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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. dyspnea - fatigue - edema and rales - multiple causes
Non
LV failure - pulm venous distention transudation of fluid
CHF
Vagus to medulla

2. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
RCA
Dilation
Pulsus parvus and tardus - weak - can lead to syncope

3. machine murmer
2nd degree AV block - mobitz type 1
Inc venous return exaccerbates pulm vasc congestion
In parallel
PDA

4. What is the machine like murmur? What is the heart pathology and the predisposing causes
Coarcation of aorta
ANP
Dressler's - autoimmune
Patent ductus arteriosus - congenital rubella or prematurity

5. p - anca

6. What does FROM JANE stand for in bacterial endocarditis?

7. What causes orthopnea?
EKG
Neg inotropy - HF - narcotic overdose
Increase intracellular Na - resulting in increased Ca
Inc venous return exaccerbates pulm vasc congestion

8. What is the most common cause of right heart failure
Left sided
Patent ductus arteriosus - congenital rubella or prematurity
Left heart failure
Rhabdomyomas

9. Which valve is most commonly involved in bacterial endocarditis?
V fib arrhythima
Fick principle
Septal defects - PDA - pulm art stenosis
Mitral valve

10. sawtooth wave

11. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Inc TPR and LA return (expiration)
QRS complex
Torsades de pointes

12. What is the definition of HTN?
140/90
Can progess to V fib
LAD - V1 - V4
Glossopharyngeal to soliary nucleus of medulla

13. What cardiac change occurs in pregnancy?
Volatage gated Ca channels
Yes
Increased SV
MAP

14. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
In HF
Aortic stenosis or LBBB
Posterior descending (80% off the RCA - 20% off the circumflex)

15. fibrinous pericarditis several weeks post MI

16. What is the progression of atherosclerosis?
Decrease in cAMP
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Inc central venous pressure - inc resistance to portal flow
Failure of LV to in CO during exercise

17. What causes the CO curve to shift downwards?
Subendocardial - fewer collaterals and higher pressure
Neg inotropy - HF - narcotic overdose
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
C - ANCA

18. What is the cushing triad?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
HTN - bradycardia - and respiratory depression
V fib arrhythima
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

19. failure of truncus arteriosus to divide?
Maintain blood flow to organ over wide range of perfussion pressures
Inc central venous pressure - inc resistance to portal flow
No
Persistant truncus arteriosus

20. Which class of drugs decreases afterload?
Vasodilators - (hydrAlAzine)
Aburpt halting of valve leaflets
Proportional to viscosity and inversely proportional to the radius to the 4th power
In RA return (inspiration)

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

22. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Sudden tensing of chordae tendinae
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Rapid upstroke - voltage gated Na channels open
LV failure - pulm venous distention transudation of fluid

23. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Strawberry hemangioma
The aortic before pulmonic - inspiration increases diff
Lymphangiosarcoma
Subendocardial

24. no relation between p waves and QRS intervals - treatment and predisposing factor
Aortic and pulmonary closing
3rd degree block - pacemaker - Lyme disease
Sudden tensing of chordae tendinae
Increase - increase the chance the If are open

25. Where are pacemaker cells?
SA and AV nodes
If sodium channel
Vagus to medulla
2-4 day - early coag necrosis on the first day

26. How do catecholamines increase contractility?
Aortic and pulmonary closing
Pyogenic granuloma - associated with trauma and pregnancy
Increasing activity of Ca pump in SR
Aortic stenosis or LBBB

27. What are the 5 T's of cyanoitc babies
Myxoma
Libman - sacks endocarditis
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Inc TPR and LA return (expiration)

28. what percentage of HTN is secondary to renal disease?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Wolff - Parkinson white syndrome
10%
Eccentric - concentric hypertrophy causes diastolic disfunction

29. coronary artery spasm - ST elevation
Prinzmetal angina
Mechanican contraction of the ventricles
Mitral valve
No

30. What supplies the posterior left ventricle?
The operating point of the heart
MAP
C - ANCA
CFX

31. What is the S1 sound?
Mitral and tricuspid closure
V fib arrhythima
Sturge weber - vasculitis of caps
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

32. In an EKG - What is the QT interval?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
MI
Mechanican contraction of the ventricles
Non

33. What is the formula for EF?
Persistant truncus arteriosus
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Yes
SV/ EDV

34. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
The operating point of the heart
Pulmonic stenosis and RBBB
LCX - I - aVL

35. PCWP is an estimate of...
Indomethacin closes - and pge keeps it open
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Left atrial pressure
Dilation

36. in the JVP - What is the c wave?
Liver
RV contraction (closed tricuspid valve bulding into atrium
Troponin I
Changes in CO as a function of preload

37. What does autoregulation do?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
LAD > RCA > circumflex
Angiosarcoma
Maintain blood flow to organ over wide range of perfussion pressures

38. What does TAPVR stand for
Posterior descending (80% off the RCA - 20% off the circumflex)
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Failure of LV to in CO during exercise
Total anomalous pulmonary trunk venous return

39. What does FAN MY SKIN On Wednesday stand for?
LCX - I - aVL
MAP
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Extracellular calcium - calcium induced calcium release

40. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Fast volatge gated Na channels

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

42. What causes hepatomegaly?
Mitral and tricuspid closure
Inc central venous pressure - inc resistance to portal flow
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

43. The 7 complications of MI

44. What is the time frame for arrhythmia risk in the evolution of MI
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
10%
The first 4 days
RV failure - in venous pressure

45. What happens in phase 2 of the cardiac ventricular action potential?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Cardiac tamponde
ANP
Posterior descending (80% off the RCA - 20% off the circumflex)

46. 2/3 diastolic + 1/3 systolic
P02
Neg inotropy - HF - narcotic overdose
Decrease in activity of Na/Ca exhanger and increase in contractility
MAP

47. What constitues the upstroke in pacemaker cells?
Volatage gated Ca channels
Increased efferent SANS and decreased efferent PANS
Rhabdomyomas
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

48. What is the gold standard for dx of MI in the first 6 hours
EKG
Early deaths from myocarditis
P02
In RA return (inspiration)

49. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Purkingee>atria>ventricles>AV node
Changes in CO as a function of preload
Microscopic polyangiitis - like wegener's without granulomas

50. list the coronary vessels most likely to be occluded
Venodilators (nitrogylcerine)
LAD > RCA > circumflex
In parallel
LAD