Review Stuff

Question 1

• AV nodal artery? SA?
• Channels: Transmembrane segments? Domains? + AA sensing region?
• Refractory of SA vs AV nodal cells?
• B1 acts on? M2 acts on? Effect of acting on a? B1? B2?
• Physio splitting?
• Patho splitting?
• Clicks due to?
• Early peak in diamond murmur?
• Early diastolic murmurs? Mid to late diastolic?

Answer 1

• RCA; LCX
• 6 transmembrane; 4 domains; 4 with AA
• SA is shorter
• Gs (Incr cAMP acts on If; increased PKA inotropy); Gi; a = vasocontrict; B1 = Increased ino; B2 = Vasodilate
• High thoracic pressure delays closure of pulmonic
• Aortic/pulmonic stenosis
• Stenosis or prolapse
• Early peak means less severe
• AR/PR; MS/TS

Question 2

• Decreased CO with HF leads to? (3)
• Venous vasodil leads to? Arterial vasodil leads to?
• HOCM: Don’t treat with? Why? Use what?
• Effect of valsalva in general? With HOCM?
• Restrictive systemic pressure? Pulmonic?
• Channels hyperpolarizing cell? Depol?
• EAD vs DAD?
• WPW Syndrome?

Answer 2

1. ) SNS (increased Ino, VC, Incr. HR)
2. ) RAAS (Incr. volume, VC)
3. ) ADH (Incr. volume)
   - Increased pre; increased post
   - Inotropes or vasodilators; small LV; BB
   - Decr. venous return and LV size; Makes murmur worse (opposite of AS murmur)
   - Higher; higher
   - Na/K pump; If HCN
   - Phase 2 due to Ca; phase 3 due to Na; phase 4 due to NCX (DAD)
   - Accessory pathway bypasses AV to ventricles

Question 3

• Junctional escape rhythm?
• Ventricular escape rhythm?
• PE sign?
• Tomponade sign?
• Digoxin effect?
• Effect of dopamine? Dobutamine? NE? E? Iso? Milirone?
• Hydralizine AA drug effect?

Answer 3

• Normal QRS but no P; Impulse below atria; Brady
• Wide QRS; ventricles depolarizing without conduction system
• Alternans
• Pulsus paradoxis (no pulse with breath)
• Increase IC calcium and increase vagal
• Draw out
• Arterial and venous vasodilation