The Final Jeopardy (This year)

Vascular

100

The ankle-brachial index (ABI) is considered abnormal below this threshold.

<0.9

200

This vascular syndrome results from compression of the left common iliac vein by the right common iliac artery.

May-Thurner Syndrome

300

After an EVAR, the two most common vessels causing type 2 endoleaks are (name 1)

Lumbar arteries and inferior mesenteric artery

400

In vascular ultrasound, this is the percentage cutoff attributed to a PSV ratio of greater than 4, or to describe severe stenosis in the renal arteries?

60%

500

What is the most common site of peripheral artery aneurysms?

Popliteal Artery

Eponyms

100

This eponym describes the paradoxical rise in jugular venous pressure on inspiration, classically seen in constrictive pericarditis.

Kussmaul sign

200

Head bobbing with each heartbeat, seen in aortic regurgitation

de Musset's sign

300

This three cardiologist named sign refers to the dynamic LVOT obstruction/gradient in the setting of PVCs in Hypertrophic Obstructive Cardiomyopathy. 

Brockenbrough-Braunwald-Morrow sign

The decrease in pulse pressure after a PVC or extrasystole is due to the following: 

• The increased inotropy (contractility) of the heart after the extrasystole, along with the reduced afterload (pressure the heart must pump against), exacerbates the LVOT obstruction. 
• This leads to a significant increase in left ventricular systolic pressure, but the arterial pulse pressure may paradoxically decrease due to the increased obstruction

400

This syndrome refers to upper extremity venous thrombosis often caused by repetitive activity, such as in athletes.

Paget-Schroetter syndrome

500

This phenomenon describes aberrant ventricular conduction, usually of right bundle branch block morphology, following a short RR interval and a preceding relatively long RR interval

Ashman phenomenon

Echo boards (again x3)

100

This paradoxical tissue Doppler finding—medial e′ velocity exceeding lateral e′ velocity—is seen in constrictive pericarditis

Annulus reversus

200

This echocardiographic parameter is defined as the slope of early diastolic transmitral inflow and reflects LV compliance.

Deceleration time

300

In prosthetic aortic valve evaluation, this Doppler parameter helps differentiate patient-prosthesis mismatch from prosthetic stenosis

Acceleration time

400

The "modified" Bernoulli equation ignores what 3 other forces/factors? Name 2 of them.

1. Viscous losses (frictional forces due to blood viscosity)

2. Inertial forces

   • Changes in momentum due to accelerating or decelerating flow

3. Proximal velocity (v₁) when it’s small relative to distal velocity (v₂)

4. Gravitational energy differences

500

Name 5 ways to quantify RV function (15 second timer)

TAPSE, S' Velocity, RV FAC, RIMP (Tei), 3D RVEF, RV Free wall strain

EP

100

What is the problem with this dual chamber pacemaker?

Failure to capture

200

This funny sounding acronym can be adjusted to prevent pacemaker mediated tachycardia from recurring

Increase the PVARP

300

In Long QT Syndrome, this subtype carries the highest risk of cardiac events during sleep or rest

LQT3 (SCN5A mutation)

400

This vagally mediated reflex may cause paradoxical worsening of hypotension when bradycardia is treated with pacing.

Bezold–Jarisch reflex

(Not Jarisch–Herxheimer reaction, Adam)

500

When ventricular lead noise mimics ventricular fibrillation, how might a device discriminate between the two?

Comparing near-field and far-field electrograms, lead integrity alert (LIA) or noise discrimination algorithm (rate stability/onset)

Calculations

100

Calculate the corrected QT interval using the bazett formula if the QT interval is 450 ms at a heart rate of 60 bpm. 

450 ms (same)

200

What is the simplified equation to calculate "strain" on echocardiography 

300

This formula (name it) is used to calculate the aortic valve areas during cardiac catheterization

Gorlin formula

400

A patient has an PW LVOT velocity of 2 m/s and an CW aortic valve velocity of 4 m/s. What is the aortic valve gradient?

48 mmHg

500

The law of Laplace states that if the wall thickness doubles, the wall stress.....

Halves

σ = (P × r) / (2h), the Law of Laplace, where σ = wall stress, P = pressure, r = radius, and h = wall thickness

The greatest vessels

100

The hepatic artery is a branch off of which artery?

Celiac trunk

200

This X-ray finding can be seen as a clue suggesting coarctation of aorta

Rib notching and the “figure 3 sign"

300

In the bovine aortic arch variant, the left common carotid artery has this location

LCC off the right brachiocephalic artery or shared

True:

400

This vascular anomaly results from this vessel encircling the trachea and esophagus.

double aortic arch

500

Due to compression of this vein between these two structures, patients will present with hematuria and flank pain, often called "nutcracker syndrome"

Compression of the left renal vein between the aorta and SMA

Congenital

100

In congenitally corrected transposition of the great arteries (L-TGA), this conduction abnormality develops in up to 30% of patients by adulthood.

Complete heart block

200

This congenital lesion results in a “snowman” appearance on chest X-ray

Total anomalous pulmonary venous return (TAPVR)

300

This type of tumor is associated with tuberous sclerosis. Don't resect it, they almost always regress spontaneously. 

Cardiac rhabdomyomas in infants

400

This angiographic sign, classically described as a “gooseneck deformity,” is seen due to elongation and narrowing of the left ventricular outflow tract and leftward displacement of the septal leaflet of the tricuspid valve found in this condition. 

Atrioventricular septal defect (AVSD), also known as endocardial cushion defect

500

In hypoplastic left heart syndrome (HLHS), survival after birth depends on patency of these two key structures

Ductus arteriosus and  atrial septal defect (or foramen ovale)

Ends in -yndrome

100

Associated with 22q11 deletion, this syndrome features conotruncal anomalies such as tetralogy of Fallot and interrupted aortic arch.

DiGeorge syndrome

200

Includes coarctation of the aorta, sub aortic stenosis, and parachute mitral valve

Shone complex (syndrome)

Also supravalvular mitral membrane and LVH as well as LV hypoplasia

300

This autosomal dominant syndrome includes prolonged QT interval, ataxia, and intermittent attacks of muscle weakness or paralysis.

Andersen-Tawil syndrome

"Hypokalemic periodic paralysis" can be treated with acetazolamide

Associated with bidirectional VT

400

This X-linked syndrome involves immunodeficiency, eczema, thrombocytopenia, and a risk of vasculitis and coronary artery aneurysms.

Wiskott-Aldrich syndrome

500

This rare X-linked disorder causes cardiomyopathy, neutropenia, and growth retardation.

Barth Syndrome