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Exam (elaborations)

NBME CBSE, ANSWERED

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  • NBME CBSE
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  • NBME CBSE

NBME CBSE, ANSWERED-Bulbus cordis - Smooth parts (outflow tract) of left and right ventricles endocardial cushions - Atrial septum, membranous interventricular septum; AV and semilunar valves neural crest left horn of the sinus venosus - coronary sinus posterior, sub cardinal, and supra...

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  • December 28, 2023
  • 34
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NBME CBSE
  • NBME CBSE
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ProfMiaKennedy
NBME CBSE, ANSWERED
Bulbus cordis - Smooth parts (outflow tract) of left and right ventricles

endocardial cushions - Atrial septum, membranous interventricular septum; AV
and semilunar valves

neural crest

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

DiGeorge Syndrome - Maldevelopment of 3 and 4 pharyngeal pouches, fascial
dysmorphia, cardiac shunt (trunks arteriosus, tetralogy of Fallot), lack of T-cells,
undeveloped paracortex

Corneal arcus - Lipid deposits in the cornea. Common in the elderly, but appears
earlier in life with hypercholesterolemia

Stanford A aortic dissection - Dissection of the ascending aorta
Tx with surgery

Stanford B aortic dissection - Dissection of the descending aorta below the level o
the left subclavian artery
Tx: Beta Blockers then vasodilators

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