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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. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
RV contraction (closed tricuspid valve bulding into atrium
Systolic dysfunction

2. which ethnic groups have higher association with HTN?
Mitral>aortic>>tricuspid - high pressure valves affected most
Boot shaped heart
Black > white > asian
Activated histiocytes

3. What other sign is often present with congenital long QT syndrome - why?
Tempral arteritis - may cause irreversible blindness
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

4. What does TAPVR stand for
Pyogenic granuloma - associated with trauma and pregnancy
Mitral stenosis
3rd degree block - pacemaker - Lyme disease
Total anomalous pulmonary trunk venous return

5. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Glomus tumor
Liver
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
R to L shunt caused by stenoic pulmonic valve

6. which medications are used to maintain patency or close the ductus arteriosus?
In series
LCX - I - aVL
SA>AV>bundle of His>ventricles
Indomethacin closes - and pge keeps it open

7. tearing chest pain radiation to the back - associated with marfan
RCA - II - III - aVF
HTN - bradycardia - and respiratory depression
Aortic disecction - intraluminal tear forming false lumen
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

8. What murmur is heard with aortic regurg?
Varicose veins - thromboembolism rare
Boot shaped heart
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
10%

9. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Pulmonic stenosis and RBBB
The aortic before pulmonic - inspiration increases diff
Inc RA pressure - due to filling against closed tricupsid valve
2nd degree AV block - mobitz type 1

10. What are the different etiologies of dialted cardiomyopathy
Decrease in activity of Na/Ca exhanger and increase in contractility
Resting potential high K perm
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Decreases

11. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Ventricular repolarization
Cystic hygroma

12. most common primary cardiac tumor in children - associated with tuberous sclerosis
Microscopic polyangiitis - like wegener's without granulomas
At least 55%
LCX - I - aVL
Rhabdomyomas

13. In an EKG - What is the p wave?
Changes in CO as a function of preload
Atrial contraction
Viridans streptococci
Cyclophosphamide and corticosteroids

14. PROVe
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Neg inotropy - HF - narcotic overdose
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
P02

15. Why is contractility decreased in heart failure?
Systolic dysfunction
Babies
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
MAP

16. Which lab value indicates blood viscosity?
Neg inotropy - HF - narcotic overdose
Hyperlipidemia
Changes in CO as a function of preload
Hematocrit

17. How are cadiac myocytes eltrically coupled?
Gap junctions
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
CK- MB
Systolic dysfunction

18. What are the complications of atherosclerosis?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Subendocardial
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Holosystoiic

19. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
Myxoma
Age related calcifications or bicuspid aortic valve
Hypertrophied cardiomyopathy

20. sawtooth wave

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21. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Inc central venous pressure - inc resistance to portal flow
MAP
Venodilators (nitrogylcerine)

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

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23. How does a patient with Tet of fallot learn to improve symptoms?
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Squat. Compression of femoral arteries - inc TPR - dec
Rhabdomyomas

24. What is associated with paradoxical spliting of S2
Aortic stenosis or LBBB
Posterior descending (80% off the RCA - 20% off the circumflex)
RF
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

25. list the coronary vessels most likely to be occluded
Patent ductus arteriosus - congenital rubella or prematurity
LAD > RCA > circumflex
ASD - VSD - AV septal defect (endocardial cushion defect)
Transfusion

26. What is the machine like murmur? What is the heart pathology and the predisposing causes
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Patent ductus arteriosus - congenital rubella or prematurity
Diastolic
...

27. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Mitral valve prolapse
Coarcation of aorta
S. aureus
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

28. How does angiotensin II raise MAP
Mitral and tricuspid closure
Late diastolic murmur following an opening snap
Inc central venous pressure - inc resistance to portal flow
Vasocxn

29. cavernous lymphangioma of the neck - associated with turner's
In parallel
Cystic hygroma
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Babies

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

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31. When does extracellular calcium enter the cardiac muscle cells during contraction?
SV/ EDV
Pulmonic stenosis and RBBB
The plateau period
During diastole

32. What are aschoff bodies
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Granuloma with giant cells
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

33. In an EKG - What is the T wave?
Postinfarction fibrinous pericarditis
Ventricular repolarization
Kidney
Arteriorles

34. Which organ has the largest arteriovenous difference
LAD
The operating point of the heart
P02
Heart - 02 extraction is always around 100%

35. What constitues the upstroke in pacemaker cells?
Activated histiocytes
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Stroke volume affected by contractility - afterload - and preload
Volatage gated Ca channels

36. Expiration causes an increase in which sided heart sounds
Transmural
SV/ EDV
During HF from microhemorrhages from inc pulm cap pressure
Left sided

37. What happens with a decrease of extracellular Na
Decrease in activity of Na/Ca exhanger and increase in contractility
Inc central venous pressure - inc resistance to portal flow
In RA return (inspiration)
5-10 days - macs have degraded structural components

38. What is association with fixed S2 splitting - does not increase with inspiration
Increase contractility
ASD
In RA return (inspiration)
Posterior descending (80% off the RCA - 20% off the circumflex)

39. Where does coronary artery occlusion occur most commonly?
Fick principle
Apex and anterior interventricular septum
Unstable/crescendo angina
LAD

40. What does the U wave indicated?
HypoK and bradycardia
S. epidermidis
Pulmonic stenosis and RBBB
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

41. Left to right shunts are more common in babies or kids?
Kids
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Diastolic
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

42. What is sudden cardiac death most commonly due to...
V fib arrhythima
Increase in Pc
Septal defects - PDA - pulm art stenosis
Diastolic

43. What does the atria release in response to inc blood volume and atrial pressure
ANP
7 weeks
RF
Atherosclerosis

44. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Troponin I
Cherry hemangioma
S. bovis
LAD

45. What does HTN predispose to?
Subendocardial
In HF
Late diastolic murmur following an opening snap
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

46. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
Pulmonary flow murmur and diastolic rumble
CFX
Eccentric - concentric hypertrophy causes diastolic disfunction

47. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Rapid upstroke - voltage gated Na channels open
Aortic insuffic - late
Yes
Hyperlipidemia

48. What is the S1 sound?
ANP
Transmural
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Mitral and tricuspid closure

49. Wegener's presentation
Aburpt halting of valve leaflets
Total anomalous pulmonary trunk venous return
During diastole
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

50. What are anitschkow's cells
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
1st degree AV blodck
Troponin I
Activated histiocytes