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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. What does autoregulation do?
P02
Maintain blood flow to organ over wide range of perfussion pressures
S. epidermidis
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

2. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Group a beta hemolytic strep
Increased SV
Hematocrit
No - no pressure gradient

3. What channels do the the pacemaker cells lack?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Fast volatge gated Na channels
Kidney

4. Where does coronary artery occlusion occur most commonly?
LAD
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Raynaud's

5. What causes the murmur heard in tricuspid regurg to enhance
In RA return (inspiration)
MAP
Inc venous return exaccerbates pulm vasc congestion
S. epidermidis

6. tearing chest pain radiation to the back - associated with marfan
Mitral valve prolapse
V fib
Anterosuperior displacement of the infundibular septum
Aortic disecction - intraluminal tear forming false lumen

7. cavernous lymphangioma of the neck - associated with turner's
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
C - ANCA
Non
Cystic hygroma

8. Which bacteria causes rheumatic heart disease
Infective endocarditis
Inc venous return exaccerbates pulm vasc congestion
Inc RA pressure - due to filling against closed tricupsid valve
Group a beta hemolytic strep

9. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
S. epidermidis
HypoK and bradycardia
Libman - sacks endocarditis
Aortic dilation - bicuspid aortic valve - RF -

10. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
S. aureus
MAP
LCX - V4- V6
Fast volatge gated Na channels

11. Which organ gets the largest share of systemic cardiac output
Fetal right to left - neonate left to right leading to RVH and failure
Torsades de pointes
Liver
Isovolumetric contraction

12. How do beta blockers decrease contractility?
No - no pressure gradient
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Left heart failure
Decrease in cAMP

13. What are the four most common locations for atherosclerosis?
Hyperlipidemia
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Kids
Increased SV

14. What is the association with wide S2 splitting?
Preload
Pulmonic stenosis and RBBB
CK- MB
The aortic before pulmonic - inspiration increases diff

15. what percentage of HTN is secondary to renal disease?
V fib arrhythima
Dilated cardiomyopathy
10%
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

16. What do patients die early from in rheumatic heart disease?
In HF
Stroke volume
Raynaud's
Early deaths from myocarditis

17. Chronic mitral stenosis can lead to what changes in size of the LA
Dilation
Age related calcifications or bicuspid aortic valve
Rapid upstroke - voltage gated Na channels open
In HF

18. Which murmur do you hear in mitral stenosis?
Dilated cardiomyopathy
Kidney
Late diastolic murmur following an opening snap
Conduction delay through AV node - nl < 200 msec

19. What are the complications of atherosclerosis?
Vasodilators
R to L shunt caused by stenoic pulmonic valve
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Septal defects - PDA - pulm art stenosis

20. what conditions are associated with pulsus paradoxus
Coarcation of aorta
Kaposi's sarcoma
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Sudden tensing of chordae tendinae

21. How does acidosis affect contractility?
Dilation
Decreased
Preload
Dec P02 - inc PC02 and dec pH

22. Mitral stenosis is most often secondary to which condition?
Troponin I
RF
Atherosclerosis
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

23. What cardiac change occurs in pregnancy?
Increased SV
Pos inotropy - exercise
ASD
Transposition of great vessels

24. What does prolonged QT predispose to?
Fluid movement through capillaries
SA>AV>bundle of His>ventricles
Torsades de pointes
Decreased

25. 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
ASD - VSD - AV septal defect (endocardial cushion defect)
SA>AV>bundle of His>ventricles
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

26. What does the LAD supply?
Apex and anterior interventricular septum
Early deaths from myocarditis
Tricuspid atresia - requires ASD and VSD
Polyarteritis nodosum

27. When is the scar completely formed in an MI?
R to L shunt caused by stenoic pulmonic valve
Ventricular repolarization
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
7 weeks

28. Which class of drugs decrease the murmur heard in aortic regurg?
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Dilated cardiomyopathy
ASD - VSD - AV septal defect (endocardial cushion defect)
Vasodilators

29. What does mitral prolapse predeispose to?
Decrease in activity of Na/Ca exhanger and increase in contractility
Mean arterial pressure
Infective endocarditis
Atherosclerosis

30. Expiration causes an increase in which sided heart sounds
Decrease in activity of Na/Ca exhanger and increase in contractility
Left sided
HTN - bradycardia - and respiratory depression
3rd degree block - pacemaker - Lyme disease

31. What is the progression of atherosclerosis?
LV failure - pulm venous distention transudation of fluid
Can progess to V fib
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
EKG

32. What is the most common cause of MI
Medullary vasomotor center senses baroreceptors and JGA
Ventricular depolarization - nl < 120 msec
Acute thrombosis of coronary artery
CK- MB

33. failure of truncus arteriosus to divide?
Acute thrombosis of coronary artery
Extracellular calcium - calcium induced calcium release
Persistant truncus arteriosus
Myxoma

34. EDV is also known as
Dec P02 - inc PC02 and dec pH
Subendocardial - fewer collaterals and higher pressure
Preload
RV failure - in venous pressure

35. What is associated with paradoxical spliting of S2
Late systolic crescendo murmur with a midsystolic click
Aortic stenosis or LBBB
Extracellular calcium - calcium induced calcium release
RCA

36. congenital heart defect with marfan's
Microscopic polyangiitis - like wegener's without granulomas
Aortic insuffic - late
RCA
Resting potential high K perm

37. Do you see elevaged ASO titers in rheumatic heart disease
Yes
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
The first 4 days
Increase - increase the chance the If are open

38. In terms of starling forces - why does heart failure cause edema?
2nd degree AV block - mobitz type 1
Increase in Pc
Dec P02 - inc PC02 and dec pH
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

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

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40. p - anca

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41. disease of elastic arteries and large and medium sized muscular arteries
P02
Raynaud's
Greater ventricular EDV
Atherosclerosis

42. Which area of the endocardium is especially vulnerable to infarction? Why?
Subendocardial - fewer collaterals and higher pressure
Aortic and pulmonary closing
Granuloma with giant cells
Vasodilators

43. Hyperplastic onion skinning
Babies
C - ANCA
The operating point of the heart
Arteriolosclerosis in malignant hypertension

44. Given P = QR - what factors influence resistance?
Tricuspid atresia - requires ASD and VSD
Proportional to viscosity and inversely proportional to the radius to the 4th power
...
Left atrial pressure

45. What is the result of not have fast sodium channels in pacemaker cells?
R to L shunt caused by stenoic pulmonic valve
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Vagus to medulla

46. What other syndrom is associated with infantile aortic coarctation
Stable angina
Turners
Cystic hygroma
Squat. Compression of femoral arteries - inc TPR - dec

47. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Transposition of great vessels
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Eccentric - concentric hypertrophy causes diastolic disfunction
Inc venous return exaccerbates pulm vasc congestion

48. 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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49. Which murmur is heard with mitral prolapse?
Vasocxn
C - ANCA
Buerger's disease
Late systolic crescendo murmur with a midsystolic click

50. Which vessels account for the most total peripheral resistance
TAPVR
Hematocrit
Arteriorles
Late systolic crescendo murmur with a midsystolic click