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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. Why is there edema after burns or during infection
Inc Kf - capillary perm
Ischemic heart dz - mitral valve prolapse - LV dilation
Glossopharyngeal to soliary nucleus of medulla
Pyogenic granuloma - associated with trauma and pregnancy

2. Which artery supplies the SA and AV nodes?
RV contraction (closed tricuspid valve bulding into atrium
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
RCA
EKG

3. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Greater ventricular EDV
At least 55%
HTN - bradycardia - and respiratory depression
Angiosarcoma

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

5. What causes the murmur heard in MR to enhance?
5-10 days - macs have degraded structural components
Inc TPR and LA return (expiration)
MAP
Inc RA pressure - due to filling against closed tricupsid valve

6. What are the different etiologies of dialted cardiomyopathy
During diastole
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Strawberry hemangioma
Arteriorles

7. What are aschoff bodies
Metastasis from melanoma or lymphoma
Granuloma with giant cells
Fick principle
Black > white > asian

8. Expiration causes an increase in which sided heart sounds
Left sided
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Medullary vasomotor center senses baroreceptors and JGA
Inc venous return exaccerbates pulm vasc congestion

9. moncekberg
Mechanican contraction of the ventricles
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Transmural
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

10. Where are pacemaker cells?
Hematocrit
R to L shunt caused by stenoic pulmonic valve
SA and AV nodes
Vagus to medulla

11. congenital heart defect with marfan's
Cyclophosphamide and corticosteroids
Aortic insuffic - late
Indomethacin closes - and pge keeps it open
Lymphangiosarcoma

12. What does an isoelectric ST segment indicate?
Atherosclerosis
Dec P02 - inc PC02 and dec pH
Atrial contraction
Ventricles are depolarized

13. Central chemoreceptors do not respond directly to which parameter?
P02
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
C - ANCA
Left sided

14. What is the gold standard for dx of MI in the first 6 hours
Cystic hygroma
Aortic/pulmonic regurg and mitral/tricuspid stenosis
EKG
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

15. friction rub - 3-5 days post MI
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Postinfarction fibrinous pericarditis
In series
Lymphangiosarcoma

16. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Volatage gated Ca channels
Atherosclerosis
Viridans streptococci
ASD

17. Which bacteria causes rheumatic heart disease
The aortic before pulmonic - inspiration increases diff
Metastasis from melanoma or lymphoma
Group a beta hemolytic strep
Vasocxn - while other tissues it causes vasodilation

18. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
LAD - V1 - V4
Chordae rupture - GN - suppurative pericarditis - emboli
Stable angina
Purkingee>atria>ventricles>AV node

19. How does angiotensin II raise MAP
Vasocxn
TAPVR
Failure of LV to in CO during exercise
Wolff - Parkinson white syndrome

20. What channels do the the pacemaker cells lack?
Non
Fast volatge gated Na channels
Troponin I
Granuloma with giant cells

21. 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

22. What causes tet of fallot?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Glossopharyngeal to soliary nucleus of medulla
Neg inotropy - HF - narcotic overdose
Anterosuperior displacement of the infundibular septum

23. What is the S2 sound?
No - no pressure gradient
Arteriorles
Ischemic heart dz - mitral valve prolapse - LV dilation
Aortic and pulmonary closing

24. Which organ gets the largest share of systemic cardiac output
Dressler's - autoimmune
Decreases
Early deaths from myocarditis
Liver

25. Which lab value indicates blood viscosity?
Hematocrit
Left heart failure
EKG
Mitral and tricuspid closure

26. which heart valves are afected most in rheumatic heart diseease
Chordae rupture - GN - suppurative pericarditis - emboli
Mitral>aortic>>tricuspid - high pressure valves affected most
Group a beta hemolytic strep
Buerger's disease

27. Exercise - overtransfusiion and excitiment causes and increase in...?
During diastole
Preload
Increase contractility
S. bovis

28. PCWP > LV diastolic pressure
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Increased SV
Mitral stenosis
Patent ductus arteriosus - congenital rubella or prematurity

29. In an anterior wall infarct - which artery is effected and which leads show Q waves
Mitral and tricuspid closure
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
LAD - V1 - V4

30. Fatal arrhythmia
V fib
Activated histiocytes
Age related calcifications or bicuspid aortic valve
Pulse pressure

31. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Rhabdomyomas
Fick principle
Left sided
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

32. How does digitatlis increase contractility?
Increase intracellular Na - resulting in increased Ca
Hyperlipidemia
The operating point of the heart
Left sided

33. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Venodilators (nitrogylcerine)
LAD > RCA > circumflex
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

34. What are the systolic heart sounds
MI
Inc blood volume
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Vasocxn - while other tissues it causes vasodilation

35. What does hypoxia cause in the lung versus other tissues?
Vasocxn - while other tissues it causes vasodilation
Atrial contraction
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
LV failure - pulm venous distention transudation of fluid

36. congenital heart defect with congenital rubella
Septal defects - PDA - pulm art stenosis
Left sided
No - no pressure gradient
Henoch - Schlonlein purpura

37. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Aortic and pulmonary closing
Subendocardial - fewer collaterals and higher pressure
Lymphangiosarcoma
No - no pressure gradient

38. What is association with fixed S2 splitting - does not increase with inspiration
Truncus - tet of fallot
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
ASD
Increase contractility

39. What is the progression of atherosclerosis?
7 weeks
Aortic insuffic - late
In RA return (inspiration)
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

40. sawtooth wave

41. What is the danger of torsades to pointes?
Transmural
Black > white > asian
Can progess to V fib
Holosystolic - harsh sounding murmur - loudest over tricuspid area

42. What does prolonged QT predispose to?
Torsades de pointes
Eccentric - concentric hypertrophy causes diastolic disfunction
Mitral and tricuspid closure
Increased efferent SANS and decreased efferent PANS

43. Which vessels account for the most total peripheral resistance
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Hypertrophied cardiomyopathy
CK- MB
Arteriorles

44. Which murmur is heard with VSD?
Crescendo - decrescendo systolic ejection murmur following ejection click
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Isovolumetric contraction
Holosystolic - harsh sounding murmur - loudest over tricuspid area

45. Which class of drugs decreases afterload?
Unstable/crescendo angina
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Vasodilators - (hydrAlAzine)
Systolic dysfunction

46. fibrous plaques and atheromas in intima of arteries
Aortic insuffic - late
Pulsus parvus and tardus - weak - can lead to syncope
Atherosclerosis
Raynaud's

47. 2/3 diastolic + 1/3 systolic
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Pulsus parvus and tardus - weak - can lead to syncope
Transmural
MAP

48. In an EKG - What is the T wave?
Increased efferent SANS and decreased efferent PANS
Ventricular repolarization
Acute thrombosis of coronary artery
ASD - VSD - AV septal defect (endocardial cushion defect)

49. fibrinous pericarditis several weeks post MI

50. What causes the cushing reflex and why
Total anomalous pulmonary trunk venous return
Transfusion
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Resting potential high K perm