A.I.D.

Surface Anatomy of the Heart
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6/24/12

Regarding aortic valve which of the following is false:

a) It is semilunar valve that is located at the beginning of the arch of the aorta. b) It is about 2.5 cms in diameter. c) It has 3 cusps; one anterior & 2 posterior. d) It is located opposite the 3rd IC space at the left border of the sternum.
6/24/12

Regarding

aortic valve which of the following is false:

a) It is semilunar valve that is located at the beginning of the arch of the aorta. b) It is about 2.5 cms in diameter. c) It has 3 cusps; one anterior & 2 posterior. d) It is located opposite the 3rd IC space at the left border of the sternum.
6/24/12

A 36-year-old male office worker comes to the clinic complaining of general weakness and shortness of breath. He also relates a rapid, throbbing pulse after climbing a flight of stairs. Cardiac auscultation reveals a diastolic rumbling murmur attributable to the mitral valve. The mitral valve is best heard where?
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a. Left side adjacent to the sternum in the second intercostals space b. Left side adjacent to the sternum in the fifth intercostal space c. Left side in the midclavicular line in the fifth intercostals space d. Right side adjacent to the sternum in the second intercostals space e. Right side adjacent to the sternum in the
6/24/12 fourth intercostals space

a. Left side adjacent to the sternum in the second intercostals space b. Left side adjacent to the sternum in the fifth intercostal space c. Left side in the midclavicular line in the fifth intercostals space d. Right side adjacent to the sternum in the second intercostals space e. Right side adjacent to the sternum in the
6/24/12 fourth intercostals space

When

examining an axial/horizontal CT of the chest, remember that the origin of the pulmonary trunk just cranial to the right ventricle starts out where?

a. Anterior and to the left of the ascending aorta b. Posterior and to the left of the ascending aorta c. Anterior and to the right of the ascending aorta d. Anterior and to the left of the aorta
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When

examining an axial/horizontal CT of the chest, remember that the origin of the pulmonary trunk just cranial to the right ventricle starts out where?

a. Anterior and to the left of the ascending aorta b. Posterior and to the left of the ascending aorta c. Anterior and to the right of the ascending aorta d. Anterior and to the left of the aorta
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Identify

the four points indicated to the surface of the heart. Choose the correct one: Upper border of the left 3rd costal cartilage, 1 inch from the middle line Lower border of left 2nd costal cartilage, 2 inc from the middle line Right six intercostals space half inch from the middle line Left fifth intercostals space 3.5 inches from middle line
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a. b. c. d.

Identify

the four points indicated to the surface of the heart. Choose the correct one: Upper border of the left 3rd costal cartilage, 1 inch from the middle line Lower border of left 2nd costal cartilage, 2 inc from the middle line Right six intercostals space half inch from the middle line Left fifth intercostals space 3.5 inches from middle line
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a. b. c. d.

A

47-year-old woman with history of rheumatic fever is examined by her physician. Physical examination is significant for a low-pitched , rumbling, diastolic murmur preceded by an opening snap. The affected valve can be best evaluated by auscultation at which of the following locations?

a. Left second intercostals space b. Left fifth intercostals space c. Left lower sterna body border
6/24/12 d. right second intercostals space

A

47-year-old woman with history of rheumatic fever is examined by her physician. Physical examination is significant for a low-pitched , rumbling, diastolic murmur preceded by an opening snap. The affected valve can be best evaluated by auscultation at which of the following locations?

a. Left second intercostals space b. Left fifth intercostals space c. Left lower sterna body border
6/24/12 d. right second intercostals space

A

20-year-old man is stabbed immediately to the left body of the sternum at the fifth intercostals space. The knife most likely penetrated the

a. left atrium b. left ventricle c. right atrium d. right ventricle e. stomach
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A

20-year-old man is stabbed immediately to the left body of the sternum at the fifth intercostals space. The knife most likely penetrated the

a. left atrium b. left ventricle c. right atrium d. right ventricle e. stomach
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6/24/12

AORTIC VALVES

PULMONARY VALVES

TRICUSPID 6/24/12 VALVES

BICUSPID (MITRAL) VALVES

THANK YOU

6/24/12

A.I.D.
CARDIAC ENZYMES
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6/24/12

All

the following are the disadvantages of myoglobin EXCEPT Typical rise occurs within 2-4 hours after onset of myocardial infarction Myoglobin is not cardiac specific Can’t be used as late marker Can’t be used in diagnosis myocardial infarction in renal failure patients 6/24/12

a. b. c. d.

All

the following are the disadvantages of myoglobin EXCEPT Typical rise occurs within 2-4 hours after onset of myocardial infarction Myoglobin is not cardiac specific Can’t be used as late marker Can’t be used in diagnosis myocardial infarction in renal failure patients 6/24/12

a. b. c. d.

Choose

the correct advantages of Creatine Kinase as marker for myocardial infarction. Plasma enzyme activity increase by 95% in myocardial infarction

I-

II- Second rise indicates extent of damage III- Indicate reperfusion after thrombolytic therapy with confirmed AMI patients IV- A prolonged rise may indicate cardiac ventricular aneurysm
a.

I , II, and III

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Choose

the correct advantages of Creatine Kinase as marker for myocardial infarction. Plasma enzyme activity increase by 95% in myocardial infarction

I-

II- Second rise indicates extent of damage III- Indicate reperfusion after thrombolytic therapy with confirmed AMI patients IV- A prolonged rise may indicate cardiac ventricular aneurysm
a.

I , II, and III

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All

the following conditions can lead to increase in plasma AST concentration and increase LDH1 level EXCEPT Primary hepatic dysfunction small MI

I-

II- Secondary hepatic dysfunction after III- Congestive heart failure without infarction or pulmonary embolism IV- Myocardial infarction
a. b.

I & II II & III
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All

the following conditions can lead to increase in plasma AST concentration and increase LDH1 level EXCEPT Primary hepatic dysfunction small MI

I-

II- Secondary hepatic dysfunction after III- Congestive heart failure without infarction or pulmonary embolism IV- Myocardial infarction
a. b.

I & II II & III
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True or False
Cardiac

and skeletal forms of TnI and TnT are structurally different and can be distinguished by immunological assays. (True / False) activity assay reflects the concentration of enzymes thus having the best accuracy. (True / False)

Enzyme

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True or False
Cardiac

and skeletal forms of TnI and TnT are structurally different and can be distinguished by immunological assays. (True / False) activity assay reflects the concentration of enzymes thus having the best accuracy. (True / False)

Enzyme

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 Which

cardiac enzyme would you expect to rise within the next 3 to 8 hours : Creatine kinase (CK) Lactic dehydrogenase (LDH) LDH – 1 LDH – 2
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a. b. c. d.

Which

cardiac enzyme would you expect to rise within the next 3 to 8 hours : Creatine kinase (CK) Lactic dehydrogenase (LDH) LDH – 1 LDH – 2
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a. b. c. d.

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The

laboratory tests that would confirm a diagnosis of myocardial infarction include: LDH, CK-MB and AST Serum calcium, and alkaline phosphatase Sedimentation rate, and ALT Serum potassium
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a. b. c. d.

The

laboratory tests that would confirm a diagnosis of myocardial infarction include: LDH, CK-MB and AST Serum calcium, and alkaline phosphatase Sedimentation rate, and ALT Serum potassium
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a. b. c. d.

Elevation

of which of the following serum enzyme markers would be most useful in diagnosing a myocardial infarction in a patient who comes to your office 3 days after an episode of severe and prolonged substernal chest pain?

a. LDH isoenzymes b. CK.MB c. TroponinC d. Myoglobin

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Elevation

of which of the following serum enzyme markers would be most useful in diagnosing a myocardial infarction in a patient who comes to your office 3 days after an episode of severe and prolonged substernal chest pain?

a. LDH isoenzymes b. CK.MB c. TroponinC d. Myoglobin

6/24/12

Which

protein inhibits the interaction of actin and myosin?

a. troponin C b. troponin T c. troponin I d. tropomysin

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Which

protein inhibits the interaction of actin and myosin?

a. troponin C b. troponin T c. troponin I d. tropomysin

6/24/12

THANK YOU

6/24/12

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