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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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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. What causes the midsystolic click
Sudden tensing of chordae tendinae
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
C - ANCA
In parallel
2. What causes aortic stenosis
CHF
Angiosarcoma
Increase intracellular Na - resulting in increased Ca
Age related calcifications or bicuspid aortic valve
3. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
SV/ EDV
Mitral valve prolapse
Vasocxn - while other tissues it causes vasodilation
4. In the cardiac cycle - which period has the highest 02 consumption?
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Temporal arteritis
Activated histiocytes
Isovolumetric contraction
5. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
V fib
Kids
Increase - increase the chance the If are open
Medullary vasomotor center senses baroreceptors and JGA
6. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect
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7. What are aschoff bodies
MI
Granuloma with giant cells
Acute thrombosis of coronary artery
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
8. What is the characteristic pulse in aortic stenosis?
Pulsus parvus and tardus - weak - can lead to syncope
Myxomatous degeneration - RF - chordae rupture
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Dressler's - autoimmune
9. What is the machine like murmur? What is the heart pathology and the predisposing causes
Aortic stenosis or LBBB
Conduction delay through AV node - nl < 200 msec
Heart - 02 extraction is always around 100%
Patent ductus arteriosus - congenital rubella or prematurity
10. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Changes in CO as a function of preload
Eccentric - concentric hypertrophy causes diastolic disfunction
Tempral arteritis - may cause irreversible blindness
Aburpt halting of valve leaflets
11. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
1st degree AV blodck
Activated histiocytes
Mitral stenosis
LAD - V1- V2
12. which ethnic groups have higher association with HTN?
Temporal arteritis
Persistant truncus arteriosus
TAPVR
Black > white > asian
13. stroke volume x HR =?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
CO
Non
Vagus to medulla
14. Restrictive cardiomyopathy causes
Tricuspid atresia - requires ASD and VSD
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Left sided
15. When during cardiac nodal cells depolarize?
Ventricles are depolarized
2nd degree AV block - mobitz type 1
During diastole
Liver
16. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Inc blood volume
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Polyarteritis nodosum
Volatage gated Ca channels
17. congenital heart defect in an infant with a diabetic mother?
Inc blood volume
Failure of LV to in CO during exercise
Transposition of great vessels
Pyogenic granuloma - associated with trauma and pregnancy
18. moncekberg
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Turners
Ventricular depolarization - nl < 120 msec
19. What causes the ejection click in the Cres - decres murmur?
SA and AV nodes
Purkingee>atria>ventricles>AV node
Aburpt halting of valve leaflets
V fib
20. What causes aortic regurg
HTN - bradycardia - and respiratory depression
Rhabdomyomas
Aortic dilation - bicuspid aortic valve - RF -
V fib
21. In an anterolateral infarct - which artery is effected and which leads show Q waves
Tempral arteritis - may cause irreversible blindness
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Temporal arteritis
LCX - V4- V6
22. Which vessels account for the most total peripheral resistance
Atherosclerosis
Increase contractility
ASD
Arteriorles
23. What does prolonged QT predispose to?
Strawberry hemangioma
Torsades de pointes
Atrial contraction
Ventricular depolarization - nl < 120 msec
24. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Henoch - Schlonlein purpura
Mitral valve prolapse
Eccentric - concentric hypertrophy causes diastolic disfunction
Patent ductus arteriosus - congenital rubella or prematurity
25. What does FEVERSS stand for in rheumatic heart disease
Aortic and pulmonary closing
Stable angina
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Rhabdomyomas
26. In an EKG - What is the T wave?
7 weeks
Pulmonic stenosis and RBBB
At least 55%
Ventricular repolarization
27. When do coronary arteries fill?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Decreases
During diastole
7 weeks
28. congenital heart defect with 22q11
Truncus - tet of fallot
Libman - sacks endocarditis
Myxomatous degeneration - RF - chordae rupture
R to L shunt caused by stenoic pulmonic valve
29. What is the time frame for arrhythmia risk in the evolution of MI
S. epidermidis
The first 4 days
LCX - V4- V6
Decreased
30. in the JVP - What is the c wave?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
RV contraction (closed tricuspid valve bulding into atrium
SA and AV nodes
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
31. What are the different etiologies of dialted cardiomyopathy
Posterior descending (80% off the RCA - 20% off the circumflex)
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Aortic and pulmonary closing
Preload
32. If HR is too fast (V tach) what happens during diastole?
LAD - V1- V2
Conduction delay through AV node - nl < 200 msec
Filling is incomplete and CO falls
Preload
33. which medications are used to maintain patency or close the ductus arteriosus?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Indomethacin closes - and pge keeps it open
Increase in Pc
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
34. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Inc Kf - capillary perm
Pyogenic granuloma - associated with trauma and pregnancy
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Adult type aortic coarctation
35. What causes ankle - sacral edema - jugular venous distention
RV failure - in venous pressure
Yes
LV failure - pulm venous distention transudation of fluid
Subendocardial - fewer collaterals and higher pressure
36. EDV - ESV
Diastolic
Stroke volume
Buerger's disease
Aortic/pulmonic stenosis and mitral/tricuspid regurg
37. What kind of dysfunction ensues in restrictive cardiomyopathy
Atherosclerosis
Diastolic
CHF
Tricuspid atresia - requires ASD and VSD
38. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Transfusion
Varicose veins - thromboembolism rare
Mitral and tricuspid closure
Boot shaped heart
39. What does FAN MY SKIN On Wednesday stand for?
Mitral valve prolapse
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
SV/ EDV
Late systolic crescendo murmur with a midsystolic click
40. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST
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41. What is the early and late lesion in rheumatic heart disease
Mechanican contraction of the ventricles
Vasocxn
Microscopic polyangiitis - like wegener's without granulomas
Mitral valve prolapse
42. congenital heart defect withdown syndrome
Can progess to V fib
ASD - VSD - AV septal defect (endocardial cushion defect)
Inc Kf - capillary perm
Inc RA pressure - due to filling against closed tricupsid valve
43. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Cystic hygroma
Lower right - MC - upper right - AO - upper right AC - lower left MO
Increase contractility
Inc interstitial osmotic pressure pulling fliud out of capillaries
44. In what disease states is blood viscosity increased?
Proportional to viscosity and inversely proportional to the radius to the 4th power
SA>AV>bundle of His>ventricles
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
45. The carotid sinus transmits along which nerve?
Increase intracellular Na - resulting in increased Ca
Dec plasma proteins
CK- MB
Glossopharyngeal to soliary nucleus of medulla
46. How do beta blockers decrease contractility?
Decrease in cAMP
140/90
Sturge weber - vasculitis of caps
Mitral valve
47. Where are pacemaker cells?
Ventricular depolarization - nl < 120 msec
Heart - 02 extraction is always around 100%
SA and AV nodes
Mechanican contraction of the ventricles
48. benign cap hemangioma of infancy - spont regresses
Strawberry hemangioma
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Preload
Lower right - MC - upper right - AO - upper right AC - lower left MO
49. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Stroke volume
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Dilated cardiomyopathy
At least 55%
50. What does autoregulation do?
Atherosclerosis
Pulmonary flow murmur and diastolic rumble
Maintain blood flow to organ over wide range of perfussion pressures
During diastole
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