZSBwZXJpY2FyZGl0aXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
33 years old male patient presenting with hypotension, distended neck veins, distant or muffled heart sounds, and decrease in the systolic pressure of 10 mmHg or more during inspiration as compared with the pressure during exhalation + ECG shows low-voltage QRS and electrical alternans?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcmRpYWMgdGFtcG9uYWRlLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
52 years old patient presenting with fever, weight loss, a mid-diastolic rumbling murmur heard best at the apex, positional cardiovascular symptoms (dyspnea and syncope), embolic symptoms, and a large pedunculated mass in the left atrium + Histology shows scattered cells within a mucopolysaccharide stroma (myxoma), abnormal blood vessels due to angiogenesis, and hemorrhaging accompanied by hemosiderin laden macrophages?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF0cmlhbCBteXhvbWEu[Qq]
[q] …………. is a benign hamartoma of cardiac muscle and the most common primary cardiac tumor in children; associated with tuberous sclerosis. Usually arises in the ventricle.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJoYWJkb215b21hcy4=[Qq]
[q] ………….. is a yellow-brown, finely granular perinuclear pigment is the product of free radical injury and lipid peroxidation and is considered a normal morphological change in the aging heart.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGxpcG9mdXNjaW4u[Qq]
[q] What is the most likely diagnosis?
52 years old female presenting with unilateral headache, visual disturbances, jaw claudication, proximal stiffness in the arms, hips, and elevated ESR + Biopsy of the temporal artery shows segmental granulomatous inflammation of the media?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRlbXBvcmFsIChHaWFudCBDZWxsKSBBcnRlcml0aXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
38 years old Asian female presenting with visual disturbance, ataxia, nystagmus, and absent pulse in the upper extremity?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRha2F5YXN1IEFydGVyaXRpcy4=[Qq]
[q] What is the most likely diagnosis?
34 years old male patient wit history of hepatitis B infection presenting with hypertension, abdominal pain with melena, peripheral neuropathy, and cutaneous manifestations including livedo reticularis and palpable purpura + renal artery biopsy shows different stages of transmural inflammation with fibrinoid necrosis producing a ‘string-of-pearls’ appearance on imaging?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBvbHlhcnRlcml0aXMgTm9kb3NhLg==[Qq]
[q] What is the most likely diagnosis?
4 years old child presenting with bilateral conjunctivitis, maculopapular rash, unilateral cervical adenopathy, strawberry tongue, erythema, edema, desquamation of the hands and feet since a week ago?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEthd2FzYWtpIERpc2Vhc2Uu
Cg==Cg==[Qq][q] Although the systemic inflammation in Kawasaki disease (KD) typically self-resolves in about 12 days without intervention, untreated patients are at risk for life-threatening cardiovascular sequelae, especially ………?. The dilated arteries are prone to ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNvcm9uYXJ5IGFydGVyeSBhbmV1cnlzbXMsIHRocm9tYm90aWMgb2NjbHVzaW9uIGFuZCBjb25zZXF1ZW50IG15b2NhcmRpYWwgaXNjaGVtaWEgYW5kIGRlYXRoLg==
Cg==Cg==[Qq][q] Treatment of Kawasaki Disease is ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFzcGlyaW4gYW5kIElWSUcu[Qq]
[q] What is the most likely diagnosis?
31 years old heavy smoker male presenting with intermittent claudication, gangrene, autoamputation of digits + Biopsy of the affected vessel shows segmental thrombosing inflammation often extends into contiguous veins and nerves?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJ1ZXJnZXIgRGlzZWFzZSAodGhyb21ib2FuZ2lpdGlzIG9ibGl0ZXJhbnMpLg==[Qq]
[q] What is the most likely diagnosis?
46 years old patient presenting with nasopharyngeal ulcerations, hemoptysis with bilateral nodular lung infiltrates that is not responsive to antibiotics, hematuria, elevated BUN and creatinine + Blood test is c-ANCAs positive + Biopsy reveals large necrotizing granulomas in the lung and upper airway?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdyYW51bG9tYXRvc2lzIHdpdGggcG9seWFuZ2lpdGlzIChXZWdlbmVyKS4=[Qq]
[q] What is the most likely diagnosis?
46 years old patient presenting with bilateral nodular lung infiltrates that is not responsive to antibiotics, hematuria, elevated BUN and creatinine + Blood test is P-ANCAs positive + No granulomas in lung biopsy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1pY3Jvc2NvcGljIFBvbHlhbmdpaXRpcy4=[Qq]
[q] Asthma + peripheral eosinophilia + serum P-ANCA positive make ……….. is the most likely diagnosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVvc2lub3BoaWxpYyBncmFudWxvbWF0b3NpcyB3aXRoIHBvbHlhbmdpaXRpcyAoQ2h1cmctU3RyYXVzcyBTeW5kcm9tZSku[Qq]
[q] ………… is a systemic hypersensitivity disease of uncertain etiology that produces leukocytoclastic angiitis in small vessels of the dermis and the gastrointestinal (GI) tract and presents clinically with a purpuric rash (usually occurs on the lower extremities and buttocks), colicky abdominal pain, and polyarthralgia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlbm9jaC1TY2jDtm5sZWluIFB1cnB1cmEgKEltbXVub2dsb2J1bGluIEEgdmFzY3VsaXRpcyku[Qq]
[q] What is the most likely diagnosis?
40 years old patient with history of hepatitis C presenting with joint pain, skin lesions, and hepatosplenomegaly + Blood test is positive for IgM against Fc portion of IgG that precipitates in the Cold?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1peGVkIGNyeW9nbG9idWxpbmVtaWEu[Qq]
[q] ………… presents with recurrent aphthous ulcers, genital ulcerations, uveitis, erythema nodosum. It has high incidence in people of Turkish and eastern Mediterranean descent.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJlaMOnZXQgc3luZHJvbWUu
Cg==Cg==[Qq][q] ………… block voltage-dependent L-type calcium channels of cardiac and smooth muscle and work on blood vessels more than the heart. Used for treatment of hypertension, angina (including Prinzmetal), Raynaud phenomenon and cause peripheral edema, flushing, dizziness.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpaHlkcm9weXJpZGluZXMgY2FsY2l1bSBjaGFubmVsIGJsb2NrZXJzIChBbWxvZGlwaW5lLCBjbGV2aWRpcGluZSwgbmljYXJkaXBpbmUsIG5pZmVkaXBpbmUsIG5pbW9kaXBpbmUpLg==
Cg==Jm5ic3A7
Cg==[Qq]
[q] ……….. block voltage-dependent L-type calcium channels of cardiac and smooth muscle and work on the heart more than blood vessels. Used for treatment of hypertension, angina, atrial fibrillation/flutter and cause cardiac depression, AV block, hyperprolactinemia (verapamil increases prolactin level), constipation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vbi1EaWh5ZHJvcHlyaWRpbmVzIGNhbGNpdW0gY2hhbm5lbCBibG9ja2VycyAoZGlsdGlhemVtLCB2ZXJhcGFtaWwpLg==
Cg==Cg==[Qq][q] ……………. are useful for treating hypertensive patients with comorbid conditions such as migraine, essential tremor, angina pectoris/prior myocardial infarction, and atrial fibrillation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJldGEgYmxvY2tlcnMu
Cg==Cg==[Qq][q] Beta blockers lower blood pressure via reducing myocardial contractility and heart rate and decreasing renin release by the kidney.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJldGEgYmxvY2tlcnMu
Cg==Cg==[Qq][q] ……………. ↓ arteriolar and venous resistance and is used for treatment of of both benign prostatic hyperplasia and hypertension. It causes first-dose syncope, orthα1 blockers:ostatic hypotension, and urinary incontinence as side effects. They have good effect on lipid profile (↑ HDL, ↓ LDL).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IM6xMSBibG9ja2VyczogUHJhem9zaW4=LCBkb3hhem9zaW4=LCB0ZXJh[Qq]zosin. Tamsulosin is an α1 blocker that acts only on prostate (no effect on blood vessels).
[q] ………… work by α2 stimulation –> ↓ in sympathetic outflow. Used for treatment of mild-to-moderate hypertension, opiate withdrawal, hypertensive management in pregnancy. Abrupt discontinuation of —> upregulation of α1 receptors on blood vessels –> rebound hypertension.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENlbnRyYWwgzrEyIGFnb25pc3RzIChjbG9uaWRpbmUgYW5kIG1ldGh5bGRvcGEpLg==
Cg==Cg==[Qq][q] …………. work by ↑ cGMP –> smooth muscle relaxation –> Vasodilates arterioles > veins; afterload reduction. Used for treatment of severe hypertension (particularly acute), HF, Frequently coadministered with a β-blocker to prevent reflex tachycardia, and Preeclampsia (safe in pregnancy). It causes SLE-like syndrome in slow acetylators, Edema, and Reflex tachycardia (contraindicated in angina/CAD).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZhc29kaWxhdG9ycyBBY3RpbmcgVGhyb3VnaCBOaXRyaWMgT3hpZGUgKEh5ZHJhbGF6aW5lKS4=
Cg==Cg==[Qq][q] ……… works by ↓ TPR via dilation of both arterioles and venules. Used for treatment of hypertensive emergencies (used IV). Can cause cyanide toxicity as side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZhc29kaWxhdG9ycyBBY3RpbmcgVGhyb3VnaCBOaXRyaWMgT3hpZGUgKE5pdHJvcHJ1c3NpZGUpLg==
Cg==Cg==[Qq][q] Antidotal treatment of cyanide toxicity can be achieved by …………., …………… and ……..?[c]IFNob3cgbWUgdG hlIGFuc3dlcg==
Cg==[Qq][f]
Cg==JiM4MjExOyBEaXJlY3QgYmluZGluZyBvZiBjeWFuaWRlIGlvbnMgKGh5ZHJveG9jb2JhbGFtaW4pLg==
CiYjODIxMTsgSW5kdWN0aW9uIG9mIG1ldGhlbW9nbG9iaW5lbWlhIChzb2RpdW0gbml0cml0ZSku
CiYjODIxMTsgVXNlIG9mIGRldG94aWZ5aW5nIHN1bGZ1ciBkb25vcnMgKHNvZGl1bSB0aGlvc3VsZmF0ZSku[Qq]
[q] ………… works as an antidote in cyanide toxicity by providing additional sulfur groups for rhodanese, enhancing cyanide detoxification.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNvZGl1bSB0aGlvc3VsZmF0ZS4=[Qq]
[q] ………. work by opening K channel, causing hyperpolarization of smooth muscle –> results in arteriolar vasodilation (arteriole specific). Used for treatment of insulinoma, Severe hypertension, and baldness. Cause hypertrichosis (minoxidil), hyperglycemia (↓ insulin release), edema, and
reflex tachycardia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERydWdzIEFjdGluZyB0byBPcGVuIFBvdGFzc2l1bSBDaGFubmVscyAoTWlub3hpZGlsIGFuZCBkaWF6b3hpZGUpLg==
Cg==Cg==[Qq][q] The management of hypertensive emergency requires immediate but gradual blood pressure reduction over minutes to hours to minimize target organ damage. The most common rugs used are ………, ……., and ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG5pdHJvcHJ1c3NpZGUsIGxhYmV0YWxvbCwgb3IgdGhlIEQxIGFnb25pc3QgZmVub2xkb3BhbS4=[Qq]
[q] Since …………. is the only intravenous agent that improves renal perfusion, it may be exceptionally beneficial in hypertensive patients with concomitant renal insufficiency.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGZlbm9sZG9wYW0u[Qq]
[q] Chronic (preexisting) hypertension in pregnancy is often treated with …………….., while preeclampsia (new-onset hypertension in pregnancy) is treated with ……………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG1ldGh5bGRvcGEgb3IgbGFiZXRhbG9sLiBsYWJldGFsb2wgb3IgaHlkcmFsYXppbmUu[Qq]
[q] ………………… reduce the risk of chronic kidney disease in patients with hypertension and diabetes.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFuZ2lvdGVuc2luLWNvbnZlcnRpbmcgZW56eW1lIChBQ0UpIGluaGliaXRvcnMgYW5kIGFuZ2lvdGVuc2luIHJlY2VwdG9yIGJsb2NrZXJzIChBUkJzKS4=[Qq]
[q] In patients with hypertension and chronic ischemic myocardial failure, ………………. are considered to be the most effective long-term treatment option, as they inhibit myocardial remodeling and the associated deterioration of ventricular contractile function, in addition to reducing blood pressure.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFDRSBpbmhpYml0b3JzLg==[Qq]
[q] …………….. are presently first-line drugs to treat isolated systolic hypertension in nondiabetic patients (where an ACEI or ARB would be utilized first).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoaWF6aWRlIGRpdXJldGljcyBhbmQgZGloeWRyb3B5cmlkaW5lIGNhbGNpdW0gYW50YWdvbmlzdHMu[Qq]
[q] ………….. are metabolized within vascular smooth muscle cells to nitric oxide, which activates guanylate cyclase and promotes the conversion of guanosine triphosphate (GTP) to cyclic guanosine monophosphate (cGMP) —> decreased intracellular calcium, resultant decreased activity of myosin light-chain kinase, and, finally, myosin light chain dephosphorylation and vascular smooth muscle relaxation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5pdHJhdGUu[Qq]
[q] ………. is the form of nitrate that has a low bioavailability due to extensive first-pass hepatic metabolism prior to release in systemic circulation leading to the need for much higher doses of oral formulations as compared to sublingual nitroglycerin.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElzb3NvcmJpZGUgZGluaXRyYXRlLg==[Qq]
[q] Using …………… together with phosphodiesterase (PDE) inhibitors (sildenafil) used for erectile dysfunction and pulmonary hypertension causes a profound systemic hypotension because they both increase intracellular cGMP which causes vascular smooth muscle relaxation. Their use together is absolutely contraindicated.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG5pdHJhdGVzLg==[Qq]
[q] Nitrate-free interval must be provided every day in patients that are using daily long acting nitrates to avoid ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRvbGVyYW5jZSB0byB0aGUgZHJ1Zy4=[Qq]
[q] ………… inhibits the late phase of sodium current thereby reducing diastolic wall tension and oxygen consumption without affection on the heart rate or contractility. Used for treatment of angina refractory to other medical therapies and cause constipation and nausea as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJhbm9sYXppbmUu[Qq]
[q] ……………………. have been proven beneficial in CHF (all drugs that have been shown to improve survival do so by inhibiting remodeling).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFDRUlzLCBBUkJzLCBiZXRhIGJsb2NrZXJzLCBhbmQgc3Bpcm9ub2xhY3RvbmUu[Qq]
[q] ……………. work as ionotropic by inhibition of cardiac Na-K ATPase –> results in decreased sodium efflux and ↑ intracellular Na –> ↓ Na/Ca exchange –> ↑ intracellular Ca –> ↑ Ca release from sarcoplasmic reticulum –> ↑ actin-myosin interaction –> ↑ contractile force. And works as antiarrythmic by inhibition of neuronal Na-K ATPase –> results in ↑ vagal activity –> Good for supraventricular arrhythmia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpZ294aW4u
Cg==Cg==[Qq][q] ………… is a positive inotropic agent and provides symptomatic relief in patients with acute decompensated heart failure due to left ventricular systolic dysfunction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpZ294aW4u[Qq]
[q] ………… has an anti-adrenergic effect (via increased parasympathetic tone) with slowing of conduction through the atrioventricular node, which can help improve supraventricular tachycardias with rapid ventricular rate except Wolff-Parkinson-White syndrome.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpZ294aW4u[Qq]
[q] Factors predisposing to digoxin toxicity are ………………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==JiM4MjExOyBSZW5hbCBmYWlsdXJlICjihpMgZXhjcmV0aW9uKSwgaHlwb2thbGVtaWEgKHBlcm1pc3NpdmUgZm9yIGRpZ294aW4gYmluZGluZyBhdCBLLWJpbmRpbmcgc2l0ZSBvbiBOYS9LIEFUUGFzZSku
Cg==JiM4MjExOyBEcnVncyB0aGF0IGRpc3BsYWNlIGRpZ294aW4gZnJvbSB0aXNzdWUtYmluZGluZyBzaXRlcy4=
[Qq]– ↓ clearance (verapamil, amiodarone, quinidine).
[q] The most common presentation of digoxin toxicity is ……………, but the most specific is …………… and the most serious complivation …………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG5vbnNwZWNpZmljIGdhc3Ryb2ludGVzdGluYWwgKGFub3JleGlhLCBuYXVzZWEsIHZvbWl0aW5nKSwgY2hhbmdlcyBpbiBjb2xvciB2aXNpb24gKEJsdXJyeSB5ZWxsb3cgdmlzaW9uKSwgcG90ZW50aWFsbHkgZmF0YWwgY2FyZGlhYyBhcnJoeXRobWlhcyBvZiB2aXJ0dWFsbHkgYW55IHR5cGUu[Qq]
[q] Management of Digoxin toxicity is ……………………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNsb3dseSBub3JtYWxpemUgSywgY2FyZGlhYyBwYWNlciwgYW50aS1kaWdveGluIEZhYiBmcmFnbWVudHMsIE1nLg==[Qq]
[q]………………. is a selective phosphodiesterase (PDE)-3 enzyme inhibitor that can be used in patients with refractory heart failure due to left ventricular systolic dysfunction. It cause vasodilation, a well-known side effect of phosphodiesterase inhibitors which can occasionally limit their use in hypotensive patients.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBob3NwaG9kaWVzdGVyYXNlIDMgaW5oaWJpdG9ycyAoSW5hbQ==cmlub25lIA==YW5kIG1pbA==cmlub25lKS4=
[Qq][q] …………. is a beta-adrenergic agonist with predominant activity on beta-1 receptors, weaker activity on beta-2 receptors, and minimal activity on alpha-1 receptors. It is used for management of refractory heart failure associated with severe left ventricular systolic dysfunction and cardiogenic shock.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]U3ltcGF0aG9taW1ldGljcyAoZG9idXRhbWluZSku
Cg==Cg==[Qq][q] ………… is a metalloprotease that cleaves and inactivates both ANP and BNP. Therefore, medications that inhibit it like ……….. lead to increased levels of ANP and BNP and promote beneficial effects in heart failure.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5lcHJpbHlzaW4sIHNhY3ViaXRyaWwu
Cg==Cg==[Qq][q] Because neprilysin is also responsible for inactivating angiotensin II, inhibition of neprilysin further stimulates deleterious vasoconstriction and fluid retention via increased angiotensin II levels. Therefore, in treating heart failure, neprilysin inhibitors are combined with ……………. to mitigate these negative effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFuIGFuZ2lvdGVuc2luIGxsLXJlY2VwdG9yIGJsb2NrZXIgKHNhY3ViaXRyaWwtdmFsc2FydGFuKS4=
Cg==Cg==[Qq][q] Long-term use of beta blockers like …………. has been shown to improve survival in patients with HF due to left ventricular systolic dysfunction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNhcnZlZGlsb2wsIG1ldG9wcm9sb2wu
Cg==Cg==[Qq][q] ………. are the first-line therapy for most patients with hypercholesterolemia and works by competitively inhibit HMG CoA reductase, the enzyme responsible for the conversion of HMG CoA to mevalonate (the rate limiting step in hepatic cholesterol synthesis) –> upregulation of LDL receptors causes increased uptake of LDL from the circulation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhNRy1Db0EgcmVkdWN0YXNlIGluaGliaXRvcnMgKFN0YXRpbnMpLg==
Cg==Cg==[Qq][q] ………… are the most effective lipid-lowering drugs for primary and secondary prevention of cardiovascular events, regardless of baseline lipid levels.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXRpbnMu
Cg==Cg==[Qq][q] The risk of statin myopathy is increased when ……….. are used concomitantly?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGZpYnJhdGVzIGFuZC9vciBuaWFjaW4u[Qq]
[q] Most statins are metabolized by cytochrome P-450, with the exception of pravastatin. Concomitant administration of drugs that inhibit statin metabolism (CYP450 inhibitors) is associated with …………………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluY3JlYXNlZCBpbmNpZGVuY2Ugb2Ygc3RhdGluLWluZHVjZWQgbXlvcGF0aHkgYW5kIHJoYWJkb215b2x5c2lzLg==
Cg==Cg==[Qq][q] …………. work by binding bile acid in the gastrointestinal tract, thereby interfering with its enterohepatic circulation –> Bile acid production is increased 10-fold –> LDL is reduced as a result because hepatic cholesterol is used up for the re-synthesis of bile acids
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpbGUgYWNpZC1iaW5kaW5nIHJlc2lucyAoQ2hvbGVzdHlyYW1pbmUsIGNvbGVzZXZlbGFtIGFuZCBjb2xlc3RpcG9sKS4=
Cg==Cg==[Qq][q] Bile acid-binding agents increase the cholesterol content of bile, thus increasing the risk for ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGZvcm1hdGlvbiBvZiBjaG9sZXN0ZXJvbCBnYWxsc3RvbmVzLg==[Qq]
[q] Because of this tendency for bile acid-binding agents to increase serum triglyceride levels, they should not be used in ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGh5cGVyY2hvbGVzdGVyb2xlbWlhIHBhdGllbnRzIHdobyBoYXZlIGNvbmNvbWl0YW50IGh5cGVydHJpZ2x5Y2VyaWRlbWlhLg==[Qq]
[q] ………… work by activating peroxisome proliferator-activated receptor alpha (PPAR-α), which leads to decreased hepatic VLDL production and increased lipoprotein lipase activity. Used in hypertriglyceridemia and cause myopathy (↑ risk with statins) and gallstones (↑ risk with bile acid resins) as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZpYnJhdGVzIChHZW1maWJyb3ppbCwgRmVub2ZpYnJhdGUpLg==
Cg==Cg==[Qq][q] ………. inhibits lipolysis (hormone sensitive lipase) in adipose tissue; reduces hepatic VLDL synthesis, results in –>↓ plasma VLD, ↓ plasma LDL, ↑↑ plasma HDL (↓ clearance). It causes flushing, warmth, itching (mediated by prostaglandins and can be prevented by aspirin), hyperglycemia, hyperuricemia as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5pY290aW5pYyBhY2lkICh2aXRhbWluIEIzKS4=
Cg==Cg==[Qq][q] ……….. works by preventing cholesterol absorption at small intestine brush border –> results in ↓ LDL and cause GIT upset as side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEV6ZXRpbWliZS4=
Cg==Cg==[Qq][q] …………… works by inactivation of LDL-receptor degradation → ↑ removal of LDL from bloodstream
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBDU0s5IGluaGliaXRvcnMgKEFsaXJvY3VtYWIsIGV2b2xvY3VtYWIpLg==
Cg==Cg==[Qq][q] ………….. works by moderate Na channel blockade preferentially in the open or activated state “state-dependent” blockade –> ↓ slope of phase 0 depolarization. It also blocks K channel (prolongs repolarization) –> ↑ AP duration, ↑ effective refractory period (ERP) in ventricular action potential, ↑ QT interval.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsYXNzIDFBIE5hIGNoYW5uZWwgYmxvY2tlciAoUXVpbmlkaW5lLCBQcm9jYWluYW1pZGUsIERpc29weXJhbWlkZSku[Qq]
[q] ……….. is Class 1A antiarrhythmic drug with antimuscrinic and alpha blocking effect. It cause cinchonism (GI, tinnitus, ocular dysfunction, CNS excitation), hypotension, prolongation of QRS and ↑ QT interval associated with syncope (torsades de pointes).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFF1aW5pZGluZS4=[Qq]
[q] ……….. is Class 1A antiarrhythmic drug with less antimuscrinic blocking effect and no alpha blockade effect. It causes systemic lupus erythematosus (SLE) like syndrome (30% incidence) more likely with slow acetylators; hematotoxicity (thrombocytopenia, agranulocytosis); CV effects (torsades).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]wqBQcm9jYWluYW1pZGUu[Qq]
[q] ……………… is a weak Na channel blocker and shortens the action potential (left shift). Preferentially affect hypoxic and ischemic tissues.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsYXNzIDFCIE5hIGNoYW5uZWwgYmxvY2tlciAoTGlkb2NhaW5lLCBNZXhpbGV0aW5lLCBQaGVueXRvaW4pLg==[Qq]
[q] …………. is a class 1B Na channel blocker that is used as IV because of its first-pass metabolism. It causes CNS toxicity (seizures) as side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]wqBMaWRvY2FpbmUu[Qq]
[q] …………. is a class 1B Na channel blocker that is similar to Lidocaine but can be taken orally.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1leGlsZXRpbmUu[Qq]
[q] ………. is a class 1B antiarrhythmic agent which very specifically binds rapidly depolarizing and depolarized cells, that’s why it is specific for ischemic tissue and is the agent of choice for prevention and treatment of post-myocardial infarction arrhythmias.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExpZG9jYWluZS4=[Qq]
[q] ……….. is a strong Na channel blocker. It bind avidly to the fast sodium channels responsible for phase 0 depolarization, blocking the inward sodium current and prolonging the QRS duration with no effect on AP duration.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsYXNzIDFDIE5hIGNoYW5uZWwgYmxvY2tlciAoRmxlY2FpbmlkZSBhbmQgcHJvcGFmZW5vbmUpLg==[Qq]
[q] ……………. are the slowest of the class 1 agents to dissociate from the sodium channel. This results in a phenomenon known as use-dependence, in which their sodium blocking effects intensify as the heart rate increases due to less time between action potentials for the medication to dissociate from the receptor.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsYXNzIDFDIE5hIGNoYW5uZWwgYmxvY2tlciAoRmxlY2FpbmlkZSBhbmQgcHJvcGFmZW5vbmUpLg==[Qq]
[q] ……………. is the last resort in refractory VT. Its limited use because of proarrhythmogenic effects, leading to ↑ in sudden death post-MI and when used prophylactically in VT.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZsZWNhaW5pZGUu
Cg==Cg==[Qq][q] ……….. decrease SA and AV nodal activity by ↓ cAMP, ↓ Ca currents. It also suppress abnormal pacemakers by ↓ slope of phase 4. Used for treatment of SVT, ventricular rate control for atrial fibrillation and atrial flutter. It causes impotence, exacerbation of COPD and asthma, cardiovascular side effects (bradycardia, AV block, HF), CNS side effects (sedation, sleep alterations).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IM6yLWJsb2NrZXJzIChjbGFzcyBJSSBBbnRpYXJyaHl0aG1pYyBEcnVncyku[Qq]
[q] …………. works by ↓ IK (delayed rectifier current) slowing phase 3 (repolarization) of AP, ↑ AP duration, ↑ ERP, and ↑ QT interval. Used for treatment of Atrial fibrillation, atrial flutter; ventricular tachycardia (amiodarone, sotalol).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBvdGFzc2l1bSBjaGFubmVsIGJsb2NrZXJzIChBbWlvZGFyb25lLCBJYnV0aWxpZGUsIERvZmV0aWxpZGUsIFNvdGFsb2wpLg==[Qq]
[q] ………… mimics classes I, II, III, and IV (blocks Na, Ca, K channels and beta adrenoreceptors). Used for treatment of almost any arrhythmias. It causes pulmonary fibrosis, thyroid dysfunction, and hepatic necrosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtaW9kYXJvbmUuIFJlbWVtYmVyIHRvIGNoZWNrIFBGVHMsIExGVHMsIGFuZCBURlRzIHdoZW4gdXNpbmcgYW1pb2Rhcm9uZS4=[Qq]
[q] …………. is the only class III antiarrhythmic with beta-adrenergic blocking abilities (causing mild bradycardia) as well as class III effects (causing the QT interval prolongation). It prolongs both the PR interval and the QT interval.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNvdGFsb2wu[Qq]
[q] ………….. block slow cardiac Ca channels by blocking the L-type calcium channels, thereby decreasing phase 0, phase 4 and conduction velocity in the sinoatrial and AV nodes. This leads to slowing of the sinus rate and conduction through the AV node.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhbGNpdW0gY2hhbm5lbCBibG9ja2VycyAoY2xhc3MgSVYpLg==[Qq]
[q] ………. is the DOC for paroxysmal supraventricular tachycardias and AV nodal arrhythmias. It acts by slowing conduction through the AV node by hyperpolarizing the nodal pacemaker (↑ K efflux) and conducting cells. It causes dyspnea (due to bronchospasm) as side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFkZW5vc2luZS4=[Qq]
[q] Adenosine is antagonized by ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG1ldGh5bHhhbnRoaW5lcyAodGhlb3BoeWxsaW5lIGFuZCBjYWZmZWluZSBhcmUgYWRlbm9zaW5lIHJlY2VwdG9yIGFudGFnb25pc3RzKS4=[Qq]
[q] ……….. is used for treatment of torsades de pointes and digoxin toxicity.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hZ25lc2l1bS4=[Qq]
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