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Questions and Answers
What is the initial event in the formation of atherosclerosis?
What is the initial event in the formation of atherosclerosis?
- Activation of scavenger receptor in the macrophages
- Phagocytosis of LDL cholesterol by the macrophages
- Migration of smooth muscle onto subintimal layer
- Disruption of the single layer endothelium (correct)
What type of ion current primarily contributes to Phase 2 of the myocyte action potential?
What type of ion current primarily contributes to Phase 2 of the myocyte action potential?
- Outward Na currents
- Inward K currents
- Inward Na currents (correct)
- Outward K currents
Which shunt allows oxygenated blood to bypass the liver during fetal circulation?
Which shunt allows oxygenated blood to bypass the liver during fetal circulation?
- Truncus arteriosus
- Foramen ovale
- Ductus venosus (correct)
- Ductus arteriosus
What mechanism is primarily responsible for the long plateau phase during Phase 2 of the action potential?
What mechanism is primarily responsible for the long plateau phase during Phase 2 of the action potential?
In the case of acute lung edema, what is the primary mechanism involved?
In the case of acute lung edema, what is the primary mechanism involved?
What is responsible for the transient repolarization observed in phase 1 of the myocyte action potential?
What is responsible for the transient repolarization observed in phase 1 of the myocyte action potential?
Which segment of the ECG is typically indicative of left atrial enlargement?
Which segment of the ECG is typically indicative of left atrial enlargement?
What causes the sudden occlusion in acute coronary syndrome?
What causes the sudden occlusion in acute coronary syndrome?
What is the correct sequence of events in the development of atherosclerosis?
What is the correct sequence of events in the development of atherosclerosis?
What is the result of the activation of monocytes in relation to macrophage function?
What is the result of the activation of monocytes in relation to macrophage function?
What effect does inward K current have during the action potential phases?
What effect does inward K current have during the action potential phases?
How does the ductus arteriosus function in fetal circulation?
How does the ductus arteriosus function in fetal circulation?
Which aspect of the ECG is assessed to evaluate cardiac ischemia?
Which aspect of the ECG is assessed to evaluate cardiac ischemia?
Which condition is most likely to lead to myocardial infarction?
Which condition is most likely to lead to myocardial infarction?
How does calcium current affect cardiac muscle contraction?
How does calcium current affect cardiac muscle contraction?
Which ion plays a significant role in the formation of foam cells during atherosclerosis?
Which ion plays a significant role in the formation of foam cells during atherosclerosis?
What is the first step in the process leading to the formation of foam cells in atherosclerosis?
What is the first step in the process leading to the formation of foam cells in atherosclerosis?
Which arrhythmia is characterized by abnormal impulse formation?
Which arrhythmia is characterized by abnormal impulse formation?
In which part of the heart's conduction system does the electrical signal experience a delay?
In which part of the heart's conduction system does the electrical signal experience a delay?
What mechanism is involved in excitation-contraction coupling in cardiac myocytes?
What mechanism is involved in excitation-contraction coupling in cardiac myocytes?
What does marker 3 on an ECG signify?
What does marker 3 on an ECG signify?
Which artery is associated with the blockage that affects the left anterior descending sulcus?
Which artery is associated with the blockage that affects the left anterior descending sulcus?
What physiological event occurs during the inflow of calcium ions in cardiac myocytes?
What physiological event occurs during the inflow of calcium ions in cardiac myocytes?
Which of the following describes the abnormal heart rhythm known as bradycardia?
Which of the following describes the abnormal heart rhythm known as bradycardia?
What does a jugular vein pressure (JVP) measurement of 5 + 4 cmH2O indicate about the right atrial pressure?
What does a jugular vein pressure (JVP) measurement of 5 + 4 cmH2O indicate about the right atrial pressure?
What does the vertical height of the external jugular vein indicate when JVP is measured as 5 + 4 cmH2O?
What does the vertical height of the external jugular vein indicate when JVP is measured as 5 + 4 cmH2O?
Which statement correctly describes the automaticity of pacemaker cells?
Which statement correctly describes the automaticity of pacemaker cells?
Which of the following statements about the action potential of pacemaker cells is correct?
Which of the following statements about the action potential of pacemaker cells is correct?
Which property is NOT typical of the pacemaker cell action potential?
Which property is NOT typical of the pacemaker cell action potential?
In patients with congestive heart failure, what does a high jugular vein pressure indicate?
In patients with congestive heart failure, what does a high jugular vein pressure indicate?
What characteristic of pacemaker current distinguishes it from myocyte action potential?
What characteristic of pacemaker current distinguishes it from myocyte action potential?
What might be the consequence of action potential properties in pacemaker cells?
What might be the consequence of action potential properties in pacemaker cells?
Which statement about cardiac output in heart failure is accurate?
Which statement about cardiac output in heart failure is accurate?
What condition may result from elevated LV end-diastolic pressure in heart failure?
What condition may result from elevated LV end-diastolic pressure in heart failure?
Which of the following conditions can echocardiography NOT evaluate?
Which of the following conditions can echocardiography NOT evaluate?
Cyanosis refers to which condition?
Cyanosis refers to which condition?
What does afterload in cardiac function primarily affect?
What does afterload in cardiac function primarily affect?
In heart failure, how does increased contractility influence stroke volume?
In heart failure, how does increased contractility influence stroke volume?
How does excessive preload affect cardiac output during heart failure?
How does excessive preload affect cardiac output during heart failure?
Which factor is crucial for maintaining cardiac output in a failing heart?
Which factor is crucial for maintaining cardiac output in a failing heart?
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Study Notes
Atherosclerosis and Coronary Artery Disease
- Formation of atherosclerotic plaque in the coronary artery causes coronary artery disease.
- Initial Event: Disruption of the single layer endothelium.
- Process: LDL (low-density lipoprotein) migration into the intimal layer followed by its oxidation, monocyte adhesion, expression of scavenger receptors, formation of foam cells, and smooth muscle cell migration.
Fetal Circulation
- Oxygenated blood leaves the placenta and enters the fetus through the umbilical vein.
- Shunts exist to bypass the liver and lungs.
- Ductus Venosus bypasses the liver and directs blood to the inferior vena cava.
Acute Lung Edema
- Shortness of breath and leg edema are common symptoms.
- Mechanism: Increased hydrostatic pressure in the pulmonary capillaries.
Myocyte Action Potential
- Phase 1: Brief transient repolarization caused by the transient activation of potassium channels.
- Phase 2: Long plateau phase caused by the near equality of current from inward Ca influx and outward K efflux.
Acute Coronary Syndrome
- Sudden occlusion of the coronary artery is the primary cause.
- Mechanism: Thrombosis due to the rupture of an atherosclerotic plaque.
Arrhythmia
- Sick Sinus Syndrome: Abnormal impulse formation from the sinoatrial node.
ECG Interpretation
- P Wave: Represents atrial depolarization.
- QRS Complex: Represents ventricular depolarization.
- T Wave: Represents ventricular repolarization.
Cardiac Contraction
- Excitation-contraction coupling: Action potential reaching the myocyte induces contraction by triggering the release of calcium ions into the cytoplasm.
- Mechanism: Influx of calcium ions during phase 2 triggers the inhibition of Troponin-Tropomyosin complex, allowing actin and myosin cross-bridging and muscle contraction.
Stroke Volume Regulation
- Afterload: The resistance that the ventricle must overcome to eject blood.
Echocardiography
- Ultrasound-based diagnostic tool used in cardiac evaluations.
- Limitations: Cannot evaluate stenosis of coronary arteries.
Congenital Heart Disease
- Cyanosis: A blue-purple discoloration of the skin and mucous membranes caused by an elevated level of deoxygenated hemoglobin.
Jugular Venous Pressure (JVP)
- Measurement: Provides an estimate of right atrial pressure.
- JVP of 5 + 4 cmH2O: Indicates a right atrial pressure of 9 cmH2O.
Pacemaker Cell Automaticity
- Unique Property: The action potential of a pacemaker cell has a gradual upward slope (phase 4) due to the inward "funny" current carried by sodium ions.
- Mechanism: This gradual depolarization brings the cell to threshold, initiating the spontaneous firing of action potentials.
Mr. Sederhana
- Chest pain: Indicates a possible cardiovascular emergency.
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