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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 happens in phase 4 of the cardiac ventricular action potential?
Aortic dilation - bicuspid aortic valve - RF -
Resting potential high K perm
S. bovis
Arteriolosclerosis in malignant hypertension

2. When does extracellular calcium enter the cardiac muscle cells during contraction?
Filling is incomplete and CO falls
The plateau period
Increase intracellular Na - resulting in increased Ca
Anterosuperior displacement of the infundibular septum

3. exaggerated decrease in pulse during inspiration.

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4. What does HTN predispose to?
S. bovis
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Takayasu's arteritis
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

5. What causes the murmur heard in tricuspid regurg to enhance
Angiosarcoma
In RA return (inspiration)
Resting potential high K perm
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

6. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Stroke volume affected by contractility - afterload - and preload
MI
Ischemic heart dz - mitral valve prolapse - LV dilation
Atherosclerosis

7. fibrous plaques and atheromas in intima of arteries
Inc blood volume
Henoch - Schlonlein purpura
2-4 day - early coag necrosis on the first day
Atherosclerosis

8. What causes aortic stenosis
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Left atrial pressure
Age related calcifications or bicuspid aortic valve
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

9. Which artery supplies the SA and AV nodes?
RCA
Inc RA pressure - due to filling against closed tricupsid valve
In HF
Decrease in cAMP

10. What is the early and late lesion in rheumatic heart disease
Mitral valve prolapse
CK- MB
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Anterosuperior displacement of the infundibular septum

11. What is the association with wide S2 splitting?
Rhabdomyomas
Vasocxn
P02
Pulmonic stenosis and RBBB

12. Which class of drugs decreases afterload?
Increasing activity of Ca pump in SR
Fast volatge gated Na channels
Vasodilators - (hydrAlAzine)
Arteriolosclerosis in malignant hypertension

13. When do you find hemosiderin laden macrophages in the lungs?
MI
During HF from microhemorrhages from inc pulm cap pressure
Non
Left sided

14. What are the complications from bacterial endocarditis?
HTN - bradycardia - and respiratory depression
Chordae rupture - GN - suppurative pericarditis - emboli
S. aureus
LAD - V1- V2

15. What is the result of not have fast sodium channels in pacemaker cells?
CK- MB
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
S. epidermidis
During HF from microhemorrhages from inc pulm cap pressure

16. What do the carotid and aortic bodies respond to?
RCA - II - III - aVF
Dec P02 - inc PC02 and dec pH
Gap junctions
Sudden tensing of chordae tendinae

17. What is indicated when CO and venous return are equal?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Turners
The operating point of the heart
Vasocxn

18. When during cardiac nodal cells depolarize?
Yes
Cyclophosphamide and corticosteroids
Increase intracellular Na - resulting in increased Ca
During diastole

19. In an anterior wall infarct - which artery is effected and which leads show Q waves
LAD - V1 - V4
3rd degree block - pacemaker - Lyme disease
Cystic hygroma
Changes in CO as a function of preload

20. What causes aortic regurg
MAP
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Aortic dilation - bicuspid aortic valve - RF -
Tempral arteritis - may cause irreversible blindness

21. What does an isoelectric ST segment indicate?
Wegener's
Dressler's - autoimmune
Ventricles are depolarized
Mechanican contraction of the ventricles

22. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
2-4 day - early coag necrosis on the first day
In HF
V fib arrhythima
Varicose veins - thromboembolism rare

23. What causes ankle - sacral edema - jugular venous distention
Buerger's disease
Hypertrophied cardiomyopathy
Hyperlipidemia
RV failure - in venous pressure

24. How are the sarcomeres added in eccentric hypertrophy?
In series
If sodium channel
Fast volatge gated Na channels
EKG

25. What are common causes of mitral regurg?
Hyperlipidemia
Failure of LV to in CO during exercise
S. epidermidis
Ischemic heart dz - mitral valve prolapse - LV dilation

26. which ethnic groups have higher association with HTN?
Vasodilators - (hydrAlAzine)
Black > white > asian
In RA return (inspiration)
Kawasaki

27. What does the atria release in response to inc blood volume and atrial pressure
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
ANP
Hyperlipidemia
S. epidermidis

28. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Granuloma with giant cells
Decreases
MAP
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

29. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Can progess to V fib
Ischemic heart dz - mitral valve prolapse - LV dilation
No
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

30. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
2nd degree AV block - mobitz type 1
Subendocardial
The plateau period

31. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
QRS complex
Fick principle
7 weeks
Ventricles are depolarized

32. What is the S1 sound?
If sodium channel
Preload
Mitral and tricuspid closure
Ventricles are depolarized

33. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Dilated cardiomyopathy
Hyperlipidemia
Afterload (proportional to peripheral resistance)
Anterosuperior displacement of the infundibular septum

34. fibrinous pericarditis several weeks post MI

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35. Which organ gets the largest share of systemic cardiac output
Viridans streptococci
Inc interstitial osmotic pressure pulling fliud out of capillaries
Liver
Lymphangiosarcoma

36. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Increase - increase the chance the If are open
RF
Atrial contraction

37. 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
Aortic stenosis or LBBB
Kidney
Right sided

38. systolic - diastolic
Stable angina
Pulse pressure
...
Failure of LV to in CO during exercise

39. Which murmur is heard in aortic stenosis?
Sudden tensing of chordae tendinae
Crescendo - decrescendo systolic ejection murmur following ejection click
TAPVR
If sodium channel

40. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
10%
Cherry hemangioma
HypoK and bradycardia

41. What is the progression of atherosclerosis?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Tempral arteritis - may cause irreversible blindness
Fick principle
Dressler's - autoimmune

42. what conditions are associated with pulsus paradoxus
Fluid movement through capillaries
Fast volatge gated Na channels
Can progess to V fib
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

43. When and why is the S3 sound heard?
Diastolic
...
Yes
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

44. Which murmur is heard with VSD?
Total anomalous pulmonary trunk venous return
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Mitral valve prolapse
Tempral arteritis - may cause irreversible blindness

45. decrease stretch in baroreceptors leads to what response?
Increased efferent SANS and decreased efferent PANS
ANP
CHF
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

46. serum marker for wegener's
RV failure - in venous pressure
Decreases
ANP
C - ANCA

47. Which organ has the largest arteriovenous difference
Systolic dysfunction
Fluid movement through capillaries
Heart - 02 extraction is always around 100%
S. epidermidis

48. What are the systolic heart sounds
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Venodilators (nitrogylcerine)
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Aortic/pulmonic stenosis and mitral/tricuspid regurg

49. Restrictive cardiomyopathy causes
In RA return (inspiration)
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Can progess to V fib
LCX - V4- V6

50. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
EKG
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Eccentric - concentric hypertrophy causes diastolic disfunction
Aortic disecction - intraluminal tear forming false lumen