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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. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
CO
In HF
Arteriorles
No - no pressure gradient

2. How are the sarcomeres added in eccentric hypertrophy?
Right sided
Increase contractility
In series
Takayasu's arteritis

3. In an EKG - What is the p wave?
Atrial contraction
7 weeks
Arteriorles
HTN - bradycardia - and respiratory depression

4. Expiration causes an increase in which sided heart sounds
3rd degree block - pacemaker - Lyme disease
Proportional to viscosity and inversely proportional to the radius to the 4th power
Vasocxn - while other tissues it causes vasodilation
Left sided

5. Restrictive cardiomyopathy causes
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Buerger's disease
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Transmural

6. friction rub - 3-5 days post MI
Raynaud's
Postinfarction fibrinous pericarditis
Mitral>aortic>>tricuspid - high pressure valves affected most
1st degree AV blodck

7. Why is there edema after burns or during infection
Transmural
RF
Cherry hemangioma
Inc Kf - capillary perm

8. What does FAN MY SKIN On Wednesday stand for?
Adult type aortic coarctation
Atrial contraction
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Takayasu's arteritis

9. Most common vasculitis affecting medium and large arteries
Prinzmetal angina
Temporal arteritis
Vasodilators
Holosystolic - harsh sounding murmur - loudest over tricuspid area

10. When do coronary arteries fill?
Hypertrophied cardiomyopathy
Increased efferent SANS and decreased efferent PANS
Preload
During diastole

11. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Tricuspid atresia - requires ASD and VSD
Inc central venous pressure - inc resistance to portal flow
Glomus tumor
Viridans streptococci

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

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13. congenital heart defect withdown syndrome
ASD - VSD - AV septal defect (endocardial cushion defect)
Unstable/crescendo angina
ANP
Stable angina

14. Mitral stenosis is most often secondary to which condition?
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
RF
Proportional to viscosity and inversely proportional to the radius to the 4th power
Dressler's - autoimmune

15. What are anitschkow's cells
Inc blood volume
Chordae rupture - GN - suppurative pericarditis - emboli
Activated histiocytes
Isovolumetric contraction

16. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Mitral valve
Aortic and pulmonary closing
ASD

17. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Isovolumetric contraction
Cardiac tamponde
TAPVR
Metastasis from melanoma or lymphoma

18. In an EKG - What is the QRS complex?
SA>AV>bundle of His>ventricles
5-10 days - macs have degraded structural components
Inc TPR and LA return (expiration)
Ventricular depolarization - nl < 120 msec

19. what conditions are associated with pulsus paradoxus
Raynaud's
LV failure - pulm venous distention transudation of fluid
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Vasocxn

20. What does the atria release in response to inc blood volume and atrial pressure
Right sided
Raynaud's
ANP
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

21. Which enzymes are useful for diagnosing reinfarction
Venodilators (nitrogylcerine)
CK- MB
Pulmonary flow murmur and diastolic rumble
Late systolic crescendo murmur with a midsystolic click

22. Which organ gets the largest share of systemic cardiac output
Atherosclerosis
Septal defects - PDA - pulm art stenosis
Liver
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

23. What masks atrial repolarization?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
QRS complex
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

24. p - anca

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25. If HR is too fast (V tach) what happens during diastole?
Mitral and tricuspid closure
140/90
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Filling is incomplete and CO falls

26. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
RV contraction (closed tricuspid valve bulding into atrium
LV failure - pulm venous distention transudation of fluid
Rapid upstroke - voltage gated Na channels open
Adult type aortic coarctation

27. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Granuloma with giant cells
Greater ventricular EDV

28. stroke volume x HR =?
Eisenmenger's syndrome
CO
Group a beta hemolytic strep
Black > white > asian

29. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Hypertrophied cardiomyopathy
Decreases
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

30. 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
Mitral>aortic>>tricuspid - high pressure valves affected most
SA and AV nodes
Ventricular depolarization - nl < 120 msec

31. Which murmur do you hear in mitral stenosis?
Late diastolic murmur following an opening snap
Proportional to viscosity and inversely proportional to the radius to the 4th power
Decrease in activity of Na/Ca exhanger and increase in contractility
Crescendo - decrescendo systolic ejection murmur following ejection click

32. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Pos inotropy - exercise
Inc interstitial osmotic pressure pulling fliud out of capillaries
Lower right - MC - upper right - AO - upper right AC - lower left MO
Total anomalous pulmonary trunk venous return

33. MAP is also known as
Takayasu's arteritis
V fib arrhythima
Afterload (proportional to peripheral resistance)
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

34. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
Holosystoiic
MI
Atherosclerosis

35. 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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36. dyspnea - fatigue - edema and rales - multiple causes
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
10%
Aortic stenosis or LBBB
CHF

37. Which murmur is characteristic of mitral/tricuspid regurg?
LV failure - pulm venous distention transudation of fluid
Pulmonic stenosis and RBBB
Holosystoiic
Proportional to viscosity and inversely proportional to the radius to the 4th power

38. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
RV contraction (closed tricuspid valve bulding into atrium
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Angiosarcoma
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

39. How does a patient with Tet of fallot learn to improve symptoms?
Squat. Compression of femoral arteries - inc TPR - dec
Vasodilators
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

40. What are the diastolic heart sounds?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Posterior descending (80% off the RCA - 20% off the circumflex)
Cardiac tamponde
RCA

41. Rank the pacemakers cells
R to L shunt caused by stenoic pulmonic valve
Vagus to medulla
SA>AV>bundle of His>ventricles
CFX

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

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43. most common heart tumor
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Metastasis from melanoma or lymphoma
MI
In HF

44. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Hematocrit
Pulmonary flow murmur and diastolic rumble
Dilation

45. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Posterior descending (80% off the RCA - 20% off the circumflex)
Pulmonary flow murmur and diastolic rumble
Vasocxn - while other tissues it causes vasodilation
Hemorrhage

46. What channels do the the pacemaker cells lack?
Apex and anterior interventricular septum
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Stroke volume
Fast volatge gated Na channels

47. The carotid sinus transmits along which nerve?
Polyarteritis nodosum
Hypertrophied cardiomyopathy
No
Glossopharyngeal to soliary nucleus of medulla

48. In an anterior wall infarct - which artery is effected and which leads show Q waves
Mitral valve
LAD - V1 - V4
Pulmonary flow murmur and diastolic rumble
Dec plasma proteins

49. what percentage of HTN is secondary to renal disease?
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
10%
V fib
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

50. When during cardiac nodal cells depolarize?
ANP
Vasocxn
During diastole
Mitral and tricuspid closure