授業内クイズ

in a patient with WPW syndrome, what EKG abnormality can be seen?

shortened PR interval and delta wave

when does most of myocardial perfusion occur?

diastole

the heart is located in the ( ) of the thoracic cavity

middle

the superior border of the heart is the same height as the…

sternal angle

the heart is located in the ( ) mediastinum

middle

the heart is surrounded by pericardium which can be divided into…

fibrous and serous pericardium

in CPR, the hands should be placed on…

lower half of the sternum

the base of the heart is the ( ) surface of the heart

posterior

the ( ) has the thickest myocardium in the heart

left ventricle

which valves have 3 cusps?

aortic, tricuspid, pulmonary

how many times does the heart contract in a day?

80k

what is the average stroke volume?

60-100

how do we calculate the maximum HR of a person?

220-age

what is frank-starling’s law?

the more stress you give, the more the heart works

how will a cardiac pressure curve change if someone has aortic stenosis?

aortic pressure during systole will have a greater curve

what two things cause edema?

increased interstitial fluid and decreased interstitial fluid drainage

a patient with MI and dyspnea has edema. what is the mechanism of edema in this case?

increased interstitial oncotic pressure or increased capillary pressure

a patient with nephrotic syndrome has edema. what is the mechanism of edema in this case?

decreased plasma oncotic pressure

what is the final destination of lymphatic fluid in the drainage system

venous angle

in order to maintain adequate blood flow, the body must maintain at least a systolic BP of….

80mmHg

what types of tests are done to diagnose hypertension?

blood test, fundoscopy, neurological exam, EKG, echocardiography, chest X-ray, etc.

what are the 2 major side effects of ACEi?

dry cough and angioedema

in early stages of sepsis, cardiac output is…

increased

what is the normal CTR range?

under 50%

what is the 5 year survival rate of heart failure?

50%

what is the 10 year survival rate of heartfailure

10%

explain each stage of ACC/AHA

A: at a high risk of heart failure but no symptoms

B: structural problems but no symptoms

C: structural problems and prior/current symtpoms of HF

D: refractory (unmanageable) HF that requires special treatment

another way to say end-diastolic volume is…

preload

acetylcholine binds to what receptor?

muscarinic receptor

in chronic heart failure, which receptors are reduced in function?

atrial baroreceptors

explain ejection fraction

amount of blood pumped out of the ventricle / total amount of blood in ventricle

what causes heart failure with a preserved ejection fraction (HFpEF)?

hypertension

congestive hepatomegaly due to right-sided backward heart failure is accompanied by elevated serum levels of…

hepatic enzymes

BNP indicates….

hypertrophy

troponin indicates…

necrosis

patients with ( ) will have lower than expected BNP

cardiac tamponade / obesity

pacemakers are needed if a person has symptoms due to…

abnormally slow heart rate

4 risk factors of atherosclerosis

hypertension, high cholesterol, diabetes, smoking

in transmural ischemia, ST ( ) is observed

elevation

in subendocardial ischemia, ST ( ) is observed

depression

if you suspect a patient has acute coronary syndrome, DO NOT administer a ( ) test

stress/treadmill

what are some ways to make a heart murmur louder in hypertrophic obstructive cardiomyopathy?

valsalva, nitroglycerin, diuretics, physical activity

( )% of babies have congenital heart disease.

1

what vessel is most commonly used as grafts for CABG?

internal thoracic artery

in which weeks is the embryo most sensitive to teratogens?

3-8

( ) is the most common congenital heart malformation

ventricular septal defect

BNP is a vaso( ).

dilator

Norepinephrine increases 3 things, which are…

peripheral vascular resistance, HR, and contractility

when we suspect infective endocarditis, what are the 3 tests to make sure?

blood sample, blood culture, echocardiography

chest x ray findings of heart failure

cardiomegaly, kerly lines, blunting of CP angle

a treatment where the patient with chronic heart failure who cannot exercise goes into a warm room for vasoldilation is called…

waon therapy

4 signs of infective endocarditis

janeway lesions

osler nodes

splinter hemmorhage

roth spot

3 methods to treat stable angina

statin, aspirin, beta blocker

treatment for MI?

PCI

a mosaic patter in the echocardiography represents…

regurgitation

which type of aortic dissection requires emergency surgery?

Stamford type A

PAD (peripheral arterial disease) can cause leg pain only when walking, which is called…

claudication

initial treatment of PAD?

exercise therapy

initial treatment for PE?

heparin

jugular venous distention can reflect ( ) pressure

right atrial

what are the 3 main coronary arteries?

Right coronary, left circumflex, left anterior descending

stable angina can be confirmed with a ( ) test

stress

variant angina can be confirmed with….

holter EKG

2 drugs that improve symtpoms due to LV obstruction

beta blockers and calcium channel blockers

secondary hypertension are conditions caused by…

non-age related factors

3 symtpoms of right backward HF

ascites, perohperal edema, right upper quadrant pain, hepatomegaly

6 risk factors of aneurysm

hypertension, high cholesterol, marfan syndrome, smoking, infection, trauma

increase in ( ) can decrease blood flow

viscosity

the tendency for turbulent flow is the greatest in the ( )

aorta

MAP can be calculated by

1/3 (pulse pressure) + diastolic pressure

loop diuretics reduce ( ) in blood

K, Na, Cl, Mg, Ca

thiazides reduce ( ) in blood

Na, Cl

HFpEF is most common in..

old women

myocardial infarction leads to ( ) HF

systolic

mitral regurgitation leads to ( ) HF

systolic

3 echocardiographic parameters of diastolic function

deceleration time of LV transmitral flow pattern

E/A ratio

LA diameter

circulating levels of ( ) maybe underestimated in obese patients

BNP and NT-proBNP

nitriuretic peptides reflect…

heart failure

ANP is stored in granuales as a ( ) before secretion

prohormone

( ) is increased in pulmonary disorders with RV overload

BNP

alpha 1 adrenergic receptors are for…

vasoconstriction

isoproterenol binds to what receptor?

beta

organic nitrates use ( ) as a second messanger

cGMP

thiazides act on what part of the nephron?

distal tubule

3 drugs that reduce mortality rate of HFrEF

bradykinin increases after taking ( ) which leads to coughing

ACEi

individuals with central sleep apnea exhibit increased ( ) activity

sympathetic

in a patient with HFrEF, the severity of ( ) is associates with the risk of cardiac death

sleep apnea

( ) therapy improves cardiac systolic function and reduces sympathetic nerve activity in patients with sleep apnea

positive airway pressure

what are the 3 components to virchow’s triad

hemostasis, endothelial damage, increase in coagulation factors

4 symtpoms of DVT/PE

redness in one leg,

dyspnea,

chest pain

bloody sputum

what type of shunt causes cyanosis right after birth?

right to left

which ion concentration gradient is the greatest during heart muscle excitement?

calcium

ventricular contractions begin at the ( ) of QRS complex

end

cardiac output ( ) as blood pressure increases

decreases

1st right arch represents…

SVC

2nd right arch represents…

right atrium

1st left arch represents

aortic arch

2nd left arch represents

pulmonary artery

3rd left arch represents

left atrial appendage