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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. congenital heart defect with marfan's
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Aortic insuffic - late
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
RF

2. MAP is also known as
Arteriolosclerosis in malignant hypertension
Afterload (proportional to peripheral resistance)
Atherosclerosis
Failure of LV to in CO during exercise

3. What causes hepatomegaly?
10%
Arteriolosclerosis in malignant hypertension
Aortic dilation - bicuspid aortic valve - RF -
Inc central venous pressure - inc resistance to portal flow

4. What does the U wave indicated?
C - ANCA
HypoK and bradycardia
The first 4 days
Age related calcifications or bicuspid aortic valve

5. Which bacteria can cause endocarditis from prosthetic valves?
S. epidermidis
Tempral arteritis - may cause irreversible blindness
Atherosclerosis
Subendocardial

6. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
Increased SV
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Microscopic polyangiitis - like wegener's without granulomas

7. congenital heart defect withdown syndrome
CHF
Heart - 02 extraction is always around 100%
Mitral and tricuspid closure
ASD - VSD - AV septal defect (endocardial cushion defect)

8. What does hypoxia cause in the lung versus other tissues?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Mean arterial pressure
Vasocxn - while other tissues it causes vasodilation
Lymphangiosarcoma

9. most common primary cardiac tumor in children - associated with tuberous sclerosis
Libman - sacks endocarditis
Pulmonic stenosis and RBBB
Total anomalous pulmonary trunk venous return
Rhabdomyomas

10. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
In RA return (inspiration)
Glomus tumor
Atherosclerosis

11. What other sign is often present with congenital long QT syndrome - why?
Strawberry hemangioma
Stroke volume
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Filling is incomplete and CO falls

12. What happends in phase 1 of the ventricular cardiac action potential?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Lower right - MC - upper right - AO - upper right AC - lower left MO
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Proportional to viscosity and inversely proportional to the radius to the 4th power

13. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Decrease in activity of Na/Ca exhanger and increase in contractility
Troponin I
HTN - bradycardia - and respiratory depression
Activated histiocytes

14. What are the diastolic heart sounds?
Troponin I
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
The operating point of the heart

15. What is sudden cardiac death most commonly due to...
Fick principle
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
V fib arrhythima
Age related calcifications or bicuspid aortic valve

16. p - anca

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17. Which class of drugs decreases afterload?
Gap junctions
Squat. Compression of femoral arteries - inc TPR - dec
Pulmonic stenosis and RBBB
Vasodilators - (hydrAlAzine)

18. What does mitral prolapse predeispose to?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Infective endocarditis
Fick principle

19. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
Cystic hygroma
Filling is incomplete and CO falls
Right sided

20. Which class of drugs decrease the murmur heard in aortic regurg?
Vasodilators
Pos inotropy - exercise
Aortic dilation - bicuspid aortic valve - RF -
Aortic and pulmonary closing

21. What is indicated when CO and venous return are equal?
S. aureus
Rhabdomyomas
The operating point of the heart
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

22. How do catecholamines increase contractility?
Non
Inc blood volume
Early deaths from myocarditis
Increasing activity of Ca pump in SR

23. What are anitschkow's cells
The plateau period
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
10%
Activated histiocytes

24. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Libman - sacks endocarditis
Prinzmetal angina
LCX - V4- V6

25. What kind of infarct show ST depression
Subendocardial
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Vagus to medulla
During diastole

26. Which sympathetic receptors raise MAP
V fib
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Buerger's disease
Activated histiocytes

27. in the JVP - What is the c wave?
RV contraction (closed tricuspid valve bulding into atrium
SV/ EDV
P02
Gap junctions

28. In an acute MI - are there any visible changes via LM in the first 2-4 hours
No
Crescendo - decrescendo systolic ejection murmur following ejection click
Inc Kf - capillary perm
QRS complex

29. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
3rd degree block - pacemaker - Lyme disease
Increase contractility
Sudden tensing of chordae tendinae

30. If HR is too fast (V tach) what happens during diastole?
If sodium channel
Buerger's disease
Anterosuperior displacement of the infundibular septum
Filling is incomplete and CO falls

31. Wegener's presentation
Myxomatous degeneration - RF - chordae rupture
Late diastolic murmur following an opening snap
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

32. moncekberg
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Mitral>aortic>>tricuspid - high pressure valves affected most
During diastole
Aortic/pulmonic stenosis and mitral/tricuspid regurg

33. What happens with a decrease of extracellular Na
Subendocardial - fewer collaterals and higher pressure
Decrease in activity of Na/Ca exhanger and increase in contractility
Resting potential high K perm
R to L shunt caused by stenoic pulmonic valve

34. Mitral stenosis is most often secondary to which condition?
Strawberry hemangioma
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
RF
Cardiac tamponde

35. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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36. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
CHF
Viridans streptococci
...
Crescendo - decrescendo systolic ejection murmur following ejection click

37. What does the starling curve show?
Changes in CO as a function of preload
In HF
Chordae rupture - GN - suppurative pericarditis - emboli
Aortic dilation - bicuspid aortic valve - RF -

38. congenital heart defect with congenital rubella
Medullary vasomotor center senses baroreceptors and JGA
Aortic stenosis or LBBB
Early deaths from myocarditis
Septal defects - PDA - pulm art stenosis

39. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
S. bovis
Eccentric - concentric hypertrophy causes diastolic disfunction
ANP
If sodium channel

40. In an EKG - What is the T wave?
Age related calcifications or bicuspid aortic valve
Ventricular repolarization
Total anomalous pulmonary trunk venous return
Diastolic

41. Why is there edema after burns or during infection
Ventricular depolarization - nl < 120 msec
Inc Kf - capillary perm
Tricuspid atresia - requires ASD and VSD
Decrease in activity of Na/Ca exhanger and increase in contractility

42. Churg Strauss - presentation and test
Proportional to viscosity and inversely proportional to the radius to the 4th power
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Isovolumetric contraction
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

43. Most common vasculitis affecting medium and large arteries
SA>AV>bundle of His>ventricles
The plateau period
Temporal arteritis
2nd degree AV block - mobitz type 1

44. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Late systolic crescendo murmur with a midsystolic click
Unstable/crescendo angina
R to L shunt caused by stenoic pulmonic valve
LCX - I - aVL

45. absecnce of tricuspid valve - hypoplastic RV
RCA
Neg inotropy - HF - narcotic overdose
Henoch - Schlonlein purpura
Tricuspid atresia - requires ASD and VSD

46. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Dec plasma proteins
Subendocardial - fewer collaterals and higher pressure
LAD - V1- V2
Babies

47. What happens in phase 4 of the cardiac ventricular action potential?
Resting potential high K perm
Preload
Inc TPR and LA return (expiration)
Failure of LV to in CO during exercise

48. decrease stretch in baroreceptors leads to what response?
At least 55%
Increased efferent SANS and decreased efferent PANS
Conduction delay through AV node - nl < 200 msec
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

49. What causes the murmur heard in tricuspid regurg to enhance
In RA return (inspiration)
Viridans streptococci
Chordae rupture - GN - suppurative pericarditis - emboli
2-4 day - early coag necrosis on the first day

50. Which murmur is heard in aortic stenosis?
Heart - 02 extraction is always around 100%
Dec plasma proteins
Crescendo - decrescendo systolic ejection murmur following ejection click
Dressler's - autoimmune

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