Notes in 01 Cardiac Pathophysiology and Congenital Heart Disease

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Published	10/10/2023	Blood flows from the left atrium to the left ventricle through the {{c1::mitral (bicuspid)}} valve
Published	10/10/2023	Blood flows from the left ventricle to the {{c1::aorta}} through the {{c2::aortic}} valve
Published	10/10/2023	What effect does increased heart rate have on cardiac contractility?{{c1::Increased contractility (to an extent)}}
Published	10/10/2023	What effect does decreased heart rate have on cardiac contractility?{{c1::Decreased contractility}}
Published	10/10/2023	Cardiac {{c2::contractility}} can be estimated by the left ventricular {{c1::ejection fraction}}
Published	10/10/2023	What equation is used to calculate cardiac output given a patients stroke volume and heart rate?{{c1::CO = SV x HR}}
Published	10/10/2023	The Frank-Starling relationship states that the force of {{c1::contraction}} is proportional to the {{c2::end-diastolic length}} of the cardiac muscle…
Published	10/10/2023	Increases in contractility cause the Starling curve to shift {{c1::upward}}
Published	10/10/2023	Decreases in contractility (e.g. heart failure) cause the Starling curve to shift {{c1::downward}}
Published	10/10/2023	Exercise causes the Starling curve to shift {{c1::upward}}
Published	10/10/2023	The {{c2::width}} of a pressure-volume loop is the {{c1::stroke volume}}
Published	10/10/2023	Preload is approximated by ventricular {{c1::end-diastolic volume (EDV)}}
Published	10/10/2023	Afterload is approximated by {{c1::mean arterial pressure}}
Published	10/10/2023	Increased {{c2::preload}} results in a(n) {{c1::increased}} width on a pressure-volume loop curve
Published	10/10/2023	Increased {{c2::afterload}} results in a(n) {{c1::decreased}} width and {{c1::increased}} height on a pressure-volume loop curve
Published	10/10/2023	Increased {{c2::contractility}} results in a(n) {{c1::increased}} width and {{c1::increased}} height on a pressure-volume loop curve
Published	10/10/2023	What effect does increased preload have on stroke volume? {{c1::Increased SV}}
Published	10/10/2023	What effect does increased afterload have on stroke volume? {{c1::Decreased SV}}
Published	10/10/2023	What effect does increased afterload have on end-systolic volume? {{c1::Increased ESV}}
Published	10/10/2023	What effect does increased contractility have on end-systolic volume? {{c1::Decreased ESV}}
Published	10/10/2023	What effect does increased contractility have on stroke volume? {{c1::Increased SV}}
Published	10/10/2023	What effect does increased preload have on ejection fraction? {{c1::Increased EF}}
Published	10/10/2023	According to the law of Laplace, cardiac wall stress = {{c1::P*r / 2H}}
Published	10/16/2023	The reasons there is concentric left ventricular hypertrophy in response to systemic hypertension is that {{c1::increased::increased/decreased}} wall …
Published	10/10/2023	The left ventricle compensates for increased afterload by {{c1::thickening (hypertrophy)}} in order to decrease wall tension
Published	10/10/2023	What effect does increased aortic pressure (afterload) have on cardiac wall stress?{{c1::Increased wall stress}}
Published	10/10/2023	The {{c2::cardiac}} function curve is a plot of the relationship between {{c1::cardiac output}} of the left ventricle and {{c1::pressure}} of the righ…
Published	10/10/2023	The {{c2::vascular}} function curve is a plot of the relationship between {{c1::pressure}} of the right atrium and {{c1::venous return}}
Published	10/10/2023	The slope of the vascular function curve is determined primarily by {{c1::total peripheral resistance (TPR)}}
Published	10/10/2023	An increased blood volume (or venous tone) causes the cardiac output to {{c1::increase}} and right atrial pressure to {{c1::increase}}
Published	10/10/2023	A decreased blood volume (or venous tone) causes the cardiac output to {{c1::decrease}} and right atrial pressure to {{c1::decrease}}
Published	10/10/2023	An increased TPR causes the cardiac output to {{c1::decrease}} and venous return to {{c1::decrease}}
Published	10/10/2023	A decreased TPR causes the cardiac output to {{c1::increase}} and venous return to {{c1::increase}}
Published	10/10/2023	How does increased efferent sympathetic firing (e.g. baroreceptor reflex) affect contractility?{{c1::Increased contractility}}
Published	10/10/2023	How does increased efferent sympathetic firing (e.g. baroreceptor reflex) affect TPR?{{c1::Increased TPR (via increased arteriolar vasoconstriction)}}
Published	10/10/2023	How does exercise affect total peripheral resistance? {{c1::Decreased TPR}}
Published	10/10/2023	{{c1::Fixed}} splitting is a delayed pulmonic sound, regardless of inspiration
Published	10/10/2023	What pathology is associated with fixed splitting?{{c1::Atrial septal defect (ASD)}}
Published	10/10/2023	Does a ventricular septal defect cause a systolic or diastolic murmur?{{c1::Holo-systolic}}
Published	10/10/2023	Where is a murmur due to ventricular septal defect the loudest? {{c1::Tricuspid area}}
Published	10/10/2023	A continuous, machine-like murmur is indicative of what pathology? {{c1::Patent ductus arteriosus}}
Published	10/10/2023	A murmur due to patent ductus arteriosus is loudest at which heart sound? {{c1::S2}}
Published	10/10/2023	Where is a murmur due to atrial septal defect the loudest? {{c1::Pulmonic Area}}
Published	10/10/2023	Uncorrected left-to-right shunting eventually results in reversal, which presents with late {{c1::cyanosis}} ({{c2::Eisenmenger}} syndrome)
Published	10/10/2023	Eisenmenger syndrome is characterized by a triad of {{c1::late cyanosis}}, {{c2::clubbing}}, and {{c3::polycythemia}}
Published	10/10/2023	Compared to right-to-left shunts, left-to-right shunts lead to cyanosis at a(n) {{c1::later}} age
Published	10/10/2023	Compared to left-to-right shunts, right-to-left shunts lead to cyanosis at a(n) {{c1::earlier}} age
Published	10/10/2023	What is the most common congenital heart defect? {{c1::Ventricular Septal Defect (VSD)}}
Published	10/10/2023	Ventricular septal defect (VSD) is associated with {{c1::fetal alcohol}} syndrome
Published	10/10/2023	Smaller ventricular septal defects are often {{c1::asymptomatic}} and may close spontaneously, but on physical exam will present with a(n) {{c2::murmu…
Published	10/10/2023	What symptoms does ventricular septal defect typically present with at birth?{{c1::Typically asymptomatic}}
Published	10/10/2023	What is the most common type of Atrial Septal Defect (ASD)?{{c1::Ostium secundum (90%)}}
Published	10/10/2023	Ostium {{c1::primum}} is a less common type of atrial septal defect that is associated with {{c2::Down}} syndrome
Published	10/10/2023	What effect does atrial septal defect (ASD) have on S2 splitting? {{c1::Causes a wide, fixed split}}
Published	10/10/2023	{{c1::Paradoxical}} emboli, an important complication of atrial septal defect, are emboli that arise on the right-side of the body and crossover to lo…
Published	10/10/2023	Patent ductus arteriosus is associated with congenital {{c1::rubella}} infection
Published	10/10/2023	In the fetal period, the ductus arteriosus acts as a(n) {{c1::right}}-to-{{c1::left}} shunt
Published	10/10/2023	In the neonatal period, a patent ductus arteriosus becomes a(n) {{c1::left}}-to-{{c1::right}} shunt as pulmonary vascular resistance decreases
Published	10/10/2023	Patency of a patent ductus arteriosus is maintained by {{c1::PGE}} synthesis and low O2 tension
Published	10/10/2023	Uncorrected patent ductus arteriosus may eventually result in late cyanosis in the {{c1::lower}} extremities
Published	10/10/2023	Treatment of a patent ductus arteriosus involves {{c1::indomethacin}}, which decreases PGE, resulting in PDA closure
Published	10/10/2023	{{c1::Tetralogy of Fallot}} is a congenital heart disease that is characterized by: 1. {{c2::Pulmonary infundibular stenosis}} 2. {{c3::Right ventricu…
Published	10/10/2023	Tetralogy of Fallot results in a(n) {{c1::right}}-to-{{c1::left}} shunt with {{c2::early}} cyanosis
Published	10/10/2023	The degree of shunting in Tetralogy of Fallot is determined by the degree of {{c1::right ventricular outflow tract obstruction (from pulmonary stenosi…
Published	10/10/2023	{{c2::Tetralogy of Fallot}} is characterized by a(n) {{c1::boot}}-shaped heart on CXR
Published	10/10/2023	Patients with Tetralogy of Fallot often experience "{{c1::tet}} spells" which may be caused by crying, fever, and exercise due to exacerbation of RV o…
Published	10/10/2023	Patients with Tetralogy of Fallot may {{c1::squat}} in response to cyanotic spells, which decreases right-to-left shunting by increasing {{c2::systemi…
Published	10/10/2023	What is the most common congenital heart defect that causes early cyanosis?{{c1::Tetralogy of Fallot}}
Published	10/10/2023	Tetralogy of Fallot is caused by {{c1::anterosuperior}} displacement of the infundibular septum
Published	10/10/2023	{{c3::D-transposition of the great vessels}} is characterized by the {{c1::pulmonary artery}} arising from the left ventricle and {{c1::aorta}} from t…
Published	10/10/2023	D-transposition of great vessels is not compatible with life unless a(n) {{c1::shunt}} is created
Published	10/10/2023	D-transposition of great vessels is due to failure of the {{c1::aorticopulmonary septum}} to spiral
Published	10/10/2023	D-transposition of great vessels results in {{c1::hypertrophy}} of the right ventricle and {{c1::atrophy}} of the left ventricle
Published	10/10/2023	D-transposition of great vessels is an example of a(n) {{c1::right}}-to-{{c1::left}} shunt
Published	10/10/2023	{{c1::Persistent truncus arteriosus}} is a congenital heart disease characterized by a single large vessel arising from both ventricles before eventua…
Published	10/10/2023	Truncus arteriosus is an example of a(n) {{c1::right}}-to-{{c1::left}} shunt
Published	10/10/2023	Most patients with truncus arteriosus have accompanying {{c1::ventricular septal}} defect
Published	10/10/2023	{{c1::Tricuspid atresia}} is the failure of the tricuspid valve orifice to develop
Published	10/10/2023	Tricuspid atresia leads to right ventricle {{c1::hypoplasia}}
Published	10/10/2023	Tricuspid atresia requires both {{c1::ASD}} and {{c1::VSD}} for viability
Published	10/10/2023	Tricuspid atresia is an example of a(n) {{c1::right}}-to-{{c1::left}} shunt
Published	10/10/2023	{{c1::Coarctation of the aorta}} is the narrowing of the aorta near the insertion of the ductus arteriosus
Published	10/10/2023	The {{c2::infantile}} form of coarctation of the aorta is associated with a(n) {{c1::PDA}}
Published	10/10/2023	In the infantile form, coarctation of the aorta lies {{c1::after}} the aortic arch, but {{c1::before}} the PDA
Published	10/10/2023	Coarctation of the aorta in infants presents as {{c1::lower}} extremity cyanosis, often at birth
Published	10/10/2023	The infantile form of coarctation of the aorta is associated with {{c1::Turner}} syndrome
Published	10/10/2023	In the adult form, coarctation of the aorta lies {{c2::after}} the aortic arch
Published	10/10/2023	Coarctation of the aorta in adults presents as {{c1::hypertension}} in the upper extremities and {{c1::hypotension}} in the lower extremities
Published	10/10/2023	In the adult form of coarctation of the aorta, collateral circulation develops most notably across the {{c1::intercostal}} arteries
Published	10/10/2023	What X-ray finding is associated with the adult form of coarctation of the aorta? {{c1::'Notching' of ribs (due to engorged intercostal arteries)}}
Published	10/10/2023	Coarctation of the aorta is associated with a(n) {{c1::bicuspid}} aortic valve and an increased risk of developing {{c2::berry}} aneurysms
Published	10/10/2023	{{c1::Total anomalous pulmonary venous return (TAPVR)}} is a congenital heart disease characterized by drainage of pulmonary veins into the right circ…
Published	10/10/2023	Total anomalous pulmonary venous return (TAPVR) is associated with {{c1::ASD}} and sometimes PDA to allow for right-to-left shunting
Published	10/10/2023	Aortic {{c2::stenosis}} may lead to {{c1::concentric::con/e-centric}} left ventricular hypertrophy, which can further progress to heart failure
Published	10/10/2023	ACE inhibitors and ARBs {{c1::decrease}} both preload and afterload
Published	10/10/2023	What is the effect of dilated cardiomyopathy on contractility?{{c1::Decreased (systolic dysfunction)}}
Published	10/10/2023	Where is a murmur due to patent ductus arteriosus best heard?{{c1::Left infraclavicular area}}
Published	10/10/2023	{{c1::Ventricular}} septal defect leads to an increased O2 saturation in the {{c2::RV}} and {{c2::pulmonary artery}}
Published	10/10/2023	{{c1::Atrial}} septal defect leads to an increased O2 saturation in the {{c2::RA}}, RV and pulmonary artery
Published	10/10/2023	How do PCWP and preload change during hypovolemic shock?{{c1::Severely decreased}}
Published	10/10/2023	How do SVR and afterload change during hypovolemic shock?{{c1::Increased}}
Published	10/10/2023	How do PCWP and preload change during cardiogenic and obstructive shock?{{c1::Increased or decreased}}
Published	10/10/2023	How do SVR and afterload change during cardiogenic and obstructive shock?{{c1::Increased}}
Published	10/10/2023	How do PCWP and preload change during distributive shock?{{c1::Decreased}}
Published	10/10/2023	How do SVR and afterload change during distributive shock?{{c1::Severely decreased}}
Published	10/10/2023	Outflow tracts from the heart are formed by migrations of {{c1::neural crest}} and {{c2::endocardial}} cells, which spiral and fuse to form the {{c3::…
Published	10/10/2023	Closure of the ductus arteriosus occurs in response to increased {{c1::O2}} and decreased {{c2::PGE}} (from respiration and placental separation, resp…
Published	10/10/2023	Rank the following from highest to lowest prevalence: ASD, PDA, VSD{{c1::VSD > ASD > PDA}}
Published	10/10/2023	Persistent Truncus Arteriosus is due to failure of {{c1::neural crest}} cells to drive formation of the aorticopulmonary septum
Published	10/10/2023	Which congenital cardiovascular defects are associated with 22q11 syndrome?{{c1::Truncus arteriosus & Tetralogy of Fallot::2}}
Published	10/10/2023	The 5 T's of Right-to-Left Shunts:1. {{c1::Truncus Arteriosus::1 vessel}}2. {{c2::Transposition::2 switched vessels}}3. {{c3::Tricuspid atresia::3 = T…
Published	10/10/2023	Pulmonary Atresia often co-exists with {{c1::VSD}} for outflow of RV
Published	10/10/2023	In acute mitral regurgitation, how do the following change?- Preload = {{c1::significantly increase}}- Afterload = {{c1::decrease}}- Ejection fraction…
Published	10/10/2023	In the normal heart, the aorta is {{c2::posterior}} and to the {{c2::right}} of the pulmonary artery; whereas in D-transposition of the great vessels,…
Published	10/10/2023	How does Aortic Stenosis affect LV EDP and PCWP?{{c1::Both are increased}}
Published	10/10/2023	Patients with patent ductus arteriosus can be predisposed to {{c1::respiratory tract}} infections
Published	10/10/2023	Chronic hypertension causes the left ventricle to undergo {{c1::concentric::eccentric/concentric}} hypertrophy due to increased {{c2::afterload}} on t…
Published	10/10/2023	Patients with severe aortic stenosis depend upon {{c1::atrial contraction}} for maintenance of preload
Published	10/10/2023	Eisenmenger Syndrome leads to a decreased O2 saturation in the {{c1::LV}}
Published	10/10/2023	AV shunts {{c1::increase}} preload and {{c1::decrease}} afterload
Published	10/10/2023	Fetal alcohol syndrome and DiGeorge syndrome may predispose to {{c1::Tetralogy of Fallot::which primary immunodeficiency?}}
Published	10/10/2023	Hypertrophic cardiomyopathy is characterized by {{c1::↑::↑↓}} LV mass {{c1::↓::↑↓}} LV cavity size, and {{c1::preserved:…
Published	10/10/2023	Chronic hypertension and valvular stenosis cause diastolic heart failure by increasing {{c1::afterload}}
Published	10/10/2023	Systolic heart failure presents with {{c1::increased}} preload*bonus: why?
Published	10/10/2023	In chronic mitral regurgitation (compensated), how do the following change?- forward stroke volume = {{c1::no change}}- afterload = {{c…
Published	10/10/2023	After closure of a PDA, severe {{c1::coarctation of the aorta::congenital heart disease}} may cause heart failure and shock
Published	10/10/2023	Coarctation of the aorta may cause upper extremity hypertension and aortic {{c1::dissection}}
Published	10/10/2023	What congenital heart disease may present with lower extremity claudication?{{c1::Coarctation of the aorta}}
Published	10/10/2023	The cardiac silhouette of transposition of great vessels looks like an "{{c1::egg on a string}}" on CXR
Published	10/10/2023	TAPVR causes a dilated {{c1::right}} atrium and ventricle
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