Exam Review
50 questions, 70 minutes
One select all that apply
1. What are risk factors for Stroke? (486, 493)
a. High blood pressure
b. Ethnicity (African American males)
c. Atrial fibrillation and other conditions that predispose people to clot formation (ex.
polycythemia, sickle cell disease, blood disorders)
d. Diabetes
- More women die annually of stroke
2. Atrial Fibrillation (787)
a. What is the goal of defibrillating or cardioverting them?
i. We are trying to depolarize the passage of the current through the heart at the same
time to reset it.
ii. Defibrillation and cardioversion aim to deliver electrical energy to the heart in order
to stun it momentarily (trying to depolarize the passage of the current). This allows
for a normal sinus rhythm to kick in due to the heart’s regular pacemaker known as
the sinoatrial node
b. Fibrillation occurs when atrial cells cant repolarize in time for upcoming stimulus
c. Can be seen in patients without any history of cardiac disease, CHF, CAD, mitral valve
disease, ischemic heart disease, hypertension, MI, pericarditis, CHF, hyperthyroidism,
digitalis toxicity
d. More common in men
3. What is the role of platelets in MI’s, stroke, and peripheral vascular disease and why would we
recommend an aspirin every day? (772)
a. Know the pathophysiology as to why we would want our patients to take a daily aspirin
especially if they can’t take regular anticoagulation due to their risk of falls
b. Why would we choose aspirin?
i. Inhibits synthesis of the prostaglandin thromboxane A2 is thought to promote
reperfusion and reduce likelihood of rethrombosis
ii. Effect of aspirin on platelet function is 8-10 days
iii. Prevents platelet aggregation
4. What is the mechanism that causes stroke, peripheral vascular disease, MI’s?
a. Stroke
b. Peripheral Vascular Disease ATHEROSCLEROSIS
c. MI (stroke can be a complication of an MI)
5. Characteristics that would make you think that a lump in the breast would be carcinoma
a. Benign – mobile, firm, tender
b. Malignant - fixed, painless, harder
6. Signs and symptoms of Meningitis (494)
a. Happens often with college kids
b. Clinical manifestations – headache, fever, confusion, stiff neck/back/abdomen, N/V,
extremity pains
c. Brudzinski’s and Kernig signs to test for a suspicion of meningitis BUT cerebral spinal fluid
is the gold standard
7. Know risk factors associated with Down Syndrome (90, 807)
, a. Risk Factors – mothers age > 35
b. Caused by nondisjunction or an error in cell division during meiosis result in trisomy 21
c. Most common chromosomal disorder
8. Know when the fetus is most vulnerable to teratogens in the environment
a. Between 3rd and 9th week
b. Infectious agents (TORCH)
i. TOXOPLASMOSIS
ii. OTHER (varicella-zoster virus, listeriosis, leptospirosis, Epstein Barr, tuberculosis,
syphilis, HIV, human parvovirus)
iii. RUBELLA
iv. CYTOMEGALOVIRUS
v. HERPES
***Most susceptible to these agents during organogenesis
9. Signs and symptoms of Pulmonary Edema (800)
a. Is a symptom of severe left sided HF following an MI or CHF that has gone awry and causes
the patient to be unstable
b. Backs up the left side of the heart so it goes into the lungs causing pink, frothy sputum and
crackles
c. Rapid pulse, moist cool skin, cyanosis eventually confusion and stupor
10. Know the difference between Stable and Unstable Angina
a. Prinzmetal Angina – vasospasms
i. Usually occurs at rest or with minimal exercise and frequently occurs nocturnally
ii. People with Prinzmetal angina who have a history of serious arrhythmias during
spontaneous episodes of pain are at higher risk for sudden death
iii. Associated with migraines or Raynaud’s phenomenon
b. Unstable Angina (767) – get up and walk and get chest pain and sit down and DOESN'T go
away
i. Syndrome of myocardial ischemia
ii. DIFFERENCE BETWEEN THIS AND A NSTEMI IS THAT THIS DOES NOT
CAUSE ELEVATED SERUM MARKERS
iii. Pain can last for longer
iv. Inflammation can play a large role in plaque instability, with inflammatory cells
releasing cytokines that causes the fibrous cap to become thinner and more
vulnerable to rupture or erosion
c. Stable (774) – get up and walk and get chest pain and sit down and it DOES go away
i. Can be precipitated by cold, emotional stress, or exertion
ii. Steady and increases in intensity but does not last long
iii. Can be helped with nitroglycerin
iv. Associated with a fixed coronary obstruction that produces a disparity between
coronary blood flow and metabolic demands of the myocardium
11. Know about Histamine
a. Mast cells release histamine
b. Histamine induces endothelial cell retraction causing increased permeability of the vessels
c. Type 1 Hypersensitivities (IgE) – allergic reactions that we see commonly with a bee sting,
this is where histamine gets released from mast cells
i. Ex. Urticaria (hives), allergic rhinitis (hay fever), atopic dermatitis, food allergies,
some types of asthma
ii. Can be treated with epinephrine
50 questions, 70 minutes
One select all that apply
1. What are risk factors for Stroke? (486, 493)
a. High blood pressure
b. Ethnicity (African American males)
c. Atrial fibrillation and other conditions that predispose people to clot formation (ex.
polycythemia, sickle cell disease, blood disorders)
d. Diabetes
- More women die annually of stroke
2. Atrial Fibrillation (787)
a. What is the goal of defibrillating or cardioverting them?
i. We are trying to depolarize the passage of the current through the heart at the same
time to reset it.
ii. Defibrillation and cardioversion aim to deliver electrical energy to the heart in order
to stun it momentarily (trying to depolarize the passage of the current). This allows
for a normal sinus rhythm to kick in due to the heart’s regular pacemaker known as
the sinoatrial node
b. Fibrillation occurs when atrial cells cant repolarize in time for upcoming stimulus
c. Can be seen in patients without any history of cardiac disease, CHF, CAD, mitral valve
disease, ischemic heart disease, hypertension, MI, pericarditis, CHF, hyperthyroidism,
digitalis toxicity
d. More common in men
3. What is the role of platelets in MI’s, stroke, and peripheral vascular disease and why would we
recommend an aspirin every day? (772)
a. Know the pathophysiology as to why we would want our patients to take a daily aspirin
especially if they can’t take regular anticoagulation due to their risk of falls
b. Why would we choose aspirin?
i. Inhibits synthesis of the prostaglandin thromboxane A2 is thought to promote
reperfusion and reduce likelihood of rethrombosis
ii. Effect of aspirin on platelet function is 8-10 days
iii. Prevents platelet aggregation
4. What is the mechanism that causes stroke, peripheral vascular disease, MI’s?
a. Stroke
b. Peripheral Vascular Disease ATHEROSCLEROSIS
c. MI (stroke can be a complication of an MI)
5. Characteristics that would make you think that a lump in the breast would be carcinoma
a. Benign – mobile, firm, tender
b. Malignant - fixed, painless, harder
6. Signs and symptoms of Meningitis (494)
a. Happens often with college kids
b. Clinical manifestations – headache, fever, confusion, stiff neck/back/abdomen, N/V,
extremity pains
c. Brudzinski’s and Kernig signs to test for a suspicion of meningitis BUT cerebral spinal fluid
is the gold standard
7. Know risk factors associated with Down Syndrome (90, 807)
, a. Risk Factors – mothers age > 35
b. Caused by nondisjunction or an error in cell division during meiosis result in trisomy 21
c. Most common chromosomal disorder
8. Know when the fetus is most vulnerable to teratogens in the environment
a. Between 3rd and 9th week
b. Infectious agents (TORCH)
i. TOXOPLASMOSIS
ii. OTHER (varicella-zoster virus, listeriosis, leptospirosis, Epstein Barr, tuberculosis,
syphilis, HIV, human parvovirus)
iii. RUBELLA
iv. CYTOMEGALOVIRUS
v. HERPES
***Most susceptible to these agents during organogenesis
9. Signs and symptoms of Pulmonary Edema (800)
a. Is a symptom of severe left sided HF following an MI or CHF that has gone awry and causes
the patient to be unstable
b. Backs up the left side of the heart so it goes into the lungs causing pink, frothy sputum and
crackles
c. Rapid pulse, moist cool skin, cyanosis eventually confusion and stupor
10. Know the difference between Stable and Unstable Angina
a. Prinzmetal Angina – vasospasms
i. Usually occurs at rest or with minimal exercise and frequently occurs nocturnally
ii. People with Prinzmetal angina who have a history of serious arrhythmias during
spontaneous episodes of pain are at higher risk for sudden death
iii. Associated with migraines or Raynaud’s phenomenon
b. Unstable Angina (767) – get up and walk and get chest pain and sit down and DOESN'T go
away
i. Syndrome of myocardial ischemia
ii. DIFFERENCE BETWEEN THIS AND A NSTEMI IS THAT THIS DOES NOT
CAUSE ELEVATED SERUM MARKERS
iii. Pain can last for longer
iv. Inflammation can play a large role in plaque instability, with inflammatory cells
releasing cytokines that causes the fibrous cap to become thinner and more
vulnerable to rupture or erosion
c. Stable (774) – get up and walk and get chest pain and sit down and it DOES go away
i. Can be precipitated by cold, emotional stress, or exertion
ii. Steady and increases in intensity but does not last long
iii. Can be helped with nitroglycerin
iv. Associated with a fixed coronary obstruction that produces a disparity between
coronary blood flow and metabolic demands of the myocardium
11. Know about Histamine
a. Mast cells release histamine
b. Histamine induces endothelial cell retraction causing increased permeability of the vessels
c. Type 1 Hypersensitivities (IgE) – allergic reactions that we see commonly with a bee sting,
this is where histamine gets released from mast cells
i. Ex. Urticaria (hives), allergic rhinitis (hay fever), atopic dermatitis, food allergies,
some types of asthma
ii. Can be treated with epinephrine
