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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. How does digitatlis increase contractility?
Increase intracellular Na - resulting in increased Ca
CFX
Aortic insuffic - late
Unstable/crescendo angina

2. Restrictive cardiomyopathy causes
Turners
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Inc central venous pressure - inc resistance to portal flow
Acute thrombosis of coronary artery

3. which heart valves are afected most in rheumatic heart diseease
Libman - sacks endocarditis
Volatage gated Ca channels
Rhabdomyomas
Mitral>aortic>>tricuspid - high pressure valves affected most

4. Which artery supplies the inferior portion of the left ventricle and posterior septum?
In parallel
Posterior descending (80% off the RCA - 20% off the circumflex)
Arteriorles
RCA - II - III - aVF

5. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Troponin I
Crescendo - decrescendo systolic ejection murmur following ejection click
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
V fib arrhythima

6. What supplies the posterior left ventricle?
CFX
Mitral and tricuspid closure
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
SA and AV nodes

7. In an anterior wall infarct - which artery is effected and which leads show Q waves
Pulmonic stenosis and RBBB
Metastasis from melanoma or lymphoma
Decreased
LAD - V1 - V4

8. Which class of drugs decrease the murmur heard in aortic regurg?
LCX - V4- V6
Mechanican contraction of the ventricles
Vasodilators
Pulse pressure

9. The cause of cardiac dilation?
SA and AV nodes
Greater ventricular EDV
7 weeks
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

10. friction rub - 3-5 days post MI
LCX - I - aVL
Postinfarction fibrinous pericarditis
Granuloma with giant cells
Aortic/pulmonic regurg and mitral/tricuspid stenosis

11. What does T wave inversion indicated?
Microscopic polyangiitis - like wegener's without granulomas
MI
Pulmonic stenosis and RBBB
During HF from microhemorrhages from inc pulm cap pressure

12. What is the gold standard for dx of MI in the first 6 hours
Transposition of great vessels
S. bovis
Preload
EKG

13. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Stroke volume
Inc venous return exaccerbates pulm vasc congestion
TAPVR
S. aureus

14. what conditions are associated with pulsus paradoxus
Tricuspid atresia - requires ASD and VSD
V fib arrhythima
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

15. What causes the murmur heard in tricuspid regurg to enhance
In RA return (inspiration)
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
The aortic before pulmonic - inspiration increases diff
Arteriorles

16. Do you see elevaged ASO titers in rheumatic heart disease
Persistant truncus arteriosus
Increase in Pc
Metastasis from melanoma or lymphoma
Yes

17. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
CFX
Atherosclerosis
The operating point of the heart

18. If HR is too fast (V tach) what happens during diastole?
Wegener's
Inc central venous pressure - inc resistance to portal flow
Aortic stenosis or LBBB
Filling is incomplete and CO falls

19. Right to left shunts are more common in babies or kids?
CO
Babies
TAPVR
Increasing activity of Ca pump in SR

20. What causes ankle - sacral edema - jugular venous distention
Vagus to medulla
No - no pressure gradient
Mitral>aortic>>tricuspid - high pressure valves affected most
RV failure - in venous pressure

21. moncekberg
Myxomatous degeneration - RF - chordae rupture
Black > white > asian
LAD > RCA > circumflex
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

22. What causes aortic regurg
Decreases
Boot shaped heart
Aortic dilation - bicuspid aortic valve - RF -
Subendocardial - fewer collaterals and higher pressure

23. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
LAD - V1 - V4
ASD
Left sided

24. What is the machine like murmur? What is the heart pathology and the predisposing causes
Turners
Patent ductus arteriosus - congenital rubella or prematurity
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Proportional to viscosity and inversely proportional to the radius to the 4th power

25. What is sudden cardiac death most commonly due to...
Filling is incomplete and CO falls
In series
During diastole
V fib arrhythima

26. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
TAPVR
LAD - V1- V2
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Vasocxn

27. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
RV failure - in venous pressure
Arteriorles
Postinfarction fibrinous pericarditis
...

28. When do coronary arteries fill?
V fib
In HF
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
During diastole

29. What are aschoff bodies
Gap junctions
CO
Viridans streptococci
Granuloma with giant cells

30. What are the different etiologies of dialted cardiomyopathy
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Total anomalous pulmonary trunk venous return
V fib
Subendocardial - fewer collaterals and higher pressure

31. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Increased efferent SANS and decreased efferent PANS
EKG
Fetal right to left - neonate left to right leading to RVH and failure
LCX - I - aVL

32. EDV - ESV
Stroke volume
Troponin I
LCX - V4- V6
TAPVR

33. machine murmer
PDA
Right sided
Pyogenic granuloma - associated with trauma and pregnancy
Mitral>aortic>>tricuspid - high pressure valves affected most

34. The carotid sinus transmits along which nerve?
Increased efferent SANS and decreased efferent PANS
Lymphangiosarcoma
Aortic insuffic - late
Glossopharyngeal to soliary nucleus of medulla

35. In an inferior wall infarct - which artery is affected and which leads show Q waves
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Ventricular repolarization
RCA - II - III - aVF
Right sided

36. Which valve is most commonly involved in bacterial endocarditis?
Pulmonic stenosis and RBBB
Mitral valve
Subendocardial
RV contraction (closed tricuspid valve bulding into atrium

37. polypoid capillary hemangioma that can ulcerate and bleed
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Polyarteritis nodosum
Arteriorles
Pyogenic granuloma - associated with trauma and pregnancy

38. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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39. What 4 things drive myocardial 02 demand?
Libman - sacks endocarditis
No - no pressure gradient
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Dec plasma proteins

40. systolic - diastolic
Left heart failure
No - no pressure gradient
Pulse pressure
Septal defects - PDA - pulm art stenosis

41. Which murmur is characteristic of mitral/tricuspid regurg?
Subendocardial
Late systolic crescendo murmur with a midsystolic click
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Holosystoiic

42. congenital heart defect in an infant with a diabetic mother?
Mechanican contraction of the ventricles
The aortic before pulmonic - inspiration increases diff
Transposition of great vessels
1st degree AV blodck

43. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
140/90
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
No

44. no change in PR interval followed by dropped beat
Myxomatous degeneration - RF - chordae rupture
Yes
Increased efferent SANS and decreased efferent PANS
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

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

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46. decrease stretch in baroreceptors leads to what response?
LAD > RCA > circumflex
Strawberry hemangioma
Increased efferent SANS and decreased efferent PANS
Varicose veins - thromboembolism rare

47. What does the starling curve show?
S. epidermidis
Hematocrit
Cardiac tamponde
Changes in CO as a function of preload

48. SV CAP means?
HypoK and bradycardia
Acute thrombosis of coronary artery
In RA return (inspiration)
Stroke volume affected by contractility - afterload - and preload

49. When does EF decrease
In HF
RCA - II - III - aVF
Decreases
2-4 day - early coag necrosis on the first day

50. What causes hepatomegaly?
Inc central venous pressure - inc resistance to portal flow
In parallel
Apex and anterior interventricular septum
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)