Cardiology

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can 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. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Mechanican contraction of the ventricles
Aortic disecction - intraluminal tear forming false lumen
TAPVR
Inc RA pressure - due to filling against closed tricupsid valve


2. What does the starling curve show?
During diastole
LAD - V1- V2
Changes in CO as a function of preload
Infective endocarditis


3. Which area of the endocardium is especially vulnerable to infarction? Why?
Troponin I
Subendocardial - fewer collaterals and higher pressure
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
RV contraction (closed tricuspid valve bulding into atrium


4. with what heart sounds do ASD usually present?
Sturge weber - vasculitis of caps
Hematocrit
No
Pulmonary flow murmur and diastolic rumble


5. When and why is the S3 sound heard?
Mitral stenosis
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Late diastolic murmur following an opening snap
Transmural


6. 2/3 diastolic + 1/3 systolic
ANP
MAP
RCA - II - III - aVF
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral


7. Which bacteria can cause endocarditis from prosthetic valves?
Temporal arteritis
Stroke volume affected by contractility - afterload - and preload
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
S. epidermidis


8. What does the LAD supply?
Atherosclerosis
Crescendo - decrescendo systolic ejection murmur following ejection click
Apex and anterior interventricular septum
Ventricular depolarization - nl < 120 msec


9. How does angiotensin II raise MAP
Granuloma with giant cells
Vasocxn
Age related calcifications or bicuspid aortic valve
Ventricular depolarization - nl < 120 msec


10. Which class of drugs decrease the murmur heard in aortic regurg?
ANP
Vasodilators
Extracellular calcium - calcium induced calcium release
Patent ductus arteriosus - congenital rubella or prematurity


11. What causes the ejection click in the Cres - decres murmur?
Aburpt halting of valve leaflets
Decrease in activity of Na/Ca exhanger and increase in contractility
MI
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction


12. What are aschoff bodies
Coarcation of aorta
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Granuloma with giant cells
Buerger's disease


13. CO x Total peripheral resistance
Mean arterial pressure
Mechanican contraction of the ventricles
Temporal arteritis
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's


14. What is the association with wide S2 splitting?
Boot shaped heart
Dec plasma proteins
Pulmonic stenosis and RBBB
Cyclophosphamide and corticosteroids


15. When does extracellular calcium enter the cardiac muscle cells during contraction?
Cherry hemangioma
PDA
The plateau period
Increased SV


16. Churg Strauss - presentation and test
Strawberry hemangioma
2-4 day - early coag necrosis on the first day
Kidney
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys


17. SV CAP means?
CK- MB
Stroke volume affected by contractility - afterload - and preload
LAD > RCA > circumflex
LV failure - pulm venous distention transudation of fluid


18. Central chemoreceptors do not respond directly to which parameter?
Can progess to V fib
P02
During diastole
Stroke volume


19. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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20. What causes the CO curve to shift upwards?
Pos inotropy - exercise
Torsades de pointes
Increased efferent SANS and decreased efferent PANS
Myxomatous degeneration - RF - chordae rupture


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

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22. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Myxoma
Strawberry hemangioma
ASD
Filling is incomplete and CO falls


23. Where are pacemaker cells?
CO
Preload
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
SA and AV nodes


24. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Cardiac tamponde
Angiosarcoma
Lymphangiosarcoma


25. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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26. What does increasing intracellular Ca do?
Cardiac tamponde
Increase contractility
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Decrease in activity of Na/Ca exhanger and increase in contractility


27. What is the early and late lesion in rheumatic heart disease
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Systolic dysfunction
RV failure - in venous pressure
Mitral valve prolapse


28. What causes the early cyanosis in Tet of Fallot?
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Mitral stenosis
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
R to L shunt caused by stenoic pulmonic valve


29. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Temporal arteritis
Kids
Lower right - MC - upper right - AO - upper right AC - lower left MO
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence


30. What does HTN predispose to?
Increase - increase the chance the If are open
RV failure - in venous pressure
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy


31. in the JVP - What is the v wave?
Inc RA pressure - due to filling against closed tricupsid valve
Early deaths from myocarditis
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas


32. What are the different etiologies of dialted cardiomyopathy
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Cyclophosphamide and corticosteroids
CHF
Adult type aortic coarctation


33. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
Ischemic heart dz - mitral valve prolapse - LV dilation
RCA
Aortic/pulmonic stenosis and mitral/tricuspid regurg


34. Which murmur is characteristic of mitral/tricuspid regurg?
ANP
Holosystoiic
No - no pressure gradient
Aortic dilation - bicuspid aortic valve - RF -


35. sawtooth wave

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36. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Failure of LV to in CO during exercise
Sudden tensing of chordae tendinae
140/90


37. What can cause mitral prolapse?
CHF
Kaposi's sarcoma
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Myxomatous degeneration - RF - chordae rupture


38. What happens in phase 3 of the cardiac ventricular action potential?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Black > white > asian
MAP
Eccentric - concentric hypertrophy causes diastolic disfunction


39. What are the four most common locations for atherosclerosis?
S. aureus
LAD > RCA > circumflex
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Aortic/pulmonic stenosis and mitral/tricuspid regurg


40. Most common vasculitis affecting medium and large arteries
Aortic stenosis or LBBB
Takayasu's arteritis
Temporal arteritis
Mitral>aortic>>tricuspid - high pressure valves affected most


41. in the JVP - What is the a wave?
Boot shaped heart
Atrial contraction
Stroke volume affected by contractility - afterload - and preload
Left atrial pressure


42. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
No - no pressure gradient
Medullary vasomotor center senses baroreceptors and JGA
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)


43. Which two mechanisms sense decrease MAP?
LAD - V1- V2
Medullary vasomotor center senses baroreceptors and JGA
Can progess to V fib
Left heart failure


44. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Postinfarction fibrinous pericarditis
Myxomatous degeneration - RF - chordae rupture
Hemorrhage
Wegener's


45. coronary artery spasm - ST elevation
Diastolic
Prinzmetal angina
Acute thrombosis of coronary artery
Dec P02 - inc PC02 and dec pH


46. What are the 5 T's of cyanoitc babies
3rd degree block - pacemaker - Lyme disease
Atrial contraction
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Septal defects - PDA - pulm art stenosis


47. What does TAPVR stand for
Total anomalous pulmonary trunk venous return
Subendocardial
LCX - I - aVL
Unstable/crescendo angina


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

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49. What do the carotid and aortic bodies respond to?
Postinfarction fibrinous pericarditis
Dec P02 - inc PC02 and dec pH
Aortic/pulmonic regurg and mitral/tricuspid stenosis
The operating point of the heart


50. How are sarcomeres added in concentric hypertrophy?
In parallel
RCA
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
1st degree AV blodck