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Cardiology
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Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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study here
.
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. Which murmur is heard with mitral prolapse?
Mitral valve prolapse
TAPVR
Late systolic crescendo murmur with a midsystolic click
Transposition of great vessels
2. 2/3 diastolic + 1/3 systolic
Viridans streptococci
Black > white > asian
MAP
Turners
3. What is the gold standard for dx of MI in the first 6 hours
Tricuspid atresia - requires ASD and VSD
EKG
No - no pressure gradient
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
4. clinical signs of cardiac tamponade
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
TAPVR
Fetal right to left - neonate left to right leading to RVH and failure
Hypertrophied cardiomyopathy
5. What happens in phase 4 of the cardiac ventricular action potential?
Unstable/crescendo angina
Resting potential high K perm
Atherosclerosis
Vasodilators
6. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Kawasaki
1st degree AV blodck
Kids
7. What causes the CO curve to shift downwards?
Mitral and tricuspid closure
Neg inotropy - HF - narcotic overdose
Left atrial pressure
Inc interstitial osmotic pressure pulling fliud out of capillaries
8. Which class of drugs decrease the murmur heard in aortic regurg?
Dressler's - autoimmune
Afterload (proportional to peripheral resistance)
Vasodilators
Mitral>aortic>>tricuspid - high pressure valves affected most
9. When do you see extensive coagulative necrosis in an MI
If sodium channel
Stable angina
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
2-4 day - early coag necrosis on the first day
10. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
LAD - V1- V2
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Inc central venous pressure - inc resistance to portal flow
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
11. bening capillary hemangioma of elderly - does not regress
Infective endocarditis
During diastole
Strawberry hemangioma
Cherry hemangioma
12. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
MI
During diastole
...
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
13. what happens to capillaries in lymphatic blockage
Inc interstitial osmotic pressure pulling fliud out of capillaries
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Septal defects - PDA - pulm art stenosis
SV/ EDV
14. When during cardiac nodal cells depolarize?
Fick principle
SV/ EDV
Inc interstitial osmotic pressure pulling fliud out of capillaries
During diastole
15. Which murmur is heard in aortic stenosis?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Infective endocarditis
Crescendo - decrescendo systolic ejection murmur following ejection click
Pulsus parvus and tardus - weak - can lead to syncope
16. What channels do the the pacemaker cells lack?
Fast volatge gated Na channels
No
3rd degree block - pacemaker - Lyme disease
During diastole
17. no relation between p waves and QRS intervals - treatment and predisposing factor
3rd degree block - pacemaker - Lyme disease
Isovolumetric contraction
Increase intracellular Na - resulting in increased Ca
No
18. In terms of starling forces - why does heart failure cause edema?
Increase in Pc
P02
Pulsus parvus and tardus - weak - can lead to syncope
Varicose veins - thromboembolism rare
19. Which valve is most commonly involved in bacterial endocarditis?
Mitral valve
R to L shunt caused by stenoic pulmonic valve
Transmural
RCA
20. Left to right shunts are more common in babies or kids?
Kids
Eccentric - concentric hypertrophy causes diastolic disfunction
Greater ventricular EDV
Inc TPR and LA return (expiration)
21. Wegener's tx
HTN - bradycardia - and respiratory depression
Inc central venous pressure - inc resistance to portal flow
Cyclophosphamide and corticosteroids
Mechanican contraction of the ventricles
22. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Mitral stenosis
Pyogenic granuloma - associated with trauma and pregnancy
Hyperlipidemia
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
23. Where is the most posterior portion of the heart and What can it cause?
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
7 weeks
MI
LAD > RCA > circumflex
24. What causes the cushing reflex and why
Proportional to viscosity and inversely proportional to the radius to the 4th power
During diastole
140/90
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
25. list the coronary vessels most likely to be occluded
LAD > RCA > circumflex
Crescendo - decrescendo systolic ejection murmur following ejection click
Pulmonary flow murmur and diastolic rumble
Takayasu's arteritis
26. What do the carotid and aortic bodies respond to?
Stroke volume affected by contractility - afterload - and preload
Dec P02 - inc PC02 and dec pH
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Fick principle
27. prolonged PR interval
SA>AV>bundle of His>ventricles
The plateau period
Fast volatge gated Na channels
1st degree AV blodck
28. moncekberg
Hyperlipidemia
Increase intracellular Na - resulting in increased Ca
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Activated histiocytes
29. What are the complications from bacterial endocarditis?
HypoK and bradycardia
Dec P02 - inc PC02 and dec pH
Chordae rupture - GN - suppurative pericarditis - emboli
Ventricular repolarization
30. How are the sarcomeres added in eccentric hypertrophy?
RV failure - in venous pressure
In series
Arteriorles
MAP
31. In an EKG - What is the QT interval?
S. bovis
Wegener's
Mechanican contraction of the ventricles
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
32. congenital heart defect with marfan's
Hyperlipidemia
Pulsus parvus and tardus - weak - can lead to syncope
Aortic insuffic - late
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
33. Which kind of infarct show ST elevation - and/or pathologic Q waves
Transmural
Increase intracellular Na - resulting in increased Ca
The operating point of the heart
Vagus to medulla
34. In an EKG - What is the PR interval?
MAP
Systolic dysfunction
Increased SV
Conduction delay through AV node - nl < 200 msec
35. How do catecholamines increase contractility?
Ventricular repolarization
Mean arterial pressure
LAD
Increasing activity of Ca pump in SR
36. What does hypoxia cause in the lung versus other tissues?
Aortic dilation - bicuspid aortic valve - RF -
Glomus tumor
Inc Kf - capillary perm
Vasocxn - while other tissues it causes vasodilation
37. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Non
Prinzmetal angina
C - ANCA
Right sided
38. serum marker for wegener's
Turners
Black > white > asian
Mitral and tricuspid closure
C - ANCA
39. What causes the CO curve to shift upwards?
Inc interstitial osmotic pressure pulling fliud out of capillaries
During HF from microhemorrhages from inc pulm cap pressure
Pos inotropy - exercise
Tricuspid atresia - requires ASD and VSD
40. 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
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Aortic insuffic - late
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
41. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Inc blood volume
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
42. What does prolonged QT predispose to?
MI
Torsades de pointes
Subendocardial
Indomethacin closes - and pge keeps it open
43. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
LCX - V4- V6
Extracellular calcium - calcium induced calcium release
44. Which bacteria causes endocarditis in the presence of colon cancer
Aortic disecction - intraluminal tear forming false lumen
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Cyclophosphamide and corticosteroids
S. bovis
45. dyspnea - fatigue - edema and rales - multiple causes
LCX - V4- V6
Hypertrophied cardiomyopathy
CHF
V fib arrhythima
46. What causes aortic stenosis
Arteriorles
Medullary vasomotor center senses baroreceptors and JGA
Age related calcifications or bicuspid aortic valve
During HF from microhemorrhages from inc pulm cap pressure
47. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Hypertrophied cardiomyopathy
Microscopic polyangiitis - like wegener's without granulomas
Inc blood volume
Torsades de pointes
48. What causes the murmur heard in tricuspid regurg to enhance
Decrease in activity of Na/Ca exhanger and increase in contractility
2nd degree AV block - mobitz type 1
Purkingee>atria>ventricles>AV node
In RA return (inspiration)
49. How does a patient with Tet of fallot learn to improve symptoms?
RV contraction (closed tricuspid valve bulding into atrium
Vasodilators
Squat. Compression of femoral arteries - inc TPR - dec
Atherosclerosis
50. Why is there edema after burns or during infection
Inc Kf - capillary perm
Mean arterial pressure
2-4 day - early coag necrosis on the first day
Hematocrit
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