WBR0460: Difference between revisions

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(Created page with "{{WBRQuestion |QuestionAuthor={{Rim}} |ExamType=USMLE Step 1 |MainCategory=Anatomy |SubCategory=Cardiology |MainCategory=Anatomy |SubCategory=Cardiology |MainCategory=Anatomy ...")
 
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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Anatomy
|MainCategory=Anatomy
Line 20: Line 20:
|MainCategory=Anatomy
|MainCategory=Anatomy
|SubCategory=Cardiology
|SubCategory=Cardiology
|Prompt=A 56 year old male patient presents to the emergency department with chest pain and shortness of breath. Appropriate work-up is rapidly initiated.  Patient’s blood work-up reveals elevated levels of Troponin.  His electrocardiogram (ECG) shows ST-segment elevation in more than one lead.  The diagnosis of ST-elevation myocardial infarction (STEMI) is made.  Cardiac catheterization shows occlusion of the right coronary artery (RCA).  Which of the following components of the heart is most likely to be affected as a result of the patient’s STEMI?
|Prompt=A 56-year-old male presents to the emergency room with complaints of chest pain and shortness of breath. Blood work-up reveals elevated levels of Troponin and an electrocardiogram (ECG) demonstrates ST-segment elevation in more than one lead, leading you to diagnose him with ST-elevation myocardial infarction (STEMI).  Cardiac catheterization displays occlusion of the right coronary artery (RCA).  Which of the following components of the heart is most likely affected as a result of the patient’s STEMI?
|Explanation=The [[cardiac circulation]] is characterized by 2 main arteries that contain several branches as they descend from their sinuses at the base of the aorta.  They are the [[left main artery]] and the [[right coronary artery]] ([[RCA]]).  The [[left main artery]] is further divided into the [[left anterior descending]] ([[LAD]]) artery, also called the “widow maker” because it is the most severe and the most common artery to be occluded in [[myocardial infarction]] and subsequent death, and the [[Left circumflex]] (LCx) artery.  The LCx gives rise to the [[posterior descending artery]] (PDA) in approximately 35% of the case.   
|Explanation=The [[cardiac circulation]] is characterized by two main arteries, containing several branches as they descend from their sinuses at the base of the aorta, which are the [[left main artery]] and the [[right coronary artery]] ([[RCA]]).  The [[left main artery]] is divided into the [[left anterior descending]] ([[LAD]]) artery, also called the “widow maker” because it is the most common artery to be occluded in [[myocardial infarction]] and subsequent death, and the [[Left circumflex]] (LCx) artery.  The LCx gives rise to the [[posterior descending artery]] (PDA) in approximately 35% of cases.   
On the other hand, the RCA gives rise to the PDA in more than 65% of the cases.  The RCA supplies the [[SA node]].
The RCA, which supplies the [[SA node]], gives rise to the PDA in more than 65% of the cases.


Educational Objective:
|EducationalObjectives= The right coronary artery (RCA) is the most common arterial supply to the sinoatrial (SA) node.
The right coronary artery (RCA) is the most common arterial supply to the sinoatrial (SA) node.
|References= First Aid 2014 page 266


|AnswerA=Anterior interventricular septum
|AnswerA=Anterior interventricular septum
|AnswerAExp=Blood supply to the anterior interventricular septum is most commonly from the LAD
|AnswerAExp=The LAD usually provides the blood supply to the anterior interventricular septum.
|AnswerB=Left atrium
|AnswerB=Left atrium
|AnswerBExp=Blood supply to the left atrium is most commonly from the left main coronary artery.
|AnswerBExp=The left main coronary artery usually provides the blood supply to the left atrium.
|AnswerC=Anterolateral papillary muscle
|AnswerC=Anterolateral papillary muscle
|AnswerCExp=The anterior papillary muscle most commonly receives dual blood supply from the LAD and the LCx.
|AnswerCExp=The anterior papillary muscle most commonly receives a dual blood supply from the LAD and the LCx.
|AnswerD=Sinoatrial (SA) node
|AnswerD=Sinoatrial (SA) node
|AnswerDExp=Blood supply to the SA node is most commonly from the RCA.
|AnswerDExp=The RCA usually provides the blood supply to the SA node.
|AnswerE=Apex
|AnswerE=Apex
|AnswerEExp=The apex of the heart receives dual supply from the LAD and the PDA.  The LDA provides most of the blood supply to the apex.  
|AnswerEExp=The apex of the heart receives a dual blood supply from the LAD and the PDA.  The LDA provides the majority of the blood supply to the apex.  
|RightAnswer=D
|RightAnswer=D
|WBRKeyword=coronary, artery, sinoatrial, node, sinoatrial node, SA, right, blood, supply
|WBRKeyword=coronary artery, sinoatrial node, SA, blood supply, cardiovascular system, cardiology,
|Approved=No
|Approved=Yes
}}
}}

Revision as of 13:35, 24 July 2014
Author [[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Anatomy
Sub Category SubCategory::Cardiology
Prompt [[Prompt::A 56-year-old male presents to the emergency room with complaints of chest pain and shortness of breath. Blood work-up reveals elevated levels of Troponin and an electrocardiogram (ECG) demonstrates ST-segment elevation in more than one lead, leading you to diagnose him with ST-elevation myocardial infarction (STEMI). Cardiac catheterization displays occlusion of the right coronary artery (RCA). Which of the following components of the heart is most likely affected as a result of the patient’s STEMI?]]
Answer A AnswerA::Anterior interventricular septum
Answer A Explanation AnswerAExp::The LAD usually provides the blood supply to the anterior interventricular septum.
Answer B AnswerB::Left atrium
Answer B Explanation AnswerBExp::The left main coronary artery usually provides the blood supply to the left atrium.
Answer C AnswerC::Anterolateral papillary muscle
Answer C Explanation AnswerCExp::The anterior papillary muscle most commonly receives a dual blood supply from the LAD and the LCx.
Answer D AnswerD::Sinoatrial (SA) node
Answer D Explanation AnswerDExp::The RCA usually provides the blood supply to the SA node.
Answer E AnswerE::Apex
Answer E Explanation AnswerEExp::The apex of the heart receives a dual blood supply from the LAD and the PDA. The LDA provides the majority of the blood supply to the apex.
Right Answer RightAnswer::D
Explanation [[Explanation::The cardiac circulation is characterized by two main arteries, containing several branches as they descend from their sinuses at the base of the aorta, which are the left main artery and the right coronary artery (RCA). The left main artery is divided into the left anterior descending (LAD) artery, also called the “widow maker” because it is the most common artery to be occluded in myocardial infarction and subsequent death, and the Left circumflex (LCx) artery. The LCx gives rise to the posterior descending artery (PDA) in approximately 35% of cases.

The RCA, which supplies the SA node, gives rise to the PDA in more than 65% of the cases.
Educational Objective: The right coronary artery (RCA) is the most common arterial supply to the sinoatrial (SA) node.
References: First Aid 2014 page 266]]

Approved Approved::Yes
Keyword WBRKeyword::coronary artery, WBRKeyword::sinoatrial node, WBRKeyword::SA, WBRKeyword::blood supply, WBRKeyword::cardiovascular system, WBRKeyword::cardiology
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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