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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 are common causes of mitral regurg?
LCX - V4- V6
In series
Ischemic heart dz - mitral valve prolapse - LV dilation
SV/ EDV

2. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
2-4 day - early coag necrosis on the first day
Kawasaki
Resting potential high K perm
Fick principle

3. EDV is also known as
Proportional to viscosity and inversely proportional to the radius to the 4th power
Venodilators (nitrogylcerine)
Preload
Aortic insuffic - late

4. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?

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5. What is the danger of torsades to pointes?
Buerger's disease
MAP
Can progess to V fib
Hematocrit

6. What is the cushing triad?
HTN - bradycardia - and respiratory depression
Afterload (proportional to peripheral resistance)
Granuloma with giant cells
P02

7. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Activated histiocytes
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Posterior descending (80% off the RCA - 20% off the circumflex)
PDA

8. Which murmur is characteristic of mitral/tricuspid regurg?
...
Vasodilators
5-10 days - macs have degraded structural components
Holosystoiic

9. What causes the early cyanosis in Tet of Fallot?
Increase contractility
R to L shunt caused by stenoic pulmonic valve
Kids
C - ANCA

10. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Non
LCX - V4- V6
Tricuspid atresia - requires ASD and VSD
Wegener's

11. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Kaposi's sarcoma
Viridans streptococci
TAPVR
Apex and anterior interventricular septum

12. What happens in phase 3 of the cardiac ventricular action potential?
R to L shunt caused by stenoic pulmonic valve
HypoK and bradycardia
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Vagus to medulla

13. Which bacteria can cause endocarditis from prosthetic valves?
Mitral>aortic>>tricuspid - high pressure valves affected most
S. epidermidis
Coarcation of aorta
Failure of LV to in CO during exercise

14. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Libman - sacks endocarditis
LCX - V4- V6
Inc TPR and LA return (expiration)

15. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Aortic stenosis or LBBB
Cystic hygroma
S. bovis

16. How does aldosterone raise MAP
Stroke volume
Inc blood volume
Temporal arteritis
LCX - I - aVL

17. In an inferior wall infarct - which artery is affected and which leads show Q waves
ASD
Unstable/crescendo angina
RCA - II - III - aVF
Right sided

18. If HR is too fast (V tach) what happens during diastole?
Filling is incomplete and CO falls
Decreases
Atherosclerosis
S. epidermidis

19. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
Isovolumetric contraction
In series
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
5-10 days - macs have degraded structural components

20. CO x Total peripheral resistance
Mean arterial pressure
Left sided
Aburpt halting of valve leaflets
Polyarteritis nodosum

21. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
CHF
Fick principle
Strawberry hemangioma
Afterload (proportional to peripheral resistance)

22. What causes orthopnea?
Inc venous return exaccerbates pulm vasc congestion
Inc interstitial osmotic pressure pulling fliud out of capillaries
Conduction delay through AV node - nl < 200 msec
Hemorrhage

23. What kind of dysfunction ensues in restrictive cardiomyopathy
MI
Right sided
Diastolic
Apex and anterior interventricular septum

24. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Hemorrhage
Ventricles are depolarized
Hypertrophied cardiomyopathy
3rd degree block - pacemaker - Lyme disease

25. sawtooth wave

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26. Rank the pacemakers cells
Medullary vasomotor center senses baroreceptors and JGA
SA>AV>bundle of His>ventricles
Crescendo - decrescendo systolic ejection murmur following ejection click
Truncus - tet of fallot

27. What does the starling curve show?
The plateau period
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Changes in CO as a function of preload
Truncus - tet of fallot

28. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
V fib arrhythima
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Arteriolosclerosis in malignant hypertension

29. 2/3 diastolic + 1/3 systolic
S. aureus
Eccentric - concentric hypertrophy causes diastolic disfunction
MAP
S. epidermidis

30. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Sudden tensing of chordae tendinae
MI
Systolic dysfunction

31. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Mitral valve prolapse
Maintain blood flow to organ over wide range of perfussion pressures
During HF from microhemorrhages from inc pulm cap pressure
MI

32. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Preload
3rd degree block - pacemaker - Lyme disease
Purkingee>atria>ventricles>AV node
Late systolic crescendo murmur with a midsystolic click

33. Which two mechanisms sense decrease MAP?
Cherry hemangioma
Medullary vasomotor center senses baroreceptors and JGA
Aortic dilation - bicuspid aortic valve - RF -
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

34. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
S. aureus
EKG
ANP

35. Which artery supplies the SA and AV nodes?
RCA
2nd degree AV block - mobitz type 1
Lower right - MC - upper right - AO - upper right AC - lower left MO
Hyperlipidemia

36. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
S. aureus
Apex and anterior interventricular septum
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
MI

37. What is the most common cause of right heart failure
The first 4 days
Ventricular repolarization
Buerger's disease
Left heart failure

38. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Gap junctions
No
HypoK and bradycardia
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

39. What does an isoelectric ST segment indicate?
Varicose veins - thromboembolism rare
Filling is incomplete and CO falls
Inc central venous pressure - inc resistance to portal flow
Ventricles are depolarized

40. What is a normal EF
CFX
Inc RA pressure - due to filling against closed tricupsid valve
At least 55%
RCA

41. What happens in phase 4 of the cardiac ventricular action potential?
Tempral arteritis - may cause irreversible blindness
Microscopic polyangiitis - like wegener's without granulomas
S. epidermidis
Resting potential high K perm

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

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43. What is the definition of HTN?
140/90
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
CHF
Left heart failure

44. in the JVP - What is the c wave?
RV contraction (closed tricuspid valve bulding into atrium
S. bovis
Afterload (proportional to peripheral resistance)
Stable angina

45. What causes the CO curve to shift upwards?
Preload
Pos inotropy - exercise
Varicose veins - thromboembolism rare
Total anomalous pulmonary trunk venous return

46. which heart valves are afected most in rheumatic heart diseease
RF
Infective endocarditis
Mean arterial pressure
Mitral>aortic>>tricuspid - high pressure valves affected most

47. moncekberg
SA>AV>bundle of His>ventricles
Sturge weber - vasculitis of caps
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Holosystolic - harsh sounding murmur - loudest over tricuspid area

48. In an EKG - What is the PR interval?
Kids
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Transposition of great vessels
Conduction delay through AV node - nl < 200 msec

49. What are the four most common locations for atherosclerosis?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Granuloma with giant cells
Decrease in activity of Na/Ca exhanger and increase in contractility

50. congenital heart defect in an infant with a diabetic mother?
Stable angina
Transposition of great vessels
Polyarteritis nodosum
Aortic dilation - bicuspid aortic valve - RF -