Cardiology

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• 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. Which enzymes are useful for diagnosing reinfarction
ASD
CK- MB
EKG
At least 55%


2. Churg Strauss - presentation and test
Troponin I
2nd degree AV block - mobitz type 1
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Can progess to V fib


3. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
RV contraction (closed tricuspid valve bulding into atrium
LAD > RCA > circumflex
MI
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved


4. How does a patient with Tet of fallot learn to improve symptoms?
Varicose veins - thromboembolism rare
Inc Kf - capillary perm
Squat. Compression of femoral arteries - inc TPR - dec
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis


5. When does extracellular calcium enter the cardiac muscle cells during contraction?
Persistant truncus arteriosus
The plateau period
Glossopharyngeal to soliary nucleus of medulla
S. bovis


6. Which murmur is heard with mitral prolapse?
Aortic disecction - intraluminal tear forming false lumen
Aortic stenosis or LBBB
140/90
Late systolic crescendo murmur with a midsystolic click


7. What is the formula for EF?
SV/ EDV
V fib arrhythima
Dressler's - autoimmune
5-10 days - macs have degraded structural components


8. What happens in phase 0 of the cardiac ventricular action potential?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Rapid upstroke - voltage gated Na channels open
Postinfarction fibrinous pericarditis
Cardiac tamponde


9. PCWP is an estimate of...
Atrial contraction
Left atrial pressure
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD


10. benign cap hemangioma of infancy - spont regresses
Increasing activity of Ca pump in SR
Left heart failure
Strawberry hemangioma
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open


11. moncekberg
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
V fib
Cherry hemangioma
V fib arrhythima


12. decrease stretch in baroreceptors leads to what response?
Mitral stenosis
Increase contractility
Increased efferent SANS and decreased efferent PANS
Angiosarcoma


13. Where does coronary artery occlusion occur most commonly?
Afterload (proportional to peripheral resistance)
If sodium channel
C - ANCA
LAD


14. What is the characteristic pulse in aortic stenosis?
Filling is incomplete and CO falls
Pulsus parvus and tardus - weak - can lead to syncope
Increase contractility
LCX - V4- V6


15. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Left heart failure
Vagus to medulla
No - no pressure gradient
Subendocardial - fewer collaterals and higher pressure


16. What causes the murmur heard in MR to enhance?
Eisenmenger's syndrome
Inc TPR and LA return (expiration)
Stroke volume affected by contractility - afterload - and preload
During diastole


17. What murmur is heard with aortic regurg?
5-10 days - macs have degraded structural components
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
P02
Pulsus parvus and tardus - weak - can lead to syncope


18. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Medullary vasomotor center senses baroreceptors and JGA
140/90
Lymphangiosarcoma
Inc venous return exaccerbates pulm vasc congestion


19. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Mitral valve prolapse
Left heart failure
Transfusion
Mitral and tricuspid closure


20. In the cardiac cycle - which period has the highest 02 consumption?
Isovolumetric contraction
Inc venous return exaccerbates pulm vasc congestion
The operating point of the heart
Venodilators (nitrogylcerine)


21. most common primary cardiac tumor in children - associated with tuberous sclerosis
Vasocxn - while other tissues it causes vasodilation
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Rhabdomyomas
Dilation


22. What is the S1 sound?
Subendocardial
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
TAPVR
Mitral and tricuspid closure


23. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Posterior descending (80% off the RCA - 20% off the circumflex)
Eccentric - concentric hypertrophy causes diastolic disfunction
Boot shaped heart
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling


24. What does FAN MY SKIN On Wednesday stand for?
Inc central venous pressure - inc resistance to portal flow
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Kids
Adult type aortic coarctation


25. Which vessels account for the most total peripheral resistance
Yes
Arteriorles
LAD > RCA > circumflex
Indomethacin closes - and pge keeps it open


26. Which valve is most commonly involved in bacterial endocarditis?
Mitral valve
Atherosclerosis
Mitral valve prolapse
Vasocxn


27. What does TAPVR stand for
Total anomalous pulmonary trunk venous return
Torsades de pointes
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Chordae rupture - GN - suppurative pericarditis - emboli


28. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Black > white > asian
Conduction delay through AV node - nl < 200 msec


29. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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30. What supplies the posterior left ventricle?
S. bovis
Increase in Pc
Babies
CFX


31. What does the LAD supply?
Apex and anterior interventricular septum
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Sturge weber - vasculitis of caps
Chordae rupture - GN - suppurative pericarditis - emboli


32. The carotid sinus transmits along which nerve?
Prinzmetal angina
Torsades de pointes
Ventricular repolarization
Glossopharyngeal to soliary nucleus of medulla


33. dyspnea - fatigue - edema and rales - multiple causes
7 weeks
CHF
Pulse pressure
SA>AV>bundle of His>ventricles


34. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Hypertrophied cardiomyopathy
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Boot shaped heart


35. p - anca

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36. What is the result of not have fast sodium channels in pacemaker cells?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Left atrial pressure
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Rapid upstroke - voltage gated Na channels open


37. Hyperplastic onion skinning
Arteriolosclerosis in malignant hypertension
Hyperlipidemia
During diastole
In HF


38. exaggerated decrease in pulse during inspiration.

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39. What is the early and late lesion in rheumatic heart disease
Pulsus parvus and tardus - weak - can lead to syncope
Granuloma with giant cells
The first 4 days
Mitral valve prolapse


40. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Tricuspid atresia - requires ASD and VSD
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Acute thrombosis of coronary artery
EKG


41. The cause of dyspnea on exertion?
Volatage gated Ca channels
Left atrial pressure
...
Failure of LV to in CO during exercise


42. 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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43. What is the machine like murmur? What is the heart pathology and the predisposing causes
Arteriolosclerosis in malignant hypertension
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Patent ductus arteriosus - congenital rubella or prematurity
Increase contractility


44. What is the definition of HTN?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
140/90
Maintain blood flow to organ over wide range of perfussion pressures
Increase - increase the chance the If are open


45. What is the time frame for arrhythmia risk in the evolution of MI
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
ASD
Group a beta hemolytic strep
The first 4 days


46. What can cause mitral prolapse?
Myxomatous degeneration - RF - chordae rupture
Increased SV
Hypertrophied cardiomyopathy
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup


47. polypoid capillary hemangioma that can ulcerate and bleed
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Pyogenic granuloma - associated with trauma and pregnancy
Hemorrhage


48. in the JVP - What is the a wave?
Prinzmetal angina
Atrial contraction
Increasing activity of Ca pump in SR
Myxomatous degeneration - RF - chordae rupture


49. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Kids
Increase in Pc
LV failure - pulm venous distention transudation of fluid


50. The 7 complications of MI

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