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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. The 7 complications of MI

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2. EDV is also known as
RF
Preload
Liver
HTN - bradycardia - and respiratory depression

3. What does the atria release in response to inc blood volume and atrial pressure
Resting potential high K perm
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
ANP
Diastolic

4. What is the difference between adult and infantile type aortic coarctation?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

5. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Cherry hemangioma
No - no pressure gradient
Varicose veins - thromboembolism rare

6. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Persistant truncus arteriosus
Preload
Subendocardial - fewer collaterals and higher pressure
Henoch - Schlonlein purpura

7. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Isovolumetric contraction
Wegener's
...
Persistant truncus arteriosus

8. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Posterior descending (80% off the RCA - 20% off the circumflex)
Infective endocarditis
No - no pressure gradient
Atherosclerosis

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

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10. congenital heart defect with turner's
C - ANCA
Coarcation of aorta
Glomus tumor
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

11. What is the classic X ray finding for tet of fallot?
Anterosuperior displacement of the infundibular septum
Kidney
Persistant truncus arteriosus
Boot shaped heart

12. How does aldosterone raise MAP
CHF
Mitral stenosis
Inc blood volume
Ventricular depolarization - nl < 120 msec

13. What do patients die early from in rheumatic heart disease?
Aortic dilation - bicuspid aortic valve - RF -
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Early deaths from myocarditis
In HF

14. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Septal defects - PDA - pulm art stenosis
Yes
Adult type aortic coarctation
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

15. fibrous plaques and atheromas in intima of arteries
Anterosuperior displacement of the infundibular septum
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
C - ANCA
Atherosclerosis

16. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
HypoK and bradycardia
Aburpt halting of valve leaflets
Takayasu's arteritis

17. What happens with a decrease of extracellular Na
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Decrease in activity of Na/Ca exhanger and increase in contractility
The operating point of the heart
Vasodilators

18. CO x Total peripheral resistance
Mean arterial pressure
Temporal arteritis
Decreases
SA and AV nodes

19. Which organ has the largest arteriovenous difference
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Heart - 02 extraction is always around 100%
Angiosarcoma
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

20. Restrictive cardiomyopathy causes
140/90
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
If sodium channel
3rd degree block - pacemaker - Lyme disease

21. Which enzymes are useful for diagnosing reinfarction
Kaposi's sarcoma
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
CK- MB

22. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Pulmonic stenosis and RBBB
Hypertrophied cardiomyopathy
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Left atrial pressure

23. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
5-10 days - macs have degraded structural components
Transfusion
Fetal right to left - neonate left to right leading to RVH and failure
Torsades de pointes

24. What is the machine like murmur? What is the heart pathology and the predisposing causes
During diastole
3rd degree block - pacemaker - Lyme disease
Posterior descending (80% off the RCA - 20% off the circumflex)
Patent ductus arteriosus - congenital rubella or prematurity

25. When is the scar completely formed in an MI?
LAD > RCA > circumflex
7 weeks
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Aortic insuffic - late

26. Mitral stenosis is most often secondary to which condition?
Libman - sacks endocarditis
Viridans streptococci
RF
Turners

27. What can cause mitral prolapse?
Inc venous return exaccerbates pulm vasc congestion
Cardiac tamponde
Medullary vasomotor center senses baroreceptors and JGA
Myxomatous degeneration - RF - chordae rupture

28. When does EF decrease
Cyclophosphamide and corticosteroids
Aortic and pulmonary closing
Right sided
In HF

29. What is the S2 sound?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Rapid upstroke - voltage gated Na channels open
Aortic and pulmonary closing
Transposition of great vessels

30. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Dressler's - autoimmune
Resting potential high K perm
Troponin I
Diastolic

31. What are anitschkow's cells
Activated histiocytes
Left heart failure
Sturge weber - vasculitis of caps
Aortic and pulmonary closing

32. What is the association with wide S2 splitting?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Pulmonic stenosis and RBBB

33. When do you find hemosiderin laden macrophages in the lungs?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Dec P02 - inc PC02 and dec pH
During HF from microhemorrhages from inc pulm cap pressure
TAPVR

34. What causes aortic regurg
S. epidermidis
140/90
V fib arrhythima
Aortic dilation - bicuspid aortic valve - RF -

35. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Unstable/crescendo angina
Fetal right to left - neonate left to right leading to RVH and failure
Left sided
Holosystolic - harsh sounding murmur - loudest over tricuspid area

36. In an EKG - What is the T wave?
Ventricular repolarization
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Increase contractility
Turners

37. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Sudden tensing of chordae tendinae
Decreases
Pulmonary flow murmur and diastolic rumble
Dec P02 - inc PC02 and dec pH

38. What is the S1 sound?
Kaposi's sarcoma
Mitral and tricuspid closure
Vasodilators - (hydrAlAzine)
Filling is incomplete and CO falls

39. Most common vasculitis affecting medium and large arteries
Temporal arteritis
LAD
Glomus tumor
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

40. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
SA and AV nodes
Arteriolosclerosis in malignant hypertension
Squat. Compression of femoral arteries - inc TPR - dec

41. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
No
Dilated cardiomyopathy
Glossopharyngeal to soliary nucleus of medulla
Truncus - tet of fallot

42. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Unstable/crescendo angina
Black > white > asian
The aortic before pulmonic - inspiration increases diff
RV failure - in venous pressure

43. When and why is the S3 sound heard?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
HTN - bradycardia - and respiratory depression
Troponin I
Pulmonary flow murmur and diastolic rumble

44. dyspnea - fatigue - edema and rales - multiple causes
Granuloma with giant cells
In RA return (inspiration)
Infective endocarditis
CHF

45. When does extracellular calcium enter the cardiac muscle cells during contraction?
The plateau period
Pulse pressure
Lymphangiosarcoma
Kaposi's sarcoma

46. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
EKG
MAP
RCA

47. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Troponin I
ASD - VSD - AV septal defect (endocardial cushion defect)
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Viridans streptococci

48. stroke volume x HR =?
Anterosuperior displacement of the infundibular septum
Coarcation of aorta
Cyclophosphamide and corticosteroids
CO

49. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Venodilators (nitrogylcerine)
Fluid movement through capillaries
HypoK and bradycardia
LCX - I - aVL

50. cavernous lymphangioma of the neck - associated with turner's
Pyogenic granuloma - associated with trauma and pregnancy
Turners
Increase - increase the chance the If are open
Cystic hygroma