LOLs and PRILs
Squiggles and bumps
Know thy Heart
Cardio Baby
Eat your heart out
100
This class of medication, ending in -LOL, is commonly used to manage hypertension, reduce the risk of arrhythmias, and control symptoms of heart failure by blocking the effects of catecholamines on the heart.
What are beta-blockers?
100
This part of the ECG waveform represents the time it takes for the electrical impulse to travel through the atria, the AV node, and the bundle of His before it reaches the ventricles.
What is the PR interval?
100
This valve lies between the left atrium and left ventricle, preventing backflow of blood into the atrium during ventricular contraction.
What is the mitral valve?
100
This heart shaped organ pumps blood throughout the body
What is the heart?
100
In patients with prosthetic heart valves, the risk of developing infective endocarditis is higher, and prophylactic antibiotics are often given before dental procedures. What is the most commonly recommended antibiotic for this prophylaxis?
What is amoxicillin?
200
This anticoagulant is a vitamin K antagonist, frequently used for long-term anticoagulation in conditions like atrial fibrillation and deep vein thrombosis.
What is warfarin?
200
This type of myocardial infarction typically involves elevation of the ST segment in leads II, III, and aVF.
What is inferior wall STEMI?
200
This structure, also known as the heart's pacemaker, is located in the right atrium and generates electrical impulses that initiate the heartbeat.
What is the sinoatrial (SA) node?
200
This fibrous structure connects the right atrium to the left atrium in fetal circulation, allowing blood to bypass the lungs. It normally closes shortly after birth.
What is the foramen ovale?
200
This condition associated with infective endocarditis presents as non-tender, flat, hemorrhagic lesions on the palms of the hands and soles of the feet, caused by microemboli lodging in small vessels.
What are Janeway lesions?
300
This beta-blocker is considered relatively safe for use during pregnancy, particularly for managing hypertension or preeclampsia, and is often prescribed as an alternative to other antihypertensive agents.
What is labetalol?
MoA: Labetalol is a non-selective beta-blocker (affects both β₁ and β₂ receptors) and an alpha-1 blocker. This unique combination leads to vasodilation and reduced heart rate, lowering blood pressure effectively without causing significant changes to maternal blood flow or fetal oxygenation.
300
This electrolyte disturbance often results in wide QRS complexes, peaked T waves, and prolonged PR intervals on the ECG. It is most commonly associated with renal failure.
What is hyperkalemia?
300
This artery supplies the right side of the heart, including the right atrium and right ventricle, as well as the inferior wall of the left ventricle.
What is the right coronary artery (RCA)?
300
This structure acts as the fetal shunt between the pulmonary artery and the aorta, allowing blood to bypass the lungs. It typically closes after birth.
What is the ductus arteriosus?
300
A 45-year-old man with a history of IV drug use presents with fever, fatigue, and a new heart murmur. An echocardiogram shows large, friable vegetations on the tricuspid valve. Despite aggressive treatment with antibiotics, the patient dies suddenly. On autopsy, there is evidence of septic emboli in the brain and lungs. What was the cause of his death?
What is infective endocarditis with septic embolism?
400
ARNIs are a newer class of drugs, including sacubitril/valsartan, that works by blocking the angiotensin II receptor and by inhibiting this metalloprotease enzyme to help manage heart failure.
What is neprilysin
Neprilysin’s role is particularly relevant in heart failure. In heart failure, natriuretic peptides are beneficial because they help reduce blood volume, blood pressure, and improve heart function. However, neprilysin breaks these peptides down, limiting their effectiveness.
400
This pre-excitation syndrome shows an abnormal, slurred upstroke (delta wave) on the QRS complex due to an accessory pathway (e.g., Bundle of Kent) bypassing the normal AV node conduction system.
What is Wolff-Parkinson-White (WPW) syndrome?
400
This vein, which drains the myocardium, empties directly into the right atrium via the coronary sinus.
What is the great cardiac vein?
400
A newborn presents with cyanosis, a systolic murmur over the left upper sternal border, and absent femoral pulses. The infant’s blood pressure is higher in the upper extremities compared to the lower extremities. What is the most likely diagnosis?
What is coarctation of the aorta?
400
In pregnant women with infective endocarditis, this antibiotic, which is safe to use during pregnancy, may be used to treat group B streptococcus endocarditis.
What is penicillin G?
500
A 58-year-old woman with a history of atrial fibrillation and chronic kidney disease is prescribed a new medication for stroke prevention. She is also taking losartan for hypertension. The doctor advises her to start this medication, which works by inhibiting factor Xa. It's an oral anticoagulant that does not require routine INR monitoring.
What is rivaroxaban?
MoA: Directly inhibits Factor Xa (both free and clot-bound), which prevents the conversion of prothrombin to thrombin. This leads to a decrease in thrombus formation, reducing the risk of venous thromboembolism (VTE) and stroke in patients with conditions like atrial fibrillation.
500
A 54-year-old woman with a history of diabetes and chronic kidney disease presents with palpitations, fatigue, and dizziness. Her ECG shows narrow QRS complexes, a heart rate of 150 bpm, regular rhythm, and multiple P waves preceding each QRS complex. The P waves have a sawtooth appearance in the inferior leads (II, III, aVF), and the ventricular rate is very rapid and regular.
What is the most likely diagnosis?
What is atrial flutter with 2:1 block?
The sawtooth pattern of P waves in the inferior leads is characteristic of atrial flutter.
The regular rhythm and the very rapid ventricular rate (150 bpm) in the context of 2:1 AV block (every two atrial impulses are conducted to the ventricle) suggests atrial flutter with a 2:1 block.
The narrow QRS complex indicates that the conduction through the AV node is normal, and the P waves are notconducting in a 1:1 fashion (which would be seen in atrial fibrillation).
500
A 58-year-old male with a history of myocardial infarction (MI) presents with acute shortness of breath, tachycardia, and orthopnea. He is found to have a new holosystolic murmur at the apex of the heart. His echocardiogram shows severe mitral regurgitation with flail motion of the posterior mitral valve leaflet.
What is the most likely cause of the mitral regurgitation in this patient?
What is papillary muscle dysfunction or rupture due to myocardial infarction?
500
A 2-year-old child presents with severe cyanosis, tachypnea, and poor feeding. Physical examination reveals a harsh, systolic murmur and clubbing of the fingers. A chest X-ray shows a boot-shaped heart. What is the most likely diagnosis?
What is tetralogy of Fallot?
500
A 58-year-old male with a history of hypertension presents with worsening shortness of breath and orthopnea. On physical examination, you note jugular venous distention, bilateral pitting edema, and rales in both lungs. His echocardiogram reveals impaired systolic function, a reduced ejection fraction (EF), and thin ventricular walls. What is the most likely diagnosis?
What is dilated cardiomyopathy (DCM)?