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Cardiology

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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. The 7 complications of MI

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2. What masks atrial repolarization?
Sturge weber - vasculitis of caps
QRS complex
HTN - bradycardia - and respiratory depression
Age related calcifications or bicuspid aortic valve

3. EDV - ESV
SA and AV nodes
Stroke volume
Diastolic
Decrease in cAMP

4. In what disease states is blood viscosity increased?
Failure of LV to in CO during exercise
Mitral and tricuspid closure
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Varicose veins - thromboembolism rare

5. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
Kawasaki
Inc central venous pressure - inc resistance to portal flow
The aortic before pulmonic - inspiration increases diff

6. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

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7. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Arteriorles
Hyperlipidemia
CK- MB
Aortic disecction - intraluminal tear forming false lumen

8. Which bacteria causes endocarditis in the presence of colon cancer
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Wegener's
Inc TPR and LA return (expiration)
S. bovis

9. How does aldosterone raise MAP
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Inc Kf - capillary perm
Myxoma
Inc blood volume

10. In an EKG - What is the PR interval?
Stroke volume affected by contractility - afterload - and preload
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Conduction delay through AV node - nl < 200 msec
S. bovis

11. What is the S1 sound?
Mitral and tricuspid closure
Boot shaped heart
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Total anomalous pulmonary trunk venous return

12. Which sympathetic receptors raise MAP
P02
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Inc RA pressure - due to filling against closed tricupsid valve
Fluid movement through capillaries

13. What are the complications of atherosclerosis?
Arteriolosclerosis in malignant hypertension
Aortic dilation - bicuspid aortic valve - RF -
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
The first 4 days

14. in the JVP - What is the v wave?
Filling is incomplete and CO falls
Decreased
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Inc RA pressure - due to filling against closed tricupsid valve

15. What is sudden cardiac death most commonly due to...
Mitral>aortic>>tricuspid - high pressure valves affected most
Atrial contraction
V fib arrhythima
Atrial contraction

16. Which organ has ht highest blood flow per gram of tissue
Early deaths from myocarditis
Holosystoiic
Kidney
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

17. What is the classic X ray finding for tet of fallot?
Left sided
Boot shaped heart
Systolic dysfunction
CO

18. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
Mitral and tricuspid closure
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Ventricular depolarization - nl < 120 msec

19. Which class of drugs decrease the murmur heard in aortic regurg?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Vasodilators
Tempral arteritis - may cause irreversible blindness
S. aureus

20. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Granuloma with giant cells
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Inc TPR and LA return (expiration)
Dec plasma proteins

21. Mitral stenosis is most often secondary to which condition?
Tempral arteritis - may cause irreversible blindness
Right sided
RF
Glossopharyngeal to soliary nucleus of medulla

22. What does the starling curve show?
Changes in CO as a function of preload
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Increased efferent SANS and decreased efferent PANS
Late diastolic murmur following an opening snap

23. What supplies the posterior left ventricle?
Glomus tumor
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
CFX
Rapid upstroke - voltage gated Na channels open

24. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
7 weeks
Greater ventricular EDV
Postinfarction fibrinous pericarditis
MI

25. In an EKG - What is the p wave?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Atrial contraction
S. bovis
Vasocxn - while other tissues it causes vasodilation

26. When do you see extensive coagulative necrosis in an MI
RF
Arteriolosclerosis in malignant hypertension
Raynaud's
2-4 day - early coag necrosis on the first day

27. What happens with a decrease of extracellular Na
R to L shunt caused by stenoic pulmonic valve
Proportional to viscosity and inversely proportional to the radius to the 4th power
Decrease in activity of Na/Ca exhanger and increase in contractility
Purkingee>atria>ventricles>AV node

28. What does FEVERSS stand for in rheumatic heart disease
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
LCX - V4- V6

29. polypoid capillary hemangioma that can ulcerate and bleed
Cherry hemangioma
During HF from microhemorrhages from inc pulm cap pressure
Pyogenic granuloma - associated with trauma and pregnancy
Subendocardial - fewer collaterals and higher pressure

30. What is a normal EF
Strawberry hemangioma
The first 4 days
At least 55%
Changes in CO as a function of preload

31. What does TAPVR stand for
ASD
Early deaths from myocarditis
Mitral valve prolapse
Total anomalous pulmonary trunk venous return

32. cavernous lymphangioma of the neck - associated with turner's
Stable angina
Cystic hygroma
CFX
Mitral>aortic>>tricuspid - high pressure valves affected most

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

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34. congenital heart defect with turner's
Stable angina
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Coarcation of aorta
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

35. What other sign is often present with congenital long QT syndrome - why?
Wolff - Parkinson white syndrome
Takayasu's arteritis
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
LAD

36. What does hypoxia cause in the lung versus other tissues?
Prinzmetal angina
Wegener's
Decreased
Vasocxn - while other tissues it causes vasodilation

37. failure of truncus arteriosus to divide?
Persistant truncus arteriosus
ANP
Dec plasma proteins
Adult type aortic coarctation

38. What does mitral prolapse predeispose to?
Dressler's - autoimmune
Infective endocarditis
LAD - V1 - V4
Mitral valve prolapse

39. MAP is also known as
The operating point of the heart
Wolff - Parkinson white syndrome
Afterload (proportional to peripheral resistance)
During diastole

40. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
LCX - I - aVL
V fib arrhythima
In RA return (inspiration)
LCX - V4- V6

41. congenital heart defect in an infant with a diabetic mother?
Pulmonic stenosis and RBBB
Vasocxn
Transposition of great vessels
Vasodilators - (hydrAlAzine)

42. The carotid sinus transmits along which nerve?
Torsades de pointes
LAD
Wolff - Parkinson white syndrome
Glossopharyngeal to soliary nucleus of medulla

43. stroke volume x HR =?
Hyperlipidemia
Polyarteritis nodosum
CO
Decreased

44. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
No - no pressure gradient
Postinfarction fibrinous pericarditis
Subendocardial - fewer collaterals and higher pressure
S. epidermidis

45. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Inc TPR and LA return (expiration)
Isovolumetric contraction
P02
Purkingee>atria>ventricles>AV node

46. What causes the midsystolic click
Gap junctions
In RA return (inspiration)
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Sudden tensing of chordae tendinae

47. In an anterior wall infarct - which artery is effected and which leads show Q waves
2-4 day - early coag necrosis on the first day
Mitral and tricuspid closure
LAD - V1 - V4
Stroke volume

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

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49. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Fetal right to left - neonate left to right leading to RVH and failure
Left sided
ASD - VSD - AV septal defect (endocardial cushion defect)
Fick principle

50. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Myxoma
Boot shaped heart
Neg inotropy - HF - narcotic overdose
Septal defects - PDA - pulm art stenosis

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