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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 to capillaries in lymphatic blockage
During diastole
Eccentric - concentric hypertrophy causes diastolic disfunction
Inc interstitial osmotic pressure pulling fliud out of capillaries
Aortic dilation - bicuspid aortic valve - RF -

2. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Dec plasma proteins
Group a beta hemolytic strep
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

3. How does a patient with Tet of fallot learn to improve symptoms?
Squat. Compression of femoral arteries - inc TPR - dec
Dilated cardiomyopathy
Inc venous return exaccerbates pulm vasc congestion
Pos inotropy - exercise

4. Which bacteria causes rheumatic heart disease
Group a beta hemolytic strep
Ventricular repolarization
Subendocardial
SA>AV>bundle of His>ventricles

5. What does TAPVR stand for
Total anomalous pulmonary trunk venous return
Arteriorles
CK- MB
Aortic/pulmonic stenosis and mitral/tricuspid regurg

6. no relation between p waves and QRS intervals - treatment and predisposing factor
Mean arterial pressure
Age related calcifications or bicuspid aortic valve
3rd degree block - pacemaker - Lyme disease
Torsades de pointes

7. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Posterior descending (80% off the RCA - 20% off the circumflex)
Lymphangiosarcoma
Lower right - MC - upper right - AO - upper right AC - lower left MO
Fick principle

8. When do you find hemosiderin laden macrophages in the lungs?
Rhabdomyomas
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
During HF from microhemorrhages from inc pulm cap pressure
Aortic/pulmonic stenosis and mitral/tricuspid regurg

9. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Inc interstitial osmotic pressure pulling fliud out of capillaries
Mitral>aortic>>tricuspid - high pressure valves affected most
During diastole
Dilated cardiomyopathy

10. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
CHF
Henoch - Schlonlein purpura
Patent ductus arteriosus - congenital rubella or prematurity

11. What are aschoff bodies
Granuloma with giant cells
S. epidermidis
MI
Stroke volume affected by contractility - afterload - and preload

12. friction rub - 3-5 days post MI
Neg inotropy - HF - narcotic overdose
Inc interstitial osmotic pressure pulling fliud out of capillaries
Varicose veins - thromboembolism rare
Postinfarction fibrinous pericarditis

13. How are the sarcomeres added in eccentric hypertrophy?
V fib arrhythima
In series
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Conduction delay through AV node - nl < 200 msec

14. What kind of infarct show ST depression
Subendocardial
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Mitral valve
Glossopharyngeal to soliary nucleus of medulla

15. What happends in phase 1 of the ventricular cardiac action potential?
S. bovis
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Rhabdomyomas

16. What is the danger of torsades to pointes?
Eisenmenger's syndrome
Viridans streptococci
Vasocxn
Can progess to V fib

17. Which two mechanisms sense decrease MAP?
Gap junctions
Non
Systolic dysfunction
Medullary vasomotor center senses baroreceptors and JGA

18. Wegener's presentation
Decreases
Hematocrit
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Subendocardial - fewer collaterals and higher pressure

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

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20. What causes the murmur heard in tricuspid regurg to enhance
Ischemic heart dz - mitral valve prolapse - LV dilation
CO
Preload
In RA return (inspiration)

21. Why is contractility decreased in heart failure?
Gap junctions
PDA
Aburpt halting of valve leaflets
Systolic dysfunction

22. clinical signs of cardiac tamponade
Kidney
In RA return (inspiration)
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
S. epidermidis

23. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
Posterior descending (80% off the RCA - 20% off the circumflex)
Ventricles are depolarized
In parallel

24. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Fetal right to left - neonate left to right leading to RVH and failure
In HF
Increased efferent SANS and decreased efferent PANS
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

25. Which kind of infarct show ST elevation - and/or pathologic Q waves
CO
Ventricular repolarization
Transmural
Glomus tumor

26. The cause of dyspnea on exertion?
Persistant truncus arteriosus
MI
Failure of LV to in CO during exercise
In HF

27. What causes ankle - sacral edema - jugular venous distention
RV failure - in venous pressure
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
140/90
3rd degree block - pacemaker - Lyme disease

28. benign - painful - red - blue tumor under fingernails from smooth muscle cells
LCX - V4- V6
Glomus tumor
Stroke volume affected by contractility - afterload - and preload
Rapid upstroke - voltage gated Na channels open

29. systolic - diastolic
Pulse pressure
Yes
Increase - increase the chance the If are open
LAD - V1 - V4

30. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Left atrial pressure
Volatage gated Ca channels
Increase - increase the chance the If are open
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

31. In an EKG - What is the QRS complex?
Ventricular depolarization - nl < 120 msec
In RA return (inspiration)
Increase contractility
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

32. What are common causes of mitral regurg?
V fib arrhythima
Ischemic heart dz - mitral valve prolapse - LV dilation
In series
R to L shunt caused by stenoic pulmonic valve

33. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Atherosclerosis
Lymphangiosarcoma
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

34. which medications are used to maintain patency or close the ductus arteriosus?
Indomethacin closes - and pge keeps it open
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
During diastole
Stable angina

35. What causes the ejection click in the Cres - decres murmur?
Sturge weber - vasculitis of caps
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Aburpt halting of valve leaflets

36. What causes aortic stenosis
CO
Age related calcifications or bicuspid aortic valve
P02
Preload

37. with what heart sounds do ASD usually present?
CK- MB
1st degree AV blodck
Pulmonary flow murmur and diastolic rumble
Mean arterial pressure

38. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Aortic dilation - bicuspid aortic valve - RF -
If sodium channel
Atrial contraction
Angiosarcoma

39. What is the classic X ray finding for tet of fallot?
LCX - I - aVL
Boot shaped heart
CFX
...

40. Which artery supplies the SA and AV nodes?
RCA
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Aburpt halting of valve leaflets
Patent ductus arteriosus - congenital rubella or prematurity

41. What is indicated when CO and venous return are equal?
QRS complex
Isovolumetric contraction
The operating point of the heart
The first 4 days

42. What murmur is heard with aortic regurg?
CFX
Pulmonary flow murmur and diastolic rumble
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Kaposi's sarcoma

43. What is the definition of HTN?
140/90
RCA
Babies
Posterior descending (80% off the RCA - 20% off the circumflex)

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

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45. What causes aortic regurg
In HF
Aortic dilation - bicuspid aortic valve - RF -
LCX - I - aVL
LV failure - pulm venous distention transudation of fluid

46. PCWP is an estimate of...
Aortic stenosis or LBBB
Decrease in activity of Na/Ca exhanger and increase in contractility
Left atrial pressure
Inc RA pressure - due to filling against closed tricupsid valve

47. In an EKG - What is the PR interval?
Atrial contraction
Postinfarction fibrinous pericarditis
Changes in CO as a function of preload
Conduction delay through AV node - nl < 200 msec

48. p - anca

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49. Do you see elevaged ASO titers in rheumatic heart disease
CHF
Yes
Granuloma with giant cells
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

50. What does mitral prolapse predeispose to?
Pulsus parvus and tardus - weak - can lead to syncope
Conduction delay through AV node - nl < 200 msec
Infective endocarditis
TAPVR