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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. machine murmer
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
PDA
Aortic disecction - intraluminal tear forming false lumen
In HF

2. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Increasing activity of Ca pump in SR
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Changes in CO as a function of preload
Cardiac tamponde

3. fibrous plaques and atheromas in intima of arteries
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Atherosclerosis
The plateau period
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

4. What is the machine like murmur? What is the heart pathology and the predisposing causes
Atherosclerosis
Subendocardial - fewer collaterals and higher pressure
Group a beta hemolytic strep
Patent ductus arteriosus - congenital rubella or prematurity

5. sawtooth wave

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6. decrease stretch in baroreceptors leads to what response?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
The first 4 days
ASD
Increased efferent SANS and decreased efferent PANS

7. Churg Strauss - presentation and test
Atrial contraction
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
In RA return (inspiration)
LV failure - pulm venous distention transudation of fluid

8. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Cherry hemangioma
Dec plasma proteins
Atrial contraction
Resting potential high K perm

9. What is indicated when CO and venous return are equal?
Crescendo - decrescendo systolic ejection murmur following ejection click
The operating point of the heart
Coarcation of aorta
Preload

10. What happens with a decrease of extracellular Na
Atrial contraction
Decrease in activity of Na/Ca exhanger and increase in contractility
Increase - increase the chance the If are open
During HF from microhemorrhages from inc pulm cap pressure

11. What does TAPVR stand for
Activated histiocytes
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Mitral stenosis
Total anomalous pulmonary trunk venous return

12. How does acidosis affect contractility?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Diastolic
Decreased
Ischemic heart dz - mitral valve prolapse - LV dilation

13. In an EKG - What is the QT interval?
Greater ventricular EDV
Fast volatge gated Na channels
Mechanican contraction of the ventricles
Turners

14. in the JVP - What is the c wave?
R to L shunt caused by stenoic pulmonic valve
Vasocxn
RV contraction (closed tricuspid valve bulding into atrium
Torsades de pointes

15. When and why do you hear the S4 sound
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Arteriorles
Proportional to viscosity and inversely proportional to the radius to the 4th power
Hematocrit

16. How are cadiac myocytes eltrically coupled?
Anterosuperior displacement of the infundibular septum
Gap junctions
Wolff - Parkinson white syndrome
Henoch - Schlonlein purpura

17. stroke volume x HR =?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
ANP
Mean arterial pressure
CO

18. Which valve is most commonly involved in bacterial endocarditis?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Holosystoiic
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Mitral valve

19. polypoid capillary hemangioma that can ulcerate and bleed
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Glomus tumor
Pyogenic granuloma - associated with trauma and pregnancy
Fick principle

20. What does FAN MY SKIN On Wednesday stand for?
During HF from microhemorrhages from inc pulm cap pressure
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Babies
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

21. What is the classic X ray finding for tet of fallot?
Squat. Compression of femoral arteries - inc TPR - dec
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Boot shaped heart
Adult type aortic coarctation

22. what percentage of HTN is secondary to renal disease?
10%
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

23. What channels do the the pacemaker cells lack?
SA and AV nodes
Fast volatge gated Na channels
Torsades de pointes
Hemorrhage

24. What is the formula for EF?
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
SV/ EDV
Inc RA pressure - due to filling against closed tricupsid valve
Pulmonic stenosis and RBBB

25. most common primary cardiac tumor in children - associated with tuberous sclerosis
CK- MB
Vasocxn - while other tissues it causes vasodilation
Rhabdomyomas
Tempral arteritis - may cause irreversible blindness

26. MAP is also known as
Kids
Afterload (proportional to peripheral resistance)
Subendocardial
ASD

27. Which bacteria causes rheumatic heart disease
7 weeks
ANP
Group a beta hemolytic strep
Increasing activity of Ca pump in SR

28. What causes the cushing reflex and why
Increase intracellular Na - resulting in increased Ca
Subendocardial - fewer collaterals and higher pressure
Infective endocarditis
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

29. How do beta blockers decrease contractility?
Decrease in cAMP
Boot shaped heart
Tricuspid atresia - requires ASD and VSD
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

30. The aortic arch receptors transmit along which nerve?
CK- MB
Strawberry hemangioma
Squat. Compression of femoral arteries - inc TPR - dec
Vagus to medulla

31. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
SV/ EDV
Lymphangiosarcoma
Chordae rupture - GN - suppurative pericarditis - emboli
Left sided

32. What is the most common cause of MI
Afterload (proportional to peripheral resistance)
In HF
Decreases
Acute thrombosis of coronary artery

33. congenital heart defect with congenital rubella
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Pyogenic granuloma - associated with trauma and pregnancy
Septal defects - PDA - pulm art stenosis
If sodium channel

34. Inspiration causes an increase in which sided heart sounds?
Late systolic crescendo murmur with a midsystolic click
Gap junctions
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Right sided

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. What does increasing intracellular Ca do?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Late diastolic murmur following an opening snap
S. bovis
Increase contractility

37. What do patients die early from in rheumatic heart disease?
Early deaths from myocarditis
Lower right - MC - upper right - AO - upper right AC - lower left MO
QRS complex
Indomethacin closes - and pge keeps it open

38. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Pos inotropy - exercise
Troponin I
The aortic before pulmonic - inspiration increases diff

39. What stimulates release of calcium from the SR?
RCA
Extracellular calcium - calcium induced calcium release
During diastole
Heart - 02 extraction is always around 100%

40. prolonged PR interval
Sturge weber - vasculitis of caps
Lymphangiosarcoma
The plateau period
1st degree AV blodck

41. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Increase contractility
Pulsus parvus and tardus - weak - can lead to syncope
CO
Posterior descending (80% off the RCA - 20% off the circumflex)

42. When do you find hemosiderin laden macrophages in the lungs?
2nd degree AV block - mobitz type 1
During HF from microhemorrhages from inc pulm cap pressure
Non
Inc interstitial osmotic pressure pulling fliud out of capillaries

43. What happens in phase 2 of the cardiac ventricular action potential?
QRS complex
Tricuspid atresia - requires ASD and VSD
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Septal defects - PDA - pulm art stenosis

44. What kind of infarct show ST depression
Vasocxn - while other tissues it causes vasodilation
Afterload (proportional to peripheral resistance)
S. epidermidis
Subendocardial

45. What are aschoff bodies
RV contraction (closed tricuspid valve bulding into atrium
Transmural
Granuloma with giant cells
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

46. What does FEVERSS stand for in rheumatic heart disease
Aortic insuffic - late
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Hypertrophied cardiomyopathy
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

47. What causes orthopnea?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
S. aureus
Activated histiocytes
Inc venous return exaccerbates pulm vasc congestion

48. Where does coronary artery occlusion occur most commonly?
Mechanican contraction of the ventricles
Total anomalous pulmonary trunk venous return
LAD
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

49. What is the cushing triad?
Non
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
HTN - bradycardia - and respiratory depression
Cystic hygroma

50. What is the danger of torsades to pointes?
The plateau period
Inc TPR and LA return (expiration)
Can progess to V fib
Left atrial pressure