Exam (elaborations)
NBME CBSE
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Exam of 26 pages for the course NBME CBSE at NBME CBSE (NBME CBSE)
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NBME CBSEBulbus cordis Correct Answer: Smooth parts (outflow tract) of left and right ventricles
endocardial cushions Correct Answer: Atrial septum, membranous interventricular septum; AV and
semilunar valves
neural crest
left horn of the sinus venosus Correct Answer: coronary sinus
posterior, sub cardinal, and supra cardinal veins Correct Answer: IVC
Right common cardinal vein and right anterior cardinal vein Correct Answer: SVC
Right horn of sinus venosus Correct Answer: Smooth part of right atrium (sinus venarum)
Patent foramen ovale Correct Answer: failure of septum primum and septum secundum to fuse after
birth
Transposition of the great vessels
Tetralogy of Fallot
Persistent truncus arteriosus Correct Answer: Conotruncal abnormalities associated with failure of
neural crest cells to migrate
ductus venosus Correct Answer: connects the umbilical vein to the inferior vena cava, bypassing the
liver
becomes ligamentum venosum
phrenic nerve Correct Answer: innervates the diaphragm and pericardium
S3 heart sound Correct Answer: Increased ventricular filling pressure (e.g., mitral regurgitation, HF),
common in dilated ventricles
normal in kids and pregnant women
S4 heart sound Correct Answer: atrial kick late diastole, right before S1
best heard at apex in LLD position
High atrial pressure.
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
,Always abnormal
atria contract Correct Answer: a wave of JVP
c wave Correct Answer: RV contraction (closed tricuspid valve bulging into atrium) wave of JVP
x descent Correct Answer: JVP wave corresponding to downward displacement of closed tricuspid valve
during rapid ventricular ejection phase
reduced or absent in tricuspid regurge
V wave Correct Answer: JVP wave corresponding to inc'd RA pressure due to filling against closed
tricuspid valve
y descent Correct Answer: JVP wave corresponding to RA emptying into RV
absent in cardiac tamponade
plusus parvus et tardus Correct Answer: pulses are weak with delayed peak
Aortic stenosis
PR interval Correct Answer: 0.12-0.20 seconds
120 milliseconds
QT interval length Correct Answer: 9 - 11 squares = .36 to .44 seconds
Hypokalemia Correct Answer: U wave present on ECG
Mg sulfate Correct Answer: for torsades de pointe, hypokalemia (can lengthen QT and cause torsades),
and pre-eclampsia (prevent seizures)
Romano-Ward syndrome Correct Answer: -Congenital long QT syndrome
-Autosomal dominant, pure cardiac phenotype (no deafness).
Jervell and Lange-Nielsen syndrome Correct Answer: -Congenital long QT syndrome
-Autosomal recessive, sensorineural deafness
Brugada syndrome Correct Answer: -Autosomal dominant disorder affecting Na channels most common
in Asian males.
-ECG pattern of pseudo-right bundle branch block and ST elevations in V1-V3 (anterior ventricular
septum)
-inc risk of ventricular tachyarrhythmias and sudden cardiac deatgh
Prevent SCD with implantable cardioverter-defibrillator (ICD).
, Wolff-Parkinson-White Syndrome Correct Answer: Most common type of ventriuclar pre-excitation
sydnrome. Abnormal fast accessory conduction pathway from atria to venricle bypasses the rate-slowing
AV node causing a delta wave and widening QRS with shortened PR interval. Could lead to a reentrant
circuit and suprvaventicular tachy.
First degree AV block Correct Answer: - PRI >5 boxes/.20 sec (200 msec)
- Fixed but prolonged PRI
(consistent but long)
- normally get bradycardia here
second degree AV block mobitz type 2 Correct Answer: -PR interval is constant
-atrial conduction to ventricle is intermittent: dropped QRS without increasing PR interval length
-disease below AV node in His bundle
may progress to 3rd degree/complete AV block
Second Degree AV Block Mobitz Type 1 (wenckebach) Correct Answer: Progressive lengthening of pr
interval leading to dropped QRS
third degree AV block Correct Answer: The atria and Ventricles are totally dissociated.
-So, the QRSs and the P waves have no relation to each other.
PCWP Correct Answer: 4-12 mmHg
est of LA pressure
Williams Syndrome Correct Answer: a genetic condition characterized by mental retardation in most
regards but surprisingly good use of language relative to their other abilities, elfin facies
Chromosome 7
assoc with supravalvular aortic stenosis
DiGeorge Syndrome Correct Answer: Maldevelopment of 3 and 4 pharyngeal pouches, fascial
dysmorphia, cardiac shunt (trunks arteriosus, tetralogy of Fallot), lack of T-cells, undeveloped paracortex
Corneal arcus Correct Answer: Lipid deposits in the cornea. Common in the elderly, but appears earlier
in life with hypercholesterolemia
Stanford A aortic dissection Correct Answer: Dissection of the ascending aorta
Tx with surgery
Stanford B aortic dissection Correct Answer: Dissection of the descending aorta below the level o the
left subclavian artery
Tx: Beta Blockers then vasodilators
Left bundle branch block Correct Answer: QRS> 120 msec
Deep, broad S waves in V1 and V2
Broad R waves in in V5 and V6
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