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Cardiology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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 vessels account for the most total peripheral resistance
Afterload (proportional to peripheral resistance)
In RA return (inspiration)
HTN - bradycardia - and respiratory depression
Arteriorles

2. stroke volume x HR =?
CO
Fluid movement through capillaries
Transmural
P02

3. What is sudden cardiac death most commonly due to...
V fib arrhythima
RCA
Patent ductus arteriosus - congenital rubella or prematurity
Hemorrhage

4. What are aschoff bodies
Granuloma with giant cells
SA>AV>bundle of His>ventricles
Increase contractility
Troponin I

5. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Coarcation of aorta
The operating point of the heart
Dec plasma proteins
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

6. In an EKG - What is the p wave?
Atrial contraction
ASD - VSD - AV septal defect (endocardial cushion defect)
Early deaths from myocarditis
Decrease in cAMP

7. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
RCA
V fib arrhythima
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

8. What cardiac change occurs in pregnancy?
In series
Late systolic crescendo murmur with a midsystolic click
Increased SV
Vasocxn - while other tissues it causes vasodilation

9. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Ventricular repolarization
Fick principle

10. What do the carotid and aortic bodies respond to?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Aortic and pulmonary closing
ANP
Dec P02 - inc PC02 and dec pH

11. What happens in phase 2 of the cardiac ventricular action potential?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Kawasaki
V fib arrhythima
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

12. What causes tet of fallot?
Anterosuperior displacement of the infundibular septum
Late systolic crescendo murmur with a midsystolic click
Isovolumetric contraction
SA and AV nodes

13. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Mechanican contraction of the ventricles
Posterior descending (80% off the RCA - 20% off the circumflex)
Mitral>aortic>>tricuspid - high pressure valves affected most
Viridans streptococci

14. What is the S2 sound?
Volatage gated Ca channels
Aortic and pulmonary closing
Extracellular calcium - calcium induced calcium release
Cyclophosphamide and corticosteroids

15. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Ventricles are depolarized
Transfusion
Vasodilators - (hydrAlAzine)
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

16. EDV is also known as
Myxomatous degeneration - RF - chordae rupture
Preload
1st degree AV blodck
Left atrial pressure

17. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Polyarteritis nodosum
Dressler's - autoimmune
SV/ EDV
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

18. What does hypoxia cause in the lung versus other tissues?
S. aureus
Vasocxn - while other tissues it causes vasodilation
Aortic and pulmonary closing
Glomus tumor

19. What does the LAD supply?
Apex and anterior interventricular septum
Inc RA pressure - due to filling against closed tricupsid valve
HTN - bradycardia - and respiratory depression
Decrease in activity of Na/Ca exhanger and increase in contractility

20. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Aortic insuffic - late
No - no pressure gradient
Dilated cardiomyopathy
Vasodilators - (hydrAlAzine)

21. In an acute MI - are there any visible changes via LM in the first 2-4 hours
No
Decreases
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Ventricles are depolarized

22. fibrous plaques and atheromas in intima of arteries
Atherosclerosis
Acute thrombosis of coronary artery
Heart - 02 extraction is always around 100%
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

23. Which murmur is heard with VSD?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Holosystolic - harsh sounding murmur - loudest over tricuspid area
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
V fib arrhythima

24. What is the machine like murmur? What is the heart pathology and the predisposing causes
Patent ductus arteriosus - congenital rubella or prematurity
RV failure - in venous pressure
CHF
Apex and anterior interventricular septum

25. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
R to L shunt caused by stenoic pulmonic valve
Adult type aortic coarctation
Prinzmetal angina
Angiosarcoma

26. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Sturge weber - vasculitis of caps
Stable angina
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

27. sawtooth wave

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28. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
RCA
Increase - increase the chance the If are open
Aortic dilation - bicuspid aortic valve - RF -
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

29. clinical signs of cardiac tamponade
Non
In HF
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
RCA - II - III - aVF

30. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Increased efferent SANS and decreased efferent PANS
Arteriorles
Aortic disecction - intraluminal tear forming false lumen

31. What are anitschkow's cells
Hyperlipidemia
Activated histiocytes
Persistant truncus arteriosus
Ventricles are depolarized

32. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
The plateau period
The first 4 days
Fick principle
Preload

33. If HR is too fast (V tach) what happens during diastole?
QRS complex
Filling is incomplete and CO falls
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Inc Kf - capillary perm

34. EDV - ESV
Stroke volume
Ventricular repolarization
Inc central venous pressure - inc resistance to portal flow
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

35. decrease stretch in baroreceptors leads to what response?
RCA - II - III - aVF
During HF from microhemorrhages from inc pulm cap pressure
Increased efferent SANS and decreased efferent PANS
Mitral valve prolapse

36. What causes hepatomegaly?
S. bovis
LAD - V1- V2
Pulmonary flow murmur and diastolic rumble
Inc central venous pressure - inc resistance to portal flow

37. in the JVP - What is the v wave?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Fluid movement through capillaries
During HF from microhemorrhages from inc pulm cap pressure
Inc RA pressure - due to filling against closed tricupsid valve

38. What does FEVERSS stand for in rheumatic heart disease
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
2-4 day - early coag necrosis on the first day
HypoK and bradycardia
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

39. What does prolonged QT predispose to?
Henoch - Schlonlein purpura
Myxoma
At least 55%
Torsades de pointes

40. What is the time frame for arrhythmia risk in the evolution of MI
Maintain blood flow to organ over wide range of perfussion pressures
The first 4 days
SV/ EDV
Transfusion

41. What is the danger of torsades to pointes?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Can progess to V fib
Polyarteritis nodosum
Kawasaki

42. Restrictive cardiomyopathy causes
Ventricular repolarization
Ventricles are depolarized
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Preload

43. serum marker for wegener's
SV/ EDV
V fib arrhythima
Extracellular calcium - calcium induced calcium release
C - ANCA

44. In an EKG - What is the QT interval?
Babies
Mechanican contraction of the ventricles
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Granuloma with giant cells

45. in the JVP - What is the a wave?
Atrial contraction
Liver
Myxomatous degeneration - RF - chordae rupture
Henoch - Schlonlein purpura

46. What do the starling forces determine
Inc Kf - capillary perm
Viridans streptococci
Fluid movement through capillaries
CFX

47. What is a normal EF
Maintain blood flow to organ over wide range of perfussion pressures
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
At least 55%
Rapid upstroke - voltage gated Na channels open

48. Churg Strauss - presentation and test
LAD - V1 - V4
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Lower right - MC - upper right - AO - upper right AC - lower left MO

49. What causes aortic stenosis
Kaposi's sarcoma
Hemorrhage
Age related calcifications or bicuspid aortic valve
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

50. What happends in phase 1 of the ventricular cardiac action potential?
Inc blood volume
Libman - sacks endocarditis
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open