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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. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
5-10 days - macs have degraded structural components
Increase in Pc

2. When and why is the S3 sound heard?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Ventricles are depolarized
Inc Kf - capillary perm
Non

3. What is the result of not have fast sodium channels in pacemaker cells?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Temporal arteritis

4. no relation between p waves and QRS intervals - treatment and predisposing factor
Pos inotropy - exercise
Inc central venous pressure - inc resistance to portal flow
3rd degree block - pacemaker - Lyme disease
Mitral and tricuspid closure

5. Where are pacemaker cells?
Hypertrophied cardiomyopathy
Unstable/crescendo angina
SA and AV nodes
Ventricular depolarization - nl < 120 msec

6. congenital heart defect with turner's
Total anomalous pulmonary trunk venous return
Atrial contraction
Coarcation of aorta
Hypertrophied cardiomyopathy

7. decrease stretch in baroreceptors leads to what response?
P02
Eisenmenger's syndrome
Increased efferent SANS and decreased efferent PANS
Angiosarcoma

8. What causes the murmur heard in MR to enhance?
Gap junctions
TAPVR
Mitral valve
Inc TPR and LA return (expiration)

9. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Aortic insuffic - late
Vasodilators - (hydrAlAzine)
MAP
TAPVR

10. PCWP is an estimate of...
Sturge weber - vasculitis of caps
Left atrial pressure
Transposition of great vessels
Lower right - MC - upper right - AO - upper right AC - lower left MO

11. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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12. EDV - ESV
Can progess to V fib
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Stroke volume
S. aureus

13. In an EKG - What is the QRS complex?
Decreased
Atherosclerosis
Ventricular depolarization - nl < 120 msec
Apex and anterior interventricular septum

14. When is the scar completely formed in an MI?
7 weeks
Kawasaki
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Systolic dysfunction

15. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Decreased
Sturge weber - vasculitis of caps
Turners
Aortic stenosis or LBBB

16. p - anca

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17. What are the different etiologies of dialted cardiomyopathy
Torsades de pointes
Pos inotropy - exercise
Aortic disecction - intraluminal tear forming false lumen
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

18. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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19. How do beta blockers decrease contractility?
Decrease in cAMP
In HF
Buerger's disease
Conduction delay through AV node - nl < 200 msec

20. Which organ has the largest arteriovenous difference
Patent ductus arteriosus - congenital rubella or prematurity
The aortic before pulmonic - inspiration increases diff
Heart - 02 extraction is always around 100%
Dec P02 - inc PC02 and dec pH

21. What is the definition of HTN?
Pyogenic granuloma - associated with trauma and pregnancy
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
No
140/90

22. Why is contractility decreased in heart failure?
Aburpt halting of valve leaflets
Eccentric - concentric hypertrophy causes diastolic disfunction
Systolic dysfunction
Pulse pressure

23. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Inc TPR and LA return (expiration)
The first 4 days
S. aureus

24. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
If sodium channel
No - no pressure gradient
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Aortic insuffic - late

25. What causes the midsystolic click
LCX - V4- V6
Truncus - tet of fallot
Systolic dysfunction
Sudden tensing of chordae tendinae

26. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Kaposi's sarcoma
Pulse pressure
Viridans streptococci
Troponin I

27. What channels do the the pacemaker cells lack?
Decreased
Fast volatge gated Na channels
Hemorrhage
Aortic insuffic - late

28. Where does coronary artery occlusion occur most commonly?
Viridans streptococci
In parallel
LAD
Dilation

29. What is the most common cause of right heart failure
Left heart failure
Inc Kf - capillary perm
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Dilation

30. The cause of dyspnea on exertion?
Failure of LV to in CO during exercise
Mechanican contraction of the ventricles
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Inc RA pressure - due to filling against closed tricupsid valve

31. The aortic arch receptors transmit along which nerve?
Buerger's disease
At least 55%
Temporal arteritis
Vagus to medulla

32. What causes the murmur heard in tricuspid regurg to enhance
Vagus to medulla
In RA return (inspiration)
Systolic dysfunction
Indomethacin closes - and pge keeps it open

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

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34. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
Eisenmenger's syndrome
Tricuspid atresia - requires ASD and VSD
Rapid upstroke - voltage gated Na channels open

35. What causes orthopnea?
Pyogenic granuloma - associated with trauma and pregnancy
Myxomatous degeneration - RF - chordae rupture
Inc venous return exaccerbates pulm vasc congestion
Wegener's

36. benign cap hemangioma of infancy - spont regresses
Strawberry hemangioma
Atherosclerosis
Henoch - Schlonlein purpura
Fetal right to left - neonate left to right leading to RVH and failure

37. Which murmur is heard with mitral prolapse?
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Non
Hyperlipidemia
Late systolic crescendo murmur with a midsystolic click

38. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Increase in Pc
The first 4 days
Dilated cardiomyopathy
Medullary vasomotor center senses baroreceptors and JGA

39. Mitral stenosis is most often secondary to which condition?
Varicose veins - thromboembolism rare
Group a beta hemolytic strep
Transfusion
RF

40. What are anitschkow's cells
Buerger's disease
Activated histiocytes
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Mean arterial pressure

41. How does acidosis affect contractility?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
...
Decreased
S. aureus

42. What is the danger of torsades to pointes?
Rapid upstroke - voltage gated Na channels open
Can progess to V fib
Vasodilators - (hydrAlAzine)
Early deaths from myocarditis

43. Which area of the endocardium is especially vulnerable to infarction? Why?
Pyogenic granuloma - associated with trauma and pregnancy
Ventricles are depolarized
Subendocardial - fewer collaterals and higher pressure
Increase in Pc

44. What other syndrom is associated with infantile aortic coarctation
Turners
Libman - sacks endocarditis
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Arteriolosclerosis in malignant hypertension

45. Which murmur do you hear in mitral stenosis?
Volatage gated Ca channels
2-4 day - early coag necrosis on the first day
At least 55%
Late diastolic murmur following an opening snap

46. Central chemoreceptors do not respond directly to which parameter?
Coarcation of aorta
P02
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Microscopic polyangiitis - like wegener's without granulomas

47. cavernous lymphangioma of the neck - associated with turner's
Cystic hygroma
Cardiac tamponde
Aortic dilation - bicuspid aortic valve - RF -
HTN - bradycardia - and respiratory depression

48. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
The plateau period
V fib arrhythima
Hyperlipidemia
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

49. prolonged PR interval
1st degree AV blodck
Dec plasma proteins
Hypertrophied cardiomyopathy
Maintain blood flow to organ over wide range of perfussion pressures

50. What is the progression of atherosclerosis?
ANP
No - no pressure gradient
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Eisenmenger's syndrome