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Cardiology

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 do the carotid and aortic bodies respond to?
Aortic stenosis or LBBB
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Dec P02 - inc PC02 and dec pH
Decreased

2. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Stroke volume
Troponin I
Transfusion
ANP

3. What is the machine like murmur? What is the heart pathology and the predisposing causes
Mitral stenosis
Patent ductus arteriosus - congenital rubella or prematurity
Libman - sacks endocarditis
Squat. Compression of femoral arteries - inc TPR - dec

4. What is the definition of HTN?
Aortic and pulmonary closing
Pulmonary flow murmur and diastolic rumble
140/90
Total anomalous pulmonary trunk venous return

5. machine murmer
PDA
2nd degree AV block - mobitz type 1
Mitral stenosis
Cherry hemangioma

6. What does mitral prolapse predeispose to?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Infective endocarditis
Mitral>aortic>>tricuspid - high pressure valves affected most
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

7. What happens in phase 4 of the cardiac ventricular action potential?
Granuloma with giant cells
Resting potential high K perm
SV/ EDV
In RA return (inspiration)

8. What does the LAD supply?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Apex and anterior interventricular septum
Aortic disecction - intraluminal tear forming false lumen

9. What is the association with wide S2 splitting?
MI
Pulmonic stenosis and RBBB
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Can progess to V fib

10. list the coronary vessels most likely to be occluded
Inc interstitial osmotic pressure pulling fliud out of capillaries
LAD > RCA > circumflex
Wolff - Parkinson white syndrome
5-10 days - macs have degraded structural components

11. bening capillary hemangioma of elderly - does not regress
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Microscopic polyangiitis - like wegener's without granulomas
Sudden tensing of chordae tendinae
Cherry hemangioma

12. polypoid capillary hemangioma that can ulcerate and bleed
Fluid movement through capillaries
V fib
2nd degree AV block - mobitz type 1
Pyogenic granuloma - associated with trauma and pregnancy

13. benign cap hemangioma of infancy - spont regresses
Strawberry hemangioma
Rhabdomyomas
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Left sided

14. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
LV failure - pulm venous distention transudation of fluid
Takayasu's arteritis
Adult type aortic coarctation
Sudden tensing of chordae tendinae

15. How does digitatlis increase contractility?
Increase intracellular Na - resulting in increased Ca
Lymphangiosarcoma
Pulmonary flow murmur and diastolic rumble
Acute thrombosis of coronary artery

16. What happens in phase 0 of the cardiac ventricular action potential?
Aortic disecction - intraluminal tear forming false lumen
RCA - II - III - aVF
Rapid upstroke - voltage gated Na channels open
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

17. Which sympathetic receptors raise MAP
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Systolic dysfunction
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Total anomalous pulmonary trunk venous return

18. Which organ has the largest arteriovenous difference
HypoK and bradycardia
Heart - 02 extraction is always around 100%
Rapid upstroke - voltage gated Na channels open
Myxomatous degeneration - RF - chordae rupture

19. What is the result of not have fast sodium channels in pacemaker cells?
7 weeks
Venodilators (nitrogylcerine)
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Prinzmetal angina

20. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
MI
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Proportional to viscosity and inversely proportional to the radius to the 4th power
Angiosarcoma

21. What does the starling curve show?
Changes in CO as a function of preload
Transposition of great vessels
Cyclophosphamide and corticosteroids
Stroke volume affected by contractility - afterload - and preload

22. What causes ankle - sacral edema - jugular venous distention
RV failure - in venous pressure
Rhabdomyomas
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Dec P02 - inc PC02 and dec pH

23. Wegener's tx
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Volatage gated Ca channels
Cyclophosphamide and corticosteroids
Aortic insuffic - late

24. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Lymphangiosarcoma
Inc RA pressure - due to filling against closed tricupsid valve
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Aortic dilation - bicuspid aortic valve - RF -

25. What does FROM JANE stand for in bacterial endocarditis?

26. What masks atrial repolarization?
Aburpt halting of valve leaflets
Cystic hygroma
Purkingee>atria>ventricles>AV node
QRS complex

27. What does HTN predispose to?
Myxomatous degeneration - RF - chordae rupture
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Raynaud's
Aortic/pulmonic stenosis and mitral/tricuspid regurg

28. CO x Total peripheral resistance
Mean arterial pressure
...
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Decrease in activity of Na/Ca exhanger and increase in contractility

29. cavernous lymphangioma of the neck - associated with turner's
Wegener's
Indomethacin closes - and pge keeps it open
Cystic hygroma
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

30. friction rub - 3-5 days post MI
Vagus to medulla
SV/ EDV
Postinfarction fibrinous pericarditis
Maintain blood flow to organ over wide range of perfussion pressures

31. How does acidosis affect contractility?
Decreased
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Tricuspid atresia - requires ASD and VSD
Yes

32. congenital heart defect with congenital rubella
Fetal right to left - neonate left to right leading to RVH and failure
Can progess to V fib
Torsades de pointes
Septal defects - PDA - pulm art stenosis

33. sawtooth wave

34. What causes tet of fallot?
Wegener's
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Anterosuperior displacement of the infundibular septum

35. Which bacteria can cause endocarditis from prosthetic valves?
Acute thrombosis of coronary artery
Increase - increase the chance the If are open
Aortic/pulmonic regurg and mitral/tricuspid stenosis
S. epidermidis

36. What is the cushing triad?
Anterosuperior displacement of the infundibular septum
Maintain blood flow to organ over wide range of perfussion pressures
HTN - bradycardia - and respiratory depression
RCA - II - III - aVF

37. In the cardiac cycle - which period has the highest 02 consumption?
Isovolumetric contraction
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Mean arterial pressure
Anterosuperior displacement of the infundibular septum

38. What stimulates release of calcium from the SR?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Dec plasma proteins
Extracellular calcium - calcium induced calcium release
Kaposi's sarcoma

39. Which kind of infarct show ST elevation - and/or pathologic Q waves
Eccentric - concentric hypertrophy causes diastolic disfunction
MI
Transmural
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

40. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Turners
Sturge weber - vasculitis of caps
Hyperlipidemia

41. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Increase - increase the chance the If are open
Kidney
Polyarteritis nodosum
Transfusion

42. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Postinfarction fibrinous pericarditis
No
Persistant truncus arteriosus

43. What is the danger of torsades to pointes?
Can progess to V fib
ANP
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Resting potential high K perm

44. What causes hepatomegaly?
Apex and anterior interventricular septum
Temporal arteritis
Inc central venous pressure - inc resistance to portal flow
Fast volatge gated Na channels

45. PCWP > LV diastolic pressure
In RA return (inspiration)
Pulsus parvus and tardus - weak - can lead to syncope
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Mitral stenosis

46. What does FAN MY SKIN On Wednesday stand for?
Vasocxn
Decrease in activity of Na/Ca exhanger and increase in contractility
CHF
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

47. most common primary cardiac tumor in children - associated with tuberous sclerosis
Kaposi's sarcoma
CFX
Rhabdomyomas
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

48. Which murmur do you hear in mitral stenosis?
Stroke volume
Late diastolic murmur following an opening snap
Volatage gated Ca channels
Angiosarcoma

49. How are sarcomeres added in concentric hypertrophy?
Subendocardial
In parallel
Early deaths from myocarditis
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

50. decrease stretch in baroreceptors leads to what response?
Chordae rupture - GN - suppurative pericarditis - emboli
Increased efferent SANS and decreased efferent PANS
Non
Mechanican contraction of the ventricles