NBME CBSE REAL EXAM 200+ QUESTIONS AND ANSWERS LATEST (usmle step
1)MEDICAL EXAMINATION
Bulbus cordis
Smooth parts (outflow tract) of left and right ventricles
endocardial cushions
Atrial septum, membranous interventricular septum; AV and semilunar valves
neural crest
6 Ways to Show Appreciation for Your Child's Teacher
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:06
/
0:54
Full screen
left horn of the sinus venosus
coronary sinus
posterior, sub cardinal, and supra cardinal veins
IVC
Right common cardinal vein and right anterior cardinal vein
SVC
Right horn of sinus venosus
Smooth part of right atrium (sinus venarum)
Patent foramen ovale
failure of septum primum and septum secundum to fuse after birth
Transposition of the great vessels
Tetralogy of Fallot
Persistent truncus arteriosus
Conotruncal abnormalities associated with failure of neural crest cells to migrate
,ductus venosus
connects the umbilical vein to the inferior vena cava, bypassing the liver
becomes ligamentum venosum
phrenic nerve
innervates the diaphragm and pericardium
S3 heart sound
Increased ventricular filling pressure (e.g., mitral regurgitation, HF), common in dilated
ventricles
normal in kids and pregnant women
S4 heart sound
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
a wave of JVP
c wave
RV contraction (closed tricuspid valve bulging into atrium) wave of JVP
x descent
JVP wave corresponding to downward displacement of closed tricuspid valve during rapid
ventricular ejection phase
reduced or absent in tricuspid regurge
V wave
JVP wave corresponding to inc'd RA pressure due to filling against closed tricuspid valve
,y descent
JVP wave corresponding to RA emptying into RV
absent in cardiac tamponade
plusus parvus et tardus
pulses are weak with delayed peak
Aortic stenosis
PR interval
0.12-0.20 seconds
120 milliseconds
QT interval length
9 - 11 squares = .36 to .44 seconds
Hypokalemia
U wave present on ECG
Mg sulfate
for torsades de pointe, hypokalemia (can lengthen QT and cause torsades), and
pre-eclampsia (prevent seizures)
Romano-Ward syndrome
-Congenital long QT syndrome
-Autosomal dominant, pure cardiac phenotype (no deafness).
Jervell and Lange-Nielsen syndrome
-Congenital long QT syndrome
-Autosomal recessive, sensorineural deafness
Brugada syndrome
-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
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
- 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
-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)
Progressive lengthening of pr interval leading to dropped QRS
third degree AV block
The atria and Ventricles are totally dissociated.
-So, the QRSs and the P waves have no relation to each other.
PCWP
4-12 mmHg
est of LA pressure
Williams Syndrome
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
1)MEDICAL EXAMINATION
Bulbus cordis
Smooth parts (outflow tract) of left and right ventricles
endocardial cushions
Atrial septum, membranous interventricular septum; AV and semilunar valves
neural crest
6 Ways to Show Appreciation for Your Child's Teacher
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:06
/
0:54
Full screen
left horn of the sinus venosus
coronary sinus
posterior, sub cardinal, and supra cardinal veins
IVC
Right common cardinal vein and right anterior cardinal vein
SVC
Right horn of sinus venosus
Smooth part of right atrium (sinus venarum)
Patent foramen ovale
failure of septum primum and septum secundum to fuse after birth
Transposition of the great vessels
Tetralogy of Fallot
Persistent truncus arteriosus
Conotruncal abnormalities associated with failure of neural crest cells to migrate
,ductus venosus
connects the umbilical vein to the inferior vena cava, bypassing the liver
becomes ligamentum venosum
phrenic nerve
innervates the diaphragm and pericardium
S3 heart sound
Increased ventricular filling pressure (e.g., mitral regurgitation, HF), common in dilated
ventricles
normal in kids and pregnant women
S4 heart sound
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
a wave of JVP
c wave
RV contraction (closed tricuspid valve bulging into atrium) wave of JVP
x descent
JVP wave corresponding to downward displacement of closed tricuspid valve during rapid
ventricular ejection phase
reduced or absent in tricuspid regurge
V wave
JVP wave corresponding to inc'd RA pressure due to filling against closed tricuspid valve
,y descent
JVP wave corresponding to RA emptying into RV
absent in cardiac tamponade
plusus parvus et tardus
pulses are weak with delayed peak
Aortic stenosis
PR interval
0.12-0.20 seconds
120 milliseconds
QT interval length
9 - 11 squares = .36 to .44 seconds
Hypokalemia
U wave present on ECG
Mg sulfate
for torsades de pointe, hypokalemia (can lengthen QT and cause torsades), and
pre-eclampsia (prevent seizures)
Romano-Ward syndrome
-Congenital long QT syndrome
-Autosomal dominant, pure cardiac phenotype (no deafness).
Jervell and Lange-Nielsen syndrome
-Congenital long QT syndrome
-Autosomal recessive, sensorineural deafness
Brugada syndrome
-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
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
- 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
-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)
Progressive lengthening of pr interval leading to dropped QRS
third degree AV block
The atria and Ventricles are totally dissociated.
-So, the QRSs and the P waves have no relation to each other.
PCWP
4-12 mmHg
est of LA pressure
Williams Syndrome
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
