Cardiovascular

Question 1

On an ECG what does the p wave represent?

Answer 1

atrial depolarisation

Question 2

What does the PR interval represent?

Answer 2

AV node delay

Question 3

What does the QRS complex represent?

Answer 3

Ventricular depolarisation and atrial repolarisation

Question 4

What does the T wave represent?

Answer 4

Ventricular repolarisation

Question 5

What are the units of one BIG square on ECG paper?

Answer 5

x axis = 0.2 seconds
y = 0.5mV

Question 6

You’re given an ECG to interpret, where are the different heart areas on the ECG paper?

Answer 6

• aVF, II, III = Inferior = RCA
• V1-4 = Anteroseptal = LAD
• V5, 6, I, aVF = Lateral = LCx

Question 7

Where would you look for reciprocal changes on an ECG?

Answer 7

Lateral leads

Question 8

Haematocrit is made up of …

Answer 8

RBCs, WBCs, platelets, plasma

Question 9

What is the lifespan of a RBC?

Answer 9

120 days

Question 10

What is the lifespan of a WBC?

Answer 10

6-10 hours

Question 11

What is the lifespan of platelets?

Answer 11

7-10 days

Question 12

What are RBCs formed from?

Answer 12

erythropoetin

Question 13

What is the order of conduction in the cardiac cycle?

Answer 13

SAN > Bachman bundles > AVN > Bundles of His > Purkinje fibres

Question 14

What are the 1st and 2nd heart sounds?

Answer 14

HS1 = LUBB = AV valves shut
HS2 = DUBB = Aortic valves shut

Question 15

What is the 3rd heart sound?

Answer 15

• Normal in a young athlete
• Pathologic in mitral regurgitation or heart failure

From rapid ventricular filling

Question 16

What is the 4th heart sound?

Answer 16

Always pathological ‘gallop’ in LVH + HOCM

Question 17

Name the types of receptors in the cardiac system and what they do (peripheral and central)

Answer 17

Peripheral:
- Chemoreceptors detect decreased O2, raised CO2 and increased BP
- Baroreceptors detect BP increase and work to reduce it

Central:
- Medullary centres respond to peripheral receptors

Question 18

Are chemoreceptors sympathetic or parasympathetic?

Answer 18

Sympathetic

Question 19

Are baroreceptors sympathetic or parasympathetic?

Answer 19

Parasympathetic

Question 20

Where are peripheral receptos located (chemo and baro)?

Answer 20

Aortic arch and carotid sinus

Question 21

What is the equation for cardiac output?

Answer 21

CO = SV x HR

Question 22

What is the equation for mean arterial pressure?

Answer 22

MAP = CO x TRP

Question 23

Define contractility

Answer 23

how hard the heart contracts

Question 24

Define compliance

Answer 24

how readily the heart fills

Question 25

What is the Frank Starling curve / rule?

Answer 25

That an increase in blood volume in the heart (preload) prompts an immediate increase in stroke volume or pressure development

Question 26

What is the modified Duke criteria?

Answer 26

Used to diagnose infective endocarditis. A diagnosis requires either: - 1 major plus 3 minor criteria - 5 minor criteria

Question 27

What are the 2 major criteria in the Modified Dukes Criteria?

Answer 27

Major: - Persistently + blood cultures - Specific imaging findings (vegetation on ECHO)

Question 28

Name some minor criteria in the Modified Dukes Criteria

Answer 28

- Predisposition (e.g. IV drug use, heart valve pathology) - Fever above 38 - Vascular phenomena - Immunological phenomena - Microbiological phenomena

Question 29

Management of infective endocarditis

Answer 29

IV broad spectrum antibiotics (Amoxicillin and optional Gentamicin) 4 weeks with own / native heart valves 6 weeks if prosthetic valve

Question 30

Name 4 specific arrythmias that have a risk of asystole / cardiac arrest

Answer 30

- Mobitz type 2 - 3rd degree / complete heart block - Previous asystole - Ventricular pauses >3 seconds

Question 31

Name 3 cardiac enzymes

Answer 31

- CK-MB (creatine kinase) - AST (aspartate aminotransferase) - LDH (lactate dehydrogenase)

Question 32

Describe the levels of the 3 cardiac enzymes post-MI

Answer 32

- CK-MB increases from 3-6 hours post-MI and peaks at 18-24 hours, then decreases to normal in 2-3 days - AST - LDH