Cardiology

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Which bacteria causes endocarditis in the presence of colon cancer
Decrease in activity of Na/Ca exhanger and increase in contractility
CO
In series
S. bovis


2. What is sudden cardiac death most commonly due to...
The operating point of the heart
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
LCX - I - aVL
V fib arrhythima


3. Irregularly irregular ECG - no p waves: dx and treatment
3rd degree block - pacemaker - Lyme disease
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Takayasu's arteritis
Ventricular repolarization


4. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Granuloma with giant cells
Hypertrophied cardiomyopathy
Subendocardial
Mitral and tricuspid closure


5. fibrous plaques and atheromas in intima of arteries
Boot shaped heart
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Dilation
Atherosclerosis


6. How does digitatlis increase contractility?
Vagus to medulla
Increase intracellular Na - resulting in increased Ca
Ischemic heart dz - mitral valve prolapse - LV dilation
Stable angina


7. fibrinous pericarditis several weeks post MI

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8. What does FROM JANE stand for in bacterial endocarditis?

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9. congenital heart defect with marfan's
Aortic insuffic - late
...
Decreased
Decrease in cAMP


10. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
5-10 days - macs have degraded structural components
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
S. epidermidis
Vasodilators - (hydrAlAzine)


11. What are the 5 T's of cyanoitc babies
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Increased SV
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea


12. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
LCX - I - aVL
Raynaud's
CHF
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli


13. Hyperplastic onion skinning
Arteriolosclerosis in malignant hypertension
Non
Atherosclerosis
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)


14. What are common causes of mitral regurg?
Transposition of great vessels
Filling is incomplete and CO falls
Ischemic heart dz - mitral valve prolapse - LV dilation
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy


15. Which valve is most commonly involved in bacterial endocarditis?
Fick principle
S. epidermidis
Eccentric - concentric hypertrophy causes diastolic disfunction
Mitral valve


16. In an EKG - What is the T wave?
Ventricular repolarization
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Increasing activity of Ca pump in SR
Wegener's


17. What causes the murmur heard in tricuspid regurg to enhance
In RA return (inspiration)
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Medullary vasomotor center senses baroreceptors and JGA


18. How does aldosterone raise MAP
RV contraction (closed tricuspid valve bulding into atrium
Inc blood volume
Vasodilators - (hydrAlAzine)
CFX


19. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Age related calcifications or bicuspid aortic valve
Transmural
Wegener's


20. machine murmer
Right sided
PDA
Vasodilators
MI


21. In an EKG - What is the PR interval?
Raynaud's
During diastole
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Conduction delay through AV node - nl < 200 msec


22. What constitues the upstroke in pacemaker cells?
140/90
Prinzmetal angina
Volatage gated Ca channels
Total anomalous pulmonary trunk venous return


23. exaggerated decrease in pulse during inspiration.

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24. What are the complications of atherosclerosis?
Lymphangiosarcoma
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Mitral stenosis
LAD - V1 - V4


25. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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26. p - anca

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27. How do beta blockers decrease contractility?
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Decrease in cAMP
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn


28. When do you find hemosiderin laden macrophages in the lungs?
Temporal arteritis
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
During HF from microhemorrhages from inc pulm cap pressure
QRS complex


29. Which artery supplies the SA and AV nodes?
If sodium channel
PDA
RCA
Vasocxn


30. In an EKG - What is the QRS complex?
No
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Ventricular depolarization - nl < 120 msec
Kids


31. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
Hypertrophied cardiomyopathy
Hyperlipidemia
Group a beta hemolytic strep


32. What does TAPVR stand for
CHF
Conduction delay through AV node - nl < 200 msec
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Total anomalous pulmonary trunk venous return


33. Chronic mitral stenosis can lead to what changes in size of the LA
Dilation
Raynaud's
Filling is incomplete and CO falls
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's


34. Restrictive cardiomyopathy causes
Medullary vasomotor center senses baroreceptors and JGA
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Decreased
Decrease in activity of Na/Ca exhanger and increase in contractility


35. Which enzymes are useful for diagnosing reinfarction
Raynaud's
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Rhabdomyomas
CK- MB


36. What stimulates release of calcium from the SR?
Extracellular calcium - calcium induced calcium release
10%
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Holosystoiic


37. When do you see extensive coagulative necrosis in an MI
2-4 day - early coag necrosis on the first day
Transmural
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
In parallel


38. Which murmur do you hear in mitral stenosis?
During diastole
Late diastolic murmur following an opening snap
Total anomalous pulmonary trunk venous return
Patent ductus arteriosus - congenital rubella or prematurity


39. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

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40. What does the starling curve show?
Polyarteritis nodosum
Filling is incomplete and CO falls
Gap junctions
Changes in CO as a function of preload


41. When during cardiac nodal cells depolarize?
RV contraction (closed tricuspid valve bulding into atrium
During diastole
Cystic hygroma
Polyarteritis nodosum


42. Exercise - overtransfusiion and excitiment causes and increase in...?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Activated histiocytes
Crescendo - decrescendo systolic ejection murmur following ejection click
Preload


43. When does extracellular calcium enter the cardiac muscle cells during contraction?
Apex and anterior interventricular septum
Ventricular repolarization
The plateau period
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD


44. congenital heart defect withdown syndrome
Vasodilators
ASD - VSD - AV septal defect (endocardial cushion defect)
Extracellular calcium - calcium induced calcium release
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical


45. What is the time frame for arrhythmia risk in the evolution of MI
Atrial contraction
Pyogenic granuloma - associated with trauma and pregnancy
The first 4 days
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis


46. What supplies the posterior left ventricle?
Fluid movement through capillaries
Gap junctions
CFX
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)


47. Which bacteria can cause endocarditis from prosthetic valves?
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
S. epidermidis
MI
Aortic/pulmonic regurg and mitral/tricuspid stenosis


48. Rank the pacemakers cells
Buerger's disease
Temporal arteritis
Truncus - tet of fallot
SA>AV>bundle of His>ventricles


49. Why is there edema after burns or during infection
Adult type aortic coarctation
Hematocrit
Inc Kf - capillary perm
Group a beta hemolytic strep


50. congenital heart defect with turner's
Takayasu's arteritis
Atrial contraction
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Coarcation of aorta