apex

1) What is most common cause of secondary hypertension

a. Renal artery stenosis

1) During open cardiac surgery what is HGIH systolic blood pressure where aorta can be safetly cannulated a. 80 b. 90 c. 100 d. 110

- 100: hypertension during cannulation can cause aortic dissection

1) Transition to cardiopulmonary bypass may commence after activated clotting time exceeds a. 250 b. 300 c. 350 d. 400

- > 400

1) Congenital defects associated with TOF include all of the following except

- ASD

1) Causes of coronary vasodilation include (2) a. Beta-2 stimulation b. Hypocapnia c. Alpha-1 stimulation d. Adenosine

- Adenosine and beta-2 stimulation

1) decrease in which following most likely cause stroke volume to increase? a. Mean arterial blood pressure b. Contractility c. Preload d. Afterload

- Afterload: tension heart overcome to eject stroke volume. Set by SVR

1) Which following MOST closely associated with diastolic heart failure (3) a. Essential hypertension b. Aortic stenosis c. Ischemic heart disease d. S3 heart sound e. Dilated cardiomyopathy f. Tricuspid regurgitation

- Aortic stenosis, ischemic heart disease, essential hypertension - Diastolic failure is associated with decreased ventricular compliance, the heart is unable to relax to accept incoming volume. Ventricle doesn't fill properly. This explains why the end-diastolic pressure overestimates the end-diastolic volume. Defining characteristic diastolic dysfunction is symptomatic heart failure with normal ejection fraction. Contractility is generally preserved until late stage of disease. An S4 may be heard. Most common cause: aortic stenosis, ischemic heart disease, long-standing essential hypertension.

1) Which valvular disorders are associated with systolic murmur a. Mitral insufficiency b. Mitral stenosis c. Aortic insufficiency d. Aortic stenosis

- Aortic stenosis, mitral insufficiency o ASSS= Aortic Stenosis Systolic murmur at right Sternal border o ARDS= Aortic Regurg. Diastolic murmur at right Sternal border o MSDA= Mitral Stenosis Diastolic murmur at Apex and Axilla o MRSA= Mitral Regurg. Sysolic murmur at Apex and Axilla

1) A patient presents with a history a angina, syncope, and dyspnea. What is MOST likely diagnosis? a. Acute aortic insufficiency b. Aortic stenosis c. Mitral stenosis d. Chronic mitral regurgitation

- Aortic stenosis: SAD - Mitral stenosis: pulmonary congestion and a-fib - Chronic mitral regurg. DOE, paroxysmal nocturnal dyspnea and afib - Acute aortic insufficiency presents with severe pulmonary edema and CHF

1) Identify BEST monitor of neurologic integrity during carotid endarterectomy a. Awake patient b. Cerebral oximetry c. Transcranial doppler d. Electroencephalography

- Awake patient

1) Identify the statement that MOST accurately describes the patient with abdominal aortic aneurysm (2) a. Risk of aneurysmal rupture is best described by poiseuilles law b. Back pain and hypotension suggest rupture c. It is more common in females d. Surgical intervention is recommended when diameter >5.5 cm

- Back pain and hypotension suggest rupture and Surgical intervention is recommended when >5.5 cm - Law of laplace (no poiseulles) states that increased diameter increases wall tension. Greater wall tension the greater risk of rupture

1) A patient has a prosthetic aortic valve. Which surgical procedure presents an indication for antibiotic prophylaxis against endocarditis? a. Cystoscopy b. Colonoscopy c. Esophagogastroduodenoscopy d. Bronchoscopy with biopsy

- Bronchoscopy with biopsy

1) what is the BEST way to preserve spinal cord blood flow during ascending aortic aneurysm repair? a. Controlled hypotension b. Patient warming to 38 C c. Induced hypoglycemia d. Cerebrospinal fluid drainage

- Cerebrospinal fluid drainage

1) Modified new York association function classification of heart failure: a. Class I asymptomatic b. Class II symptomatic with moderate activity c. Class III symptomatic with mild activity d. Class IV symptomatic at rest

- Class I- asymptomatic, class II-symptomatic with moderate activity, class III- symptomatic with mild activity, class IV-symptomatic at rest

1) Pathophysiologic complications related to chronic hypertension include all of the following except: a. Left ventricular hypertrophy b. Decreased diastolic filling time c. Increased myocardial oxygen consumption d. Dysrhythmias

- Decreased diastolic filling time

1) Following aortic valve replacement for aortic stenosis, the left ventricular end-systolic volume will be: a. Increased due to afterload reduction b. Increased due to decreased transvalvular gradient c. Decreased due to reduction in impedance to ventricular ejection d. Unchanged

- Decreased due to reduction in impedance to ventricular ejection

1) After suffering a myocardial infarction, patient presents with left ventricular papillary muscle rupture and mitral regurgitation. Which following will worsen patients conditions (3) a. Increased heart rate b. Decreased heart rate c. Increased systemic vascular resistance d. Decreased systemic vascular resistance e. Increased LV to LA pressure gradient f. Decreased LV to LA pressure gradient

- Decreased heart rate, increased systemic vascular resistance, increased LV to LA pressure gradient

1) A patient presents to preoperative clinic with previous history of infective endocarditis. Which procedure puts this patient at the HGIHEST risk of adverse outcome? a. Cystoscopy b. Dental implant c. Colonoscopy d. Coronary stent placement

- Dental implant: pt at risk for endocarditis (valve replacements complex congenital heart disease, and previous endocarditis) "dirty procedures associated with transient bacteremia should receive preoperative antibiotics

1) All following are synonyms for idiopathic hypertrophic subaortic stenosis except: a. Obstructive hypertrophic cardiomyopathy b. Hypertrophic obstructive cardiomyopathy c. Asymmetric septal hypertrophy d. Dilated cardiomyopathy

- Dilated cardiomyopathy: hypertrophic cardiomyopathy is most common genetic cardiac disorder, and it most common cause of sudden cardiac death in young athletes. This disease process goes by several names, and you never know which one might appear.

1) A patient with history of coronary artery disease and ejection fraction of 35% developed atrial fib. With rapid ventricular rate. Select best treatment for patient: a. Verapamil b. Nifedipine c. Diltiazem d. Nicardipine

- Diltiazem: calcium channel blockers reduce CA cardiac and vascular smooth muscle. Some drugs target myocardium

1) Following mitral valve repair you observe systolic anterior motion of anterior leaflet on the TEE. This patient MOST likely received: (2) a. Dobutamine b. Nitroprusside c. 500 mL NaCL bolus d. Phenylephrine

- Dobutamine and nitroprusside - Systolic anterior motion (SAM) is complication of mitral valve repair. Left ventricular outflow tract becomes occluded. Risk of SAM is increased when the anterior leaflet is longer than posterior leaflet or when there is narrow angler between mitral annulus and aortic annulus.

1) Match each shunt location within fetal circulation a. Foramen ovale pulmonary artery descending aorta b. Ductus venosus right atrium left atrium c. Ductus arteriosus umbilical vein inferior vena cava

- Ductus venosus= umbilical vein inferior vena cava (oxygen rich blood form placenta bypasses the liver) - Foramen ovale= right atrium left atrium (oxygen rich blood bypasses the lungs and preferentially delivered to heart and brain) - Ductus arteriosus = pulmonary artery proximal descending aorta (lower oxygen blood bypasses the lungs and delivered to body)

1) Which drugs proven to reverse left ventricle remodeling in patient with heart failure? a. Enalapril b. Clonidine c. Esmolol d. Spironolactone

- Enalapril and spironolactone: failing heart changes its size shape function in an attempt to preserve cardiac output. Known as cardiac remodeling. Overtime these compensatory mechanism creates problem of their own and decline in myocardial function ensures. o Heart becomes thicker (concentric hypertrophy) in response to pressure overload o Heart becomes dilated (eccentric hypertrophy) in response to volume overload

1) Which drugs most likely to contribute to hemodynamic instability in patient who is symptomatic from severe mitral stenosis (2): a. Furosemide b. Phenylephrine c. Ephedrine d. Nitrous oxide

- Ephedrine, nitrous oxide: goal= full slow and constricted

1) An increase in which following is associated with HGIHEST increase myocardial oxygen a. Heart rate b. Volume work c. Pressure work d. Wall stress

- Heart rate, pressure work: highest O2 consumption activity to lowest o2: heart rate= pressure work > contractility> wall stress> volume work

1) Which conditions increase Pulmonary vascular resistance (3) a. Light anesthesia b. Anemia c. Hypercarbia d. Trendelenburg e. Nitric oxide f. Alkalosis

- Hypercarbia, Trendelenburg position, light anesthesia - Along with hypoxemia, acidosis, atelectasis, hypothermia, vasoconstrictors, pain

1) Patient scheduled for Fontan procedure MOST likely diagnosis of: a. Truncus arteriosus b. Ebstein anomaly c. Transposition of great arteries d. Hypoplastic left heart syndrome

- Hypoplastic left heart syndrome

1) Identify statement that BEST describes the postoperative complication following carotid endarterectomy (2) a. Hypotension is most common postoperative complication b. If hematoma causes airway compromise, the anesthetist should remove sutures for incision site c. Injury to superior laryngeal nerve may result in hoarseness and inspiratory stridor d. Carotid denervation reduces ventilatory response in hypoxia

- If a hematoma causes airway compromise the anesthetist should remove sutures from incision site - Carotid denervation reduces ventilatory response in hypoxia

1) Anesthetic consideration for patient with systolic heart failure includes: a. Increased preload to stretch a noncompliant ventricle b. Increased heart rate to maximize cardiac output c. Avoidance of inotrope to reduce myocardial oxygen demand d. Increased afterload to perfuse hypertrophied myocardium

- Increase heart rate to maximize cardiac output - Hallmark systolic heart failure is decreased ejection with an increased end diastolic volume (ventricle does not empty well) since the heart cant squeeze well a greater volume of blood remains in the ventricle after each contraction. The body compensates with SNS activation- this increases heart rate. Stroke volume is reduced the only way to maintain cardiac output is to increase heart rate. Anesthetic considerations: o Preload: already high- don't get higher o Afterload: decrease to reduce the LV workload o Heart rate: maintain high/normal range o Contractility: inotropic support as needed

1) Which finding MOST likely occur in patient with congestive heart failure? a. Decreased natriuretic peptide b. Decreased left ventricular end diastolic pressure c. Increased renal blood flow d. Increased sympathetic tone

- Increased sympathetic tone: rely on elevated levels of circulating catecholamines (increased SNS tone) anesthetic techniques interrupt mechanism precipitate cardiovascular collapse ex: induction propofol (2mg/kg) reduce SNS tone while reducing myocardial contractility. Ketamine preserves SNS

1) Bradycardia is caused by: a. Increasing potassium conductance b. Making the resting membrane potential more positive c. Making the threshold potential more negative d. Increasing the slope of phase 4 depolarization

- Increasing potassium conductance

1) Which of the following is the LEAST likely to precipitate pulmonary edema with mitral stenosis a. Judicious fluid administration b. Uterine contractions c. Atrial fibrillation d. Trendelenburg position

- Judicious fluid administration: pt with severe mitral stenosis condition increases left atrial volume can precipitate pulmonary edema. Judicious fluid administration is likely to raise left atrial pressure significantly. Both uterine contractions and Trendelenburg position increases preload. Atrial fib reduces cardiac output and increases back pressure in pulmonary circulation

1) Kussmauls signs is associated with an increased: a. Right ventricular compliance b. Stroke volume c. Jugular venous pressure d. Pulmonary artery occlusion pressure

- Jugular venous pressure: during inspiration, negative pressure in thoracic cavity augments blood flow into right ventricle. Reduces jugular venous pressure during inspiration. Kussmaul sign is paradoxical rise on jugular venous pressure during inspiration. Caused by restriction in RV filling and high right-sided heart pressure is reflected back to jugular veins. On the CVP waveform, the x and y descents are exaggerated. Highly suggestive constrictive pericarditis

1) Which drug MOST likely to increase the degree of prolapse in patient with mitral valve prolapse a. Phenylephrine b. Ketamine c. Etomidate d. Sevoflurane

- Ketamine: large ventricle tend to reduce MV prolapse, while a small ventricle tends to increase MV prolapse. For this reason the primary management goal for MVP is to prevent excessive cardiac emptying - To keep the heart full, youll want to avoid: SNS stimulation myocardial contractility, decreased SVR. Hypovolemia, upright posture (reverse Trendelenburg or sitting position) - Pharmacologic considerations: ketamine avoided bc activates SNS, increases myocardial contractility and augments LV emptying - Etomidate provides cardio stability, making it reasonable choice - Volatile anesthetic+ N2O and or opioids help minimize SNS stimulation but they must titrated to prevent significant decrease in systemic vascular resistance - Phenylephrine is useful hypotension - There is no contraindication to regional anesthesia

1) Select the BEST induction agent for patient with pericardial tamponade a. Ketamine b. Midazolam c. Propofol d. Etomidate

- Ketamine: pt with pericardial tamponade relies upon SNS to maintain blood pressure. Since general anesthetic cause myocardial depression and reduce afterload (both of which contribute to CV collapse) local anesthetic is the preferred technique for pericardiocentesis. Ketamine activates SNS which increase heart rate, contractility and afterload

1) Select statements that best describes constrictive pericarditis (2): a. It is commonly caused by virus b. Afterload should be reduced c. Kussmauls sign usually present d. Bradycardia should be avoided

- Kussmauls sign is usually present, bradycardia should be avoided

1) Which law explains why abdominal aneurysm is more likely to rupture during a period of hypertension a. Poiseuille b. Bernoulli c. Laplace henry

- Law of laplace: tension is a pulling force that stretches or elongates something. For cylinder (aorta) law of laplace states that tension is the product of pressure and radius (T= Px R) - Both aorta and aneurysm are exposed to mean arterial pressure. According to law of laplace if the pressure is constant and radius is increased, tension must increase as result. If this patient becomes hypertensive, the tension on aneurysm rises, possibly leading to rupture. - Poiseilles law: describes laminar flow through tube. Flow is directly proportional to radius raised to the fourth power and pressure difference along the tube (P1-P2). Flow is inversely proportional to viscosity and length of tube. Bernoullis principle describes flow through constriction. At site of constriction fluid velocity increases creating a pressure drop at the point of constriction. Henry law: describes solubility of gas in solution

1) Which region of myocardium receives the LEAST amount of perfusion during systole? a. Right ventricular epicardium b. Right ventricular subendocardium c. Left ventricular epicardium d. Left ventricular subendocardium

- Left ventricular subendocardium: primarily perfused during diastole.

1) Occlusion of artery of adamkiewicz during aneurysm repair may result in all of the following except: a. Flaccid paralysis of lower extremities b. Bowel and bladder dysfunction c. Loss of proprioception d. Loss of temperature and pain sensation

- Loss of proprioception:. The artery of adamkiewicz is largest radicular spinal artery. It is major blood lower portion of anterior spinal cord. This can result in anterior spinal artery syndrome- becks syndrome

1) Which pharmacologic agent reduce myocardial oxygen demand (2) a. Morphine b. Dobutamine c. Atropine d. Metoprolol

- Metoprolol and morphine o Metoprolol: improves O2 supply and demand by attenuating HR and contractility o Morphine: improves O2 supply/demand balance o Atropine: increases heart rate- increase O2 demand while decrease O2 supply o Dobutamine: increases heart rate as well as myocardial contractility

1) Which of the following components of becks triad? (3) a. Tachycardia b. Muffled heart tones c. Mill wheel murmur d. Hypotension e. Increased pulmonary artery occlusion pressure f. Jugular venous distension

- Muffled heart tones due to fluid accumulation in pericardial sac - jugular venous distension due to decreased venous return to right heart - hypotension due to decreased stroke volume

1) Elevated creatine kinase-MB is MOST consistent with: a. Myocardial infarction b. Aortic stenosis c. Rheumatic fever d. Congestive heart failure

- Myocardial infarction: cell requires oxygen and energy to maintain the integrity of cell membrane. A cell that dies as a result of inadequate oxygenation is no longer able to maintain the integrity of its cell membrane. As consequence intracellular components are released into circulation.

1) All of the following reduce outflow obstruction in obstructive hypertrophic cardiomyopathy except: a. Esmolol b. Nitroglycerin c. Phenylephrine d. 500 mL 0.9% NaCl bolus

- Nitroglycerin

1) Which surgical procedure the HIGHEST risk of cardiovascular morbidity and mortality for patient with coronary artery disease? a. Open abdominal aortic aneurysm repair b. Carotid endarterectomy c. Open reduction and internal fixation of femur fracture d. Video assisted lung thoracoscopy

- Open abdominal aortic aneurysm repair o High risk procedures: emergency surgery, open aortic surgery, peripheral vascular surgery, long surgical procedures with significant volume shifts or blood loss

1) Primarily affects myocardial oxygen supply (2) a. Diastolic time b. Inotropy c. Wall tension d. P50

- P50 and diastolic time

1) Mitral stenosis causes: a. Parallel replication of sarcomeres in left ventricle b. Parallel replication of sarcomeres in left atrium c. Serial replication of sarcomeres in left ventricle d. Serial replication of sarcomeres in left atrium

- Parallel replication of sarcomeres in left atrium- since left atrium must generate a higher pressure to push blood past a stenotic mitral valve, LA (not the LV) hypertrophies to satisfy the demand. Heart compensates for pressure overload with concentric hypertrophy (parallel replication of sarcomeres) LV is chronically underfilled in mitral stenosis so there is no reason for chamber to increase in diameter.

1) Which of the following increase after placement of infra-renal aortic cross clamp (2): a. Cardiac output b. Mixed venous oxygen saturation c. Preload d. Renal blood flow

- Preload and mixed venous oxygen saturation: mixed venous oxygen saturation as a function of decreased oxygen consumption. You are putting the same quantity of oxygen into the lungs but cells distal to aortic clamp don't receive or consume it. Preload increases because the blood volume is shifted proximal to clamp. This increases cardiac filling pressure and wall stress. The contractile function of myocardium and increase in afterload determine cardiac output. CO usually unchanged in healthy in healthy heart and decreased in patients with reduced cardiac reserve

1) tibiotic prophylaxis against endocarditis may be indicated if a patient has history of (2) a. Prosthetic heart valve b. Cardiac stent placement c. Unrepaired cyanotic heart disease d. Mitral prolapse

- Prosthetic heart valve and unrepaired heart disease

1) which variable are related by frank starling mechanism? a. Left vent. end diastolic pressure and systemic vascular resistance b. Pulmonary artery occlusion pressure and stroke volume c. Central venous pressure and mean arterial pressure d. Contractility and cardiac output

- Pulmonary artery occlusion pressure and stroke volume: frank starling mechanism relates to ventricular volume to ventricular output

1) Which of the following are expected to increased following cross clamp removal during abdominal aortic aneurysm repair (2) a. Pulmonary vascular resistance b. Venous return c. Coronary blood flow d. Total body oxygen consumption

- Pulmonary vascular resistance, total body oxygen consumption - When aortic clamp is released ischemic tissues released acid and vasoactive substances into systemic circulation. This increases pulmonary vascular resistance and pulmonary artery pressure. Removal of aortic cross clamp increases the size of vascular tank so venous return falls. Hypotension reduces coronary blood flow.

1) Which phase in cardiac cycle characterized by open mitral valve and closed aortic valve (3) a. Atrial systole b. Isovolumetric relaxation c. Diastasis d. Ventricular ejection e. Rapid ventricular filling f. Isovolumetric contraction

- Rapid ventricular filling, diastasis, atrial systole

1) Inhaled nitric oxide (2): a. Reduces right ventricular afterload b. Causes hypotension c. Inactivated by hemoglobin d. Stimulates cAMP production

- Reduces right ventricular afterload and inactivated by hemoglobin

1) A patient undergoing surgical repair for coarcation of aorta. Select BEST site to monitor the arterial blood pressure a. Right arm b. Right leg c. Left arm d. Left leg

- Right arm: coarctation of aorta occurs when aorta narrows in area of ductus arteriosus

1) In the patient with right subclavian steal syndrome, arterial flow is diverted from the: a. Right subclavian artery to left subclavian artery b. Left subclavian artery to right subclavian artery c. Right vertebral artery to the right subclavian artery d. Left vertebral artery to right subclavian artery

- Right vertebral artery to right subclavian artery

1) During surgical repair of tetralogy of fallot, the patients blood pressure declines 25% and spo2 decrease 10%. What MOST likely explanation for these findings (2) a. Myocardial contractility increased b. Systemic vascular resistance decreased c. Pulmonary vascular resistance decreased d. Preload increased

- SVR decreased and myocardial contractility increased

1) Failure of fossa ovalis to close results in what type of atrial septal defect? a. Perimembranous b. Primum c. Secondum d. Sinus venosus

- Secondum: middle of atrial septum and results when fossa ovalis fails to close o Primum: lower region of atrial septum above tricuspid o Sinus venosus: located below IVC or above IVC

1) Which conditions promote myocardial remodeling through parallel replication of sarcomeres (2) a. Chamber dilation b. Eccentric hypertrophy c. Stenosis d. Pressure overload

- Stenosis and pressure overload:

1) Blood flow reversal through the vertebral artery is cause by a. Basilar artery stela syndrome b. Subclavian steal syndrome c. Innominate artery steal syndrome d. Carotid artery steal syndrome

- Subclavian steal syndrome occurs when there is occlusion of subclavian or innominate arty proximal to origin of ipsilateral vertebral artery. Causes flow reversal through vertebral artery and creates big problem blood would usually travel to posterior cerebral circulation (via the vertebral artery) is stole by ipsilateral arm. This function of altered pressure gradients in arterial circulation

1) Which congenital heart defect associated with ventricular outflow tract obstruction

- TOF - Pulmonary stenosis with ASD

1) Which congenital defects MOST likely cause hypoxemia (3) a. Patent ductus arteriosus b. Tetralogy of fallot c. Ebsteins anomaly d. Eisenmengers syndrome e. Ventricular septal defect f. Coarctation of aorta

- Tetralolgy of fallot, eisenmengers syndrome, ebsteins anomaly

1) Thoracoabdominal aneurysm that is associated with HIGHEST incidence of paraplegia following open surgical repair: a. Type I descending- all, abdominal-upper b. Type II descending-all, abdominal- most c. Type III descending-lower, abdominal-most d. Type IV descending-none, abdominal- most

- Type II most significant risk paraplegia and renal failure bc mandatory period of stopping blood flow to renal arteries and radicular arteries that perfuse the anterior spinal cord (artery adamkiewicz)

1) What is the most common congenital heart defect in neonate

- VSD

1) Which of the following MOST likely to reduce stroke volume in patient with hypertrophic cardiomyopathy? (3) a. Esmolol b. Ephedrine c. Nitroprusside d. Hypervolemia e. Phenylephrine f. Valsalva maneuver

- Valsalva maneuver, ephedrine, nitroprusside:

1) Select BEST treatment of hypotensive patient with mirtal stenosis a. Dobutamine b. Vasopressin c. Ephedrine d. Epinephrine

- Vasopressin: increased HR could be detrimental with mitral stenosis because it reduces diastolic filling time, increases left atrial volume and pressure and increases the risk of pulmonary edema. Ephedrine, epinephrine and dobutamine increase heart rate. Pt treated with pure vasoconstrictor (vasopressin) bc it does not increase heart rate. Phenylephrine first best choice.

1) What is the most common cause of aortic stenosis: a. Infective endocarditis b. Ruptured papillary muscle c. Bicuspid aortic valve d. Rheumatic fever

- bicuspid aortic valve:

1) Potential consequence of thoracic aortic cross-clamp include: a. Spastic paralysis of lower extremities b. Loss of proprioception c. Spinothalamic tract impairment d. Beck triad

- spinothalamic tract impairment: consist of: 2 posterior spinal arteries (dorsal cord= sensory) and one anterior spinal artery (anterior cord= motor)

1) most appropriate management for patient with pressure-volume loop (2): a. systemic vascular resistance= 1500 b. pulmonary artery occlusion pressure= 12 c. central venous pressure= 1 d. heart rate= 45 bpm

- systemic vascular resistance=1500, pulmonary artery occlusion pressure= 12: concerned with rate, volume and distention. - Rate- maintain NSR tachycardia reduces filling time. Bradycardia creates LV distension. - Volume: increase preload. Keep CVP and PAOP at high/normal - Afterload: afterload is set by stenotic aortic valve. SVR must be kept high help perfuse the coronary arteries (CPP= AoDBP- LVEDP)

1) What conditions impair myocardial contractility? (3) a. Hyperthermia b. Hyperkalemia c. Hypoxia d. Hypercapnia e. Hypovolemia f. Hypercalcemia

Hypoxia and acidosis: o : in absence of o2 cardiac myocytes convert to anaerobic metabolism. Intracellular lactate increase-> acidosis and impaired enzymatic function-> decreased contractility o Hypercapnia: result of accumulation of volatile acids o Hyperkalemia: increase RMP voltage gated channels firer in response to depolarization, if RMP riase level that exceed channels would repolarize, stuck closed and inactive

1) match hemodynamic variable with math equations: Mean arterial blood pressure [(COxSV)/80] +CVP Ejection fractions [EDV-ESV)/EDV] x100 Stroke volume CO x (1000xHR) Systemic vascular resistance [MAP-CVP/ CO] x 80

Stroke volume= CO x (1000/HR) Ejection fraction= [(EDV-ESV)/EDV] x100 Systemic vascular resistance= [(MAP-CVP)/CO] x80 Mean arterial blood pressure= [(COxSVR)/80] +CVP

1) Which of the valvular disease are associated with eccentric hypertrophy? a. mitral stenosis b. mitral regurgitation c. aortic stenosis d. aortic regurgitation

mitral regurgitation, aortic regurgitation o regurgitation lesion tend to produce volume overload. Heart compensates with eccentric hypertrophy (thin wall+ dilated chamber) - stenotic lesions produce pressure overload. Heart compensates with concentric hypertrophy (thick wall+ small chamber)