Download ANCE Blueprint Cardiology - All Smarty PANCE cardiology sets combined + EKG (Latest 2026 / and more Exams Cardiology in PDF only on Docsity!
ANCE Blueprint Cardiology - All Smarty
PANCE cardiology sets combined + EKG
(Latest 2026 / 2027) Questions with
Answers 100% Correct {Grade A}
What is the definition of cardiomyopathy? Heart disease resulting from a primary abnormality in the myocardium List two types of surgical procedures to correct hypertrophic obstructive cardiomyopathy
- Open heart and excision
- Alcohol ablation done through cardiac catheterization What heart sound will likely be present with hypertrophic obstructive cardiomyopathy? S List three medications that may be used both to prevent arrhythmia and ease symptoms with hypertrophic obstructive cardiomyopathy
- Diuretics 2 Beta-blockers
- Non-dihydropyridine CCB (verapamil or diltiazem) Once a patient is diagnosed with hypertrophic obstructive cardiomyopathy what family counseling must be done? Entire family must be screened for HOCM Angina , syncope , and heart failure in a child likely represents ____________. HOCM (Hypertrophic Cardiomyopathy) What causes the sudden cardiac death in a patient with hypertrophic obstructive cardiomyopathy? Ventricular tachycardia that degenerates into ventricular fibrillation What maneuver makes the hypertrophic obstructive cardiomyopathy murmur louder? Valsalva or standing What are the signs of hypertrophic obstructive cardiomyopathy on the exam?
Sudden death due to VT Which chamber is most affected in cardiomyopathies? Left ventricle What chambers are affected (and how) in dilated cardiomyopathy? Enlargement and dilation of all four chambers What is the most common cause of non-ischemic dilated cardiomyopathy in the US? Chronic alcoholism What is the second most common cause of non-ischemic cardiomyopathies? (#1 in other parts of the world) Viral myocarditis What is damaged in dilated cardiomyopathy and what does it result in? Myocytes are injured and necrosis occurs with myocardial fibrosis - when muscle cells fail they dilate Does dilated cardiomyopathy have a systolic or diastolic dysfunction? Systolic dysfunction What is the number one cause of d ilated cardiomyopathy overall?
Ischemic cardiomyopathy (more than 60% of patients with heart failure have this) What is seen histologically in dilated cardiomyopathy? Nonspecific abnormalities, variations in myocyte size, myocyte vacuolization, fibrosis, and fat replace myocardium How does alcoholism lead to dilated cardiomyopathy? Alcohol destroys microvilli brush border and leads to nutritional deficits (thiamine in particular) (glutamine helps regenerate) alcohol is toxic to cardiac tissue which leads to myocyte death What does the heart of someone with dilated cardiomyopathy resemble? Basketball In which chamber are changes seen in hypertrophic cardiomyopathy? L ventricle hypertrophy without ventricular chamber dilation What is hypertrophic cardiomyopathy characterized by? Myocardial hypertrophy, abnormal diastolic filling in 1/3 of cases, and intermittent ventricular outflow obstruction Which wall of the ventricle is more hypertrophic in hypertrophic cardiomyopathy?
Sinus bradycardia is a normal sinus rhythm with a rate of _________ bpm < 60 bpm EKG: no discrete P waves and an irregularly irregular pattern of QRS complexes. What's the dx? Atrial Fibrillation EKG: Regular, sawtooth pattern (F-waves), narrow QRS complex. What's the dx? Atrial Flutter EKG: PR interval > .2 seconds. What's the dx? First degree AV block EKG: Progressive prolongation of the PR interval culminating in a non-conducted P wave. What's the dx? Mobitz I Wenckebach block (longer, longer, drop now you've got a Wenckebach) EKG: Intermittent non-conducted P waves without progressive prolongation of the PR interval. What's the dx? Type II Mobitz block (some get dropped some get through now you've got Mobitz 2)
EKG: there is complete absence of AV conduction - none of the supraventricular impulses are conducted to the ventricles. What's the dx? Third degree AV block (P's and Q's don't agree now you've got a 3rd degree) EKG: R and R' (upward bunny ears) in V4-V6. What's the dx? Left bundle branch block EKG: R and R' (upward bunny ears) in V1-V3. What's the dx? Right bundle branch block A faster-than-normal heart rate beginning above the heart's two lower chambers in the atria, AV junction or SA node. What's the dx? Supraventricular Tachycardia EKG: Shorter PR Interval, longer QRS complex and a delta wave - slurring slow rise of initial portion of the QRS. What's the dx? Wolff-Parkinson-White Syndrome EKG: Rapid irregular rhythm > 100 bpm. At least 3 distinct P-wave morphologies. What's the dx? Multifocal Atrial Tachycardia
EKG: Chaotic irregular deflections of varying amplitude No identifiable P waves, QRS complexes, or T waves. What's the dx? Ventricular Fibrillation EKG: Polymorphic ventricular tachycardia that appears to be twisting around a baseline. What's the dx? Torsades de Pointes (TdP) EKG: Vertical spikes of short duration, usually 2 ms. May be difficult to see in all leads Pacemaker Rhythm with *pacing spikes" Prolonged absence of sinus node activity (absent P waves) < 3 seconds Sinus pause Prolonged absence of sinus node activity (absent P waves) > 3 seconds Sinus arrest Which antihypertensive medications can cause bradycardia? Beta blockers - Non-dihydropyridine CCB - Central agents (clonidine) Which antihypertensive medications can cause AV block? Non-dihydropyridine CCB - Central agents (clonidine)
What is the most likely cause of syncope which occurs in a child during an argument? Long QT syndrome Non-cardiac hypoxia (e.g. pneumonia, COPD) commonly causes what arrhythmia? Atrial fibrillation What arrhythmia can occur with structural changes such as hypertrophy or dilatation of the ventricle? Ventricular tachycardia What two murmurs are most associated with atrial fibrillation? Mitral stenosis - Mitral regurgitation What HTN med classes can cause bradycardia? Beta Blockers - Central agents (clonidine) - Verapamil and Cardizem What arrhythmia is associated with arterial embolism? Atrial fibrillation A 24-year-old has a syncopal event. EKG demonstrates a short PR interval with an upswept initial QRS. What underlying condition caused the syncope? Wolf Parkinson White
Symptoms include palpitations and sometimes weakness, effort intolerance, dyspnea, and presyncope What is seen on an ECG tracing of atrial fibrillation? An ECG tracing of atrial fibrillation shows an erratic baseline and no discrete P waves , in between irregularly spaced QRS complexes What is a serious complication associated with atrial fibrillation? A serious complication associated with atrial fibrillation is thrombotic embolism , due to blood stagnation in the atria What is used to monitor patients on warfarin therapy for the prevention of thrombotic embolism complicating atrial fibrillation? INR and prothrombin time are used to monitor patients on warfarin therapy for prevention of thrombotic embolism complicating atrial fibrillation What is the adjusted-dose warfarin target INR for patients with A-fib? Adjusted-dose warfarin target INR is 2.5 (range 2– 3 ) Where do the ectopic impulses causing atrial fibrillation most commonly originate?
The ectopic impulses causing atrial fibrillation most commonly originates from the roots of the pulmonary veins How is the atrial fibrillation rhythm typically described? The atrial fibrillation rhythm is described as irregularly irregular How is paroxysmal atrial fibrillation defined? Paroxysmal atrial fibrillation is defined as intermittent attacks that resolve spontaneously in less than seven days How is persistent atrial fibrillation defined? Persistent atrial fibrillation is defined as atrial fibrillation rhythm that lasts more than seven days Rate control strategy of managing atrial fibrillation aims to keep the heart rate below what rate? Rate control strategy of managing atrial fibrillation aims to keep the heart rate below 110 beats per minute What is the scoring system to assess the risk of stroke in patients with Afib?
D =diabetes - 1 point S2 (stroke or TIA)- 2 points How are CHADS2 and CHA2DS2-VASc used to determine which patients should receive anticoagulation? Based on scoring system: 0 points – no therapy or 81–325 mg/day of aspirin 1 point – either 81–325 mg/day of aspirin or anticoagulation 2 or more points – anticoagulation When indicated, what class of medication is preferable in patients with atrial fibrillation? Direct oral anticoagulants or DOAC (eg, dabigatran, rivaroxaban, apixaban, or edoxaban) rather than warfarin for most patients in whom oral anticoagulant therapy is chosen What are some instances warfarin should be chosen over DOACs in patients with Afib.?
Warfarin is preferable to DOACs in patients with mechanical heart valves, mitral stenosis, unacceptable increase in cost, EGFR < 30 ml/min, on certain medications (ex. phenytoin or certain antiretroviral therapy) What is atrial flutter? Atrial flutter is similar to atrial fibrillation , a common disorder that causes the heart to beat in abnormal patterns due to a large atrial reentrant circuit What are the symptoms of atrial flutter? Symptoms a atrial flutter are the same as A-fib and include palpitations and sometimes weakness, effort intolerance, dyspnea, and presyncope Diagnosis of atrial flutter? The diagnosis of atrial flutter is by ECG. In typical flutter, ECG shows continuous and regular atrial activation with a sawtooth pattern , most obvious in leads II, III, and aVF Treatment of atrial flutter? Treatment of atrial flutter is the same as that for A-fib and focuses on ventricular rate control , rhythm control , and prevention of thromboembolism.
As the electrical signal that controls one's heartbeat is partially or completely blocked the heart beats slowly or skip beats and can't pump blood effectively. Symptoms include dizziness , fainting , fatigue , and shortness of breath A type of second degree atrioventricular block that presents with dropped heartbeats that are not preceded by a change in PR interval length? Mobitz type II is a type of second degree atrioventricular block that presents with dropped heartbeats that are not preceded by a change in PR interval length. MOBITZ 2 (some get dropped some get through now you've got mobitz 2) A heart block described as a regularly irregular beat with a progressive lengthening of PR interval until a beat is “dropped” Mobitz type I (Wenckebach) is a heart block described as a regularly irregular beat with a progressive lengthening of PR interval until a beat is “dropped.” Remember : longer, longer, longer drop now you've got a Wenckebach What is the first line of treatment of Mobitz type II? Mobitz type II is always pathologic. The first line of treatment of Mobitz type II is pacemaker implantation
What is the first line of treatment of Mobitz type I? Treatment usually unnecessary unless the block causes symptomatic bradycardia and transient or reversible causes have been excluded. Treatment is then pacemaker insertion. A benign cardiac conduction abnormality where the PR interval is more than 200 milliseconds? First-degree atrioventricular block is a benign cardiac conduction abnormality where the PR interval is more than 200 milliseconds First degree atrioventricular block is diagnosed when the PR interval is more than how many small squares in the ECG? First degree atrioventricular block is diagnosed when the PR interval is more than five small squares in the ECG What is the treatment for third degree heart block? The treatment for third degree heart block is a pacemaker Atria and ventricles beat independently of each other ( P waves have no relation to QRS waves)
