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Cardiology

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 does HTN predispose to?
In HF
Gap junctions
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Increase - increase the chance the If are open

2. What is the formula for EF?
Squat. Compression of femoral arteries - inc TPR - dec
Increase in Pc
SV/ EDV
Cherry hemangioma

3. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
Babies
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
HypoK and bradycardia

4. What does autoregulation do?
CK- MB
Maintain blood flow to organ over wide range of perfussion pressures
Unstable/crescendo angina
Glomus tumor

5. congenital heart defect in an infant with a diabetic mother?
Boot shaped heart
Yes
Transmural
Transposition of great vessels

6. What are the different etiologies of dialted cardiomyopathy
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Preload
CO
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

7. Hyperplastic onion skinning
Inc venous return exaccerbates pulm vasc congestion
Apex and anterior interventricular septum
Arteriolosclerosis in malignant hypertension
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

8. failure of truncus arteriosus to divide?
Persistant truncus arteriosus
Left sided
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Isovolumetric contraction

9. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Posterior descending (80% off the RCA - 20% off the circumflex)
Viridans streptococci
Rhabdomyomas
Polyarteritis nodosum

10. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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11. When do coronary arteries fill?
During diastole
Pulse pressure
Ventricular repolarization
Aburpt halting of valve leaflets

12. What happens in phase 4 of the cardiac ventricular action potential?
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
CO
Resting potential high K perm

13. machine murmer
Inc central venous pressure - inc resistance to portal flow
Atrial contraction
PDA
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

14. fibrous plaques and atheromas in intima of arteries
Truncus - tet of fallot
Cystic hygroma
Ventricular depolarization - nl < 120 msec
Atherosclerosis

15. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Transposition of great vessels
HypoK and bradycardia
Mean arterial pressure
LCX - I - aVL

16. exaggerated decrease in pulse during inspiration.

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17. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Pulmonary flow murmur and diastolic rumble
Adult type aortic coarctation

18. What are aschoff bodies
Granuloma with giant cells
Anterosuperior displacement of the infundibular septum
Glossopharyngeal to soliary nucleus of medulla
Stable angina

19. How does acidosis affect contractility?
Decreased
Kaposi's sarcoma
CK- MB
During HF from microhemorrhages from inc pulm cap pressure

20. 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
Inc venous return exaccerbates pulm vasc congestion
In RA return (inspiration)
Can progess to V fib

21. What other sign is often present with congenital long QT syndrome - why?
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Myxoma
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Patent ductus arteriosus - congenital rubella or prematurity

22. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
In series
V fib arrhythima
Left atrial pressure

23. In an anterior wall infarct - which artery is effected and which leads show Q waves
Truncus - tet of fallot
LAD - V1 - V4
Left atrial pressure
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

24. What does T wave inversion indicated?
MI
Strawberry hemangioma
Babies
Squat. Compression of femoral arteries - inc TPR - dec

25. PROVe
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Group a beta hemolytic strep

26. What channels do the the pacemaker cells lack?
During HF from microhemorrhages from inc pulm cap pressure
Fast volatge gated Na channels
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
RF

27. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
RV failure - in venous pressure
Cyclophosphamide and corticosteroids
Unstable/crescendo angina
CK- MB

28. most common heart tumor
Metastasis from melanoma or lymphoma
Systolic dysfunction
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
S. aureus

29. What is the machine like murmur? What is the heart pathology and the predisposing causes
Left heart failure
Mean arterial pressure
Patent ductus arteriosus - congenital rubella or prematurity
Crescendo - decrescendo systolic ejection murmur following ejection click

30. What are the systolic heart sounds
Atherosclerosis
Can progess to V fib
RF
Aortic/pulmonic stenosis and mitral/tricuspid regurg

31. Which organ gets the largest share of systemic cardiac output
Atherosclerosis
Ventricular repolarization
Liver
Fast volatge gated Na channels

32. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Decrease in cAMP
Postinfarction fibrinous pericarditis
No
1st degree AV blodck

33. Which vessels account for the most total peripheral resistance
Indomethacin closes - and pge keeps it open
R to L shunt caused by stenoic pulmonic valve
Arteriorles
Troponin I

34. How are sarcomeres added in concentric hypertrophy?
Dec plasma proteins
In parallel
QRS complex
Isovolumetric contraction

35. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
No - no pressure gradient
SA and AV nodes
Patent ductus arteriosus - congenital rubella or prematurity
Pulsus parvus and tardus - weak - can lead to syncope

36. Irregularly irregular ECG - no p waves: dx and treatment
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Greater ventricular EDV
Angiosarcoma

37. Mitral stenosis is most often secondary to which condition?
Metastasis from melanoma or lymphoma
Inc TPR and LA return (expiration)
V fib arrhythima
RF

38. In an anterolateral infarct - which artery is effected and which leads show Q waves
LCX - V4- V6
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
2nd degree AV block - mobitz type 1
RCA - II - III - aVF

39. cavernous lymphangioma of the neck - associated with turner's
Subendocardial
Prinzmetal angina
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Cystic hygroma

40. polypoid capillary hemangioma that can ulcerate and bleed
Buerger's disease
Pyogenic granuloma - associated with trauma and pregnancy
Eccentric - concentric hypertrophy causes diastolic disfunction
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

41. What happens in phase 0 of the cardiac ventricular action potential?
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
During diastole
Rapid upstroke - voltage gated Na channels open
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction

42. When does extracellular calcium enter the cardiac muscle cells during contraction?
The plateau period
2-4 day - early coag necrosis on the first day
Inc venous return exaccerbates pulm vasc congestion
Decreases

43. Which bacteria can cause endocarditis from prosthetic valves?
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
S. epidermidis
RF
Eisenmenger's syndrome

44. congenital heart defect with congenital rubella
ASD
Takayasu's arteritis
Septal defects - PDA - pulm art stenosis
Pyogenic granuloma - associated with trauma and pregnancy

45. What are the 5 T's of cyanoitc babies
ASD
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Proportional to viscosity and inversely proportional to the radius to the 4th power
SA and AV nodes

46. Wegener's tx
LAD
Increase - increase the chance the If are open
Ischemic heart dz - mitral valve prolapse - LV dilation
Cyclophosphamide and corticosteroids

47. moncekberg
Aortic stenosis or LBBB
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
RV failure - in venous pressure
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

48. Chronic mitral stenosis can lead to what changes in size of the LA
Extracellular calcium - calcium induced calcium release
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Dilation
Wolff - Parkinson white syndrome

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

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50. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Inc interstitial osmotic pressure pulling fliud out of capillaries
Mitral and tricuspid closure
Vasocxn - while other tissues it causes vasodilation
Polyarteritis nodosum