CVS patho

Question 1

Shunts in patients with intracardiac fistulas are detected and quantified by?

Answer 1

Echocardiography with doppler

Question 2

TOF is Caused by :

Answer 2

anterosuperior displacement of the infundibular septum

Question 3

differential cyanosis seen in? caused by?

Answer 3

Uncorrected PDA→ can eventually result in late cyanosis in the lower extremities, clubbing without pulse and BP discrepancy

Question 4

PDA closure:
Physiologic
Anatomic

Answer 4

Physiologic at 18-24 h

Anatomical: days to weeks

Question 5

Left to right intracardiac shunts can be identified by?

Answer 5

bubble study with echocaediography

Question 6

Complications of Coarctation of aorta include

Answer 6

1. HF,
2. ↑ risk of cerebral hemorrhage (berry aneurysms)
3. aortic rupture
4. possible endocarditis

Question 7

Williams syndrome Congenital heart defect

Answer 7

Supravalvular aortic stenosis

Question 8

22q 11 syndromes Congenital heart defect

Answer 8

1. Truncus arteriosus,

2. tetralogy of Fallot

Question 9

Marfan syndrome Congenital heart defect

Answer 9

1. MVP,
2. thoracic aortic aneurysm and dissection,
3. aortic regurgitation

Question 10

Young age, alternating areas of fibrotic web and aneurysmal dilation + lack of intima:

Answer 10

Fibromuscular dysplasia

Question 11

Isolated systolic HTN in which conditions?

Answer 11

1. Age
2. Aortic regurgitation
3. Anemia
4. Hyperhyroidism

Question 12

HTN nephrosclerosis will cause ↑ EPO or ↓ EPO production?

Answer 12

↓ EPO → Anemia

Question 13

What is use of Diuretic in chronic lymphedema?

Answer 13

Contraindicated as it cause intravascular volume depletion which is already depleted → AKI

Question 14

Needle shaped clefts in arterioles:

organs affected?

Answer 14

Atheroembolization

GIT, SKIN, CNS, Renal

Question 15

Total coronary artery Ca content correlates with:

Ca scoring by cardiac CT scan is used to ____

Answer 15

total atherosclerotic plaque burden

estimate the severity of coronary artery disease

Question 16

Abdominal aortic aneurysm underlying pathology:

Answer 16

↑ inflammatory infilterates and ROS formation by smoke:

1. Transmural inflammation of aortic wall
2. Apoptosis of vascular smooth muscles
3. Degradation of extracellular matrix proteins (elastin and collagen) by metalloproteinases

Question 17

Painful pulsatile mass + Systemic signs (fever, malaise)

Answer 17

Mycotic aneurysm : Septic emboli or bacteremic seeding

Question 18

Aortic dissection trigger:

Associations:

Answer 18

Longitudinal intimal tear

(HTN, bicuspid aortic valve, Marfan syndrome)→ Risk factors of TAA

Question 19

SCD can be prevented by

Answer 19

Implantable cardioverter-defibrillator

Question 20

Lightening strike ► Death within 1 hours due to?
1.
2.

Type of burn

ANS damage leads to

Answer 20

1. Cardiac arrythmias
2. Respiratory failure

Superficial burn

Fixed dilated pupil

Question 21

Skin lesion in lightening strike

Answer 21

Lichtenberg figure (erythmatous cutaneous marks in a fern-leaf pattern)

Question 22

Stable angina pharmacotherapy used for stress test?

Results?

Answer 22

Dobutamine

Supply demand mismatch → transient ↓ in contractility → ↓EF

Question 23

Loss of cardiac myocytes contractility occurs with in ______ after total ischemia

Answer 23

60sec

Question 24

After 30 mins half of ____ stores are depleted and complete deletion of _______

Answer 24

Adenosine

Myocardial glycogen

Question 25

Histology 1-3 days after MI 3-14 days

Answer 25

1-3 days: neutrophils 3-7 days Macrophages 10-12 days prominent granulation tissue with neovascularization

Question 26

Normally R>S waves seen by lead ____ Poor R wave progression is seen in _____

Answer 26

V3 Anterior ischemia

Question 27

Transmural ischemia of septum (V1 V2) results in

Answer 27

Infranodal (mobitz type 2) 2nd degree heart block or 3rd degree heart block. But sinus bradycardia donot occur

Question 28

Gold standard for MI diagnosis in first 6 hours More specific Reinfarction

Answer 28

ECG Troponin I 4. 24. 7-10 days CK-MB 6-12. 16-24. 48h

Question 29

Drugs avoided in inferior wall MI

Answer 29

Beta blocker | nitrates

Question 30

myocardial infarction complication with time

Answer 30

``` 1-3 pericarditis 2-7 papillary muscle rupture 3-5 septum 5-14 free wall 3-14 pseudo aneu >14 true aneu ```

Question 31

Dilated cardiomyopathy treatment

Answer 31

ABDD | Na+ restriction, ACE inhibitors, ~-blockers, diuretics, digoxin, ICD, heart transplant.

Question 32

Physiology of HOCM-

Answer 32

asymmetric septaI hypertrophy and systolic anterior motion of mitral valve

Question 33

peripartum cardiomyopathy (during last month of pregnancy and 5 months after delivery) related to impaired function of______

Answer 33

angiogenic growth factor (VEGF) during peripartum period

Question 34

Cardiac amyloidosis is impaired diastolic filling due to_______ rather than _______

Answer 34

stiffening..........thickening only slight increase in thickness but LV cavity size remains normal

Question 35

Familial DCM: truncating mutation in _____ gene which encode for cardiac_____

Answer 35

TTN..............sacromere protein TITIN

Question 36

Ventricular Hypertrophy ECG:

Answer 36

High voltage ECG large S wave in V1 V2 and large R wave in V5, V6

Question 37

Endocardial fibroelastosis

Answer 37

(thick fibroelastic tissue in endocardium of young children), Restrictive/infiltrative cardiomyopathy

Question 38

Loffler endocarditis-

Answer 38

associated with hypereosinophilic syndrome; histology shows eosinophilic infiltrates in myocardium

Question 39

A patient with HF also has renal failure/ ↑K+, which drug should be avoided?

Answer 39

Mineralocorticoid receptor antagonist

Question 40

HFrEF contraindicated drug?

Answer 40

Non-DHP CCB

Question 41

Drugs improving mortality in HFrEF

Answer 41

HI-ABDs Sacubitril-valsartan

Question 42

Moderate to severe hypothermia (<32'C) can produce hypotension due to

Answer 42

bradycardia

Question 43

Of all the congenital heart defects _____ is not associated with ↑ risk of Infective endocarditis

Answer 43

ASD

Question 44

Isotonic fluids

Answer 44

Crystalloid: 0.9% N/S, R/L Colloid: Albumin (5% or 25%) → treatment of SBP, HRS

Question 45

Infective endoarditis cause which type of glomerulonephritis?

Answer 45

Diffuse proliferative glomerulonephritis

Question 46

Causes of nonbacterial (marantic/thrombotic) endocarditis:

Answer 46

malignancy (mucinous adenocarcinoma), hypercoagulable state, or lupus. less common causes: Burns, Antiphospholipid syndrome, DIC

Question 47

Infective endocarditis is rarely caused by _______ organisms

Answer 47

gram -ve, endotoxin producing

Question 48

Pericardial knock is heard in:

Answer 48

early diastole just after S2, even earlier than S3