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Cardiology
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Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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.
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. What causes the murmur heard in MR to enhance?
Inc TPR and LA return (expiration)
Greater ventricular EDV
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Cherry hemangioma
2. Which murmur is heard in aortic stenosis?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Crescendo - decrescendo systolic ejection murmur following ejection click
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Wolff - Parkinson white syndrome
3. Given P = QR - what factors influence resistance?
Group a beta hemolytic strep
Yes
Proportional to viscosity and inversely proportional to the radius to the 4th power
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
4. polypoid capillary hemangioma that can ulcerate and bleed
Pyogenic granuloma - associated with trauma and pregnancy
C - ANCA
V fib
Tricuspid atresia - requires ASD and VSD
5. What is the cushing triad?
Fetal right to left - neonate left to right leading to RVH and failure
Stable angina
Truncus - tet of fallot
HTN - bradycardia - and respiratory depression
6. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Persistant truncus arteriosus
Transfusion
CK- MB
Dec plasma proteins
7. in the JVP - What is the v wave?
Inc RA pressure - due to filling against closed tricupsid valve
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Pos inotropy - exercise
8. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Dec plasma proteins
Posterior descending (80% off the RCA - 20% off the circumflex)
Gap junctions
9. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Group a beta hemolytic strep
Stable angina
Decreases
Increase contractility
10. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Decreases
Increase - increase the chance the If are open
Pulmonic stenosis and RBBB
Atrial contraction
11. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Increase - increase the chance the If are open
Ventricles are depolarized
Henoch - Schlonlein purpura
12. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Indomethacin closes - and pge keeps it open
Metastasis from melanoma or lymphoma
13. exaggerated decrease in pulse during inspiration.
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14. Do you see elevaged ASO titers in rheumatic heart disease
In HF
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Yes
Decreased
15. benign cap hemangioma of infancy - spont regresses
Strawberry hemangioma
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Stable angina
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
16. What does the U wave indicated?
Increasing activity of Ca pump in SR
Truncus - tet of fallot
Transmural
HypoK and bradycardia
17. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Kawasaki
LV failure - pulm venous distention transudation of fluid
Truncus - tet of fallot
7 weeks
18. PCWP > LV diastolic pressure
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Mitral stenosis
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Fick principle
19. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Stable angina
Fick principle
2nd degree AV block - mobitz type 1
Left sided
20. PROVe
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Activated histiocytes
Myxoma
Vasocxn
21. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect
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22. When does extracellular calcium enter the cardiac muscle cells during contraction?
Babies
The operating point of the heart
The plateau period
Fluid movement through capillaries
23. What does TAPVR stand for
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
LV failure - pulm venous distention transudation of fluid
Takayasu's arteritis
Total anomalous pulmonary trunk venous return
24. What is the characteristic pulse in aortic stenosis?
No - no pressure gradient
RCA
Pulsus parvus and tardus - weak - can lead to syncope
Babies
25. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dilated cardiomyopathy
Glossopharyngeal to soliary nucleus of medulla
Coarcation of aorta
Diastolic
26. machine murmer
Aortic disecction - intraluminal tear forming false lumen
Apex and anterior interventricular septum
PDA
Preload
27. What does increasing intracellular Ca do?
Increase contractility
Cardiac tamponde
Temporal arteritis
Arteriorles
28. what happens to capillaries in lymphatic blockage
Troponin I
Failure of LV to in CO during exercise
Eccentric - concentric hypertrophy causes diastolic disfunction
Inc interstitial osmotic pressure pulling fliud out of capillaries
29. What murmur is heard with aortic regurg?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Maintain blood flow to organ over wide range of perfussion pressures
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
30. congenital heart defect with 22q11
Truncus - tet of fallot
Venodilators (nitrogylcerine)
Posterior descending (80% off the RCA - 20% off the circumflex)
Glossopharyngeal to soliary nucleus of medulla
31. What causes the early cyanosis in Tet of Fallot?
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Myxoma
Fick principle
R to L shunt caused by stenoic pulmonic valve
32. congenital heart defect in an infant with a diabetic mother?
SA and AV nodes
Coarcation of aorta
Fluid movement through capillaries
Transposition of great vessels
33. Mitral stenosis is most often secondary to which condition?
RF
Pos inotropy - exercise
Lower right - MC - upper right - AO - upper right AC - lower left MO
RCA
34. What other syndrom is associated with infantile aortic coarctation
Failure of LV to in CO during exercise
Turners
Sudden tensing of chordae tendinae
Granuloma with giant cells
35. Which murmur do you hear in mitral stenosis?
Late diastolic murmur following an opening snap
Atherosclerosis
Cherry hemangioma
Septal defects - PDA - pulm art stenosis
36. What causes ankle - sacral edema - jugular venous distention
Metastasis from melanoma or lymphoma
In RA return (inspiration)
RV failure - in venous pressure
Diastolic
37. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40
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38. Which organ has ht highest blood flow per gram of tissue
Black > white > asian
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Truncus - tet of fallot
Kidney
39. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
...
Cyclophosphamide and corticosteroids
LAD - V1- V2
Myxoma
40. most common primary cardiac tumor in children - associated with tuberous sclerosis
Rhabdomyomas
Mechanican contraction of the ventricles
Cyclophosphamide and corticosteroids
Henoch - Schlonlein purpura
41. Churg Strauss - presentation and test
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Ventricular depolarization - nl < 120 msec
TAPVR
Late systolic crescendo murmur with a midsystolic click
42. When and why is the S3 sound heard?
Right sided
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Polyarteritis nodosum
Crescendo - decrescendo systolic ejection murmur following ejection click
43. In an EKG - What is the T wave?
Inc blood volume
Ventricular repolarization
Unstable/crescendo angina
Filling is incomplete and CO falls
44. What causes the cushing reflex and why
Diastolic
RV failure - in venous pressure
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Libman - sacks endocarditis
45. Where is the most posterior portion of the heart and What can it cause?
Ventricles are depolarized
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Left heart failure
Adult type aortic coarctation
46. What happens in phase 0 of the cardiac ventricular action potential?
In parallel
Rapid upstroke - voltage gated Na channels open
Unstable/crescendo angina
Mitral valve
47. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Postinfarction fibrinous pericarditis
Fetal right to left - neonate left to right leading to RVH and failure
Neg inotropy - HF - narcotic overdose
Arteriolosclerosis in malignant hypertension
48. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Rapid upstroke - voltage gated Na channels open
Crescendo - decrescendo systolic ejection murmur following ejection click
No - no pressure gradient
No
49. What happends in phase 1 of the ventricular cardiac action potential?
Kawasaki
Mitral valve prolapse
Isovolumetric contraction
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
50. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Infective endocarditis
In RA return (inspiration)
...
In parallel
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