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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. absecnce of tricuspid valve - hypoplastic RV
Persistant truncus arteriosus
Strawberry hemangioma
Tricuspid atresia - requires ASD and VSD
At least 55%

2. What is the result of not have fast sodium channels in pacemaker cells?
LCX - I - aVL
Preload
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Vasocxn - while other tissues it causes vasodilation

3. most common heart tumor
Metastasis from melanoma or lymphoma
SA>AV>bundle of His>ventricles
Inc TPR and LA return (expiration)
Increased efferent SANS and decreased efferent PANS

4. What causes the CO curve to shift upwards?
Venodilators (nitrogylcerine)
Left atrial pressure
Transmural
Pos inotropy - exercise

5. What can cause mitral prolapse?
Ventricles are depolarized
Myxomatous degeneration - RF - chordae rupture
Left atrial pressure
RF

6. In an EKG - What is the PR interval?
Aortic disecction - intraluminal tear forming false lumen
Conduction delay through AV node - nl < 200 msec
Hyperlipidemia
Activated histiocytes

7. What does mitral prolapse predeispose to?
The first 4 days
Infective endocarditis
Buerger's disease
Torsades de pointes

8. What causes ankle - sacral edema - jugular venous distention
HTN - bradycardia - and respiratory depression
RV failure - in venous pressure
Fast volatge gated Na channels
Changes in CO as a function of preload

9. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Chordae rupture - GN - suppurative pericarditis - emboli
Wolff - Parkinson white syndrome
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Aortic stenosis or LBBB

10. most common primary cardiac tumor in children - associated with tuberous sclerosis
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Rhabdomyomas
Squat. Compression of femoral arteries - inc TPR - dec
7 weeks

11. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
In HF
Yes
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

12. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Heart - 02 extraction is always around 100%
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Glomus tumor
Tempral arteritis - may cause irreversible blindness

13. What causes the ejection click in the Cres - decres murmur?
Aburpt halting of valve leaflets
Atrial contraction
Apex and anterior interventricular septum
Turners

14. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
Pos inotropy - exercise
LV failure - pulm venous distention transudation of fluid
5-10 days - macs have degraded structural components

15. failure of truncus arteriosus to divide?
Inc venous return exaccerbates pulm vasc congestion
SA>AV>bundle of His>ventricles
Liver
Persistant truncus arteriosus

16. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Myxoma
In parallel
Isovolumetric contraction
Atrial contraction

17. polypoid capillary hemangioma that can ulcerate and bleed
Hyperlipidemia
Non
Pyogenic granuloma - associated with trauma and pregnancy
Yes

18. moncekberg
Conduction delay through AV node - nl < 200 msec
EKG
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Acute thrombosis of coronary artery

19. What do the starling forces determine
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Squat. Compression of femoral arteries - inc TPR - dec
Fluid movement through capillaries
Eccentric - concentric hypertrophy causes diastolic disfunction

20. Which kind of infarct show ST elevation - and/or pathologic Q waves
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Torsades de pointes
MI
Transmural

21. Left to right shunts are more common in babies or kids?
Kids
Increased efferent SANS and decreased efferent PANS
Left sided
Vasocxn

22. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Adult type aortic coarctation
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
In series
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

23. What is association with fixed S2 splitting - does not increase with inspiration
ASD
Diastolic
In HF
Cardiac tamponde

24. What does HTN predispose to?
Aortic dilation - bicuspid aortic valve - RF -
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
RF

25. Which area of the endocardium is especially vulnerable to infarction? Why?
Fluid movement through capillaries
Decrease in cAMP
Subendocardial - fewer collaterals and higher pressure
S. epidermidis

26. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Heart - 02 extraction is always around 100%
S. aureus
Cherry hemangioma
LCX - I - aVL

27. Right to left shunts are more common in babies or kids?
Decrease in cAMP
EKG
Kids
Babies

28. list the coronary vessels most likely to be occluded
Infective endocarditis
Stroke volume affected by contractility - afterload - and preload
Lower right - MC - upper right - AO - upper right AC - lower left MO
LAD > RCA > circumflex

29. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Henoch - Schlonlein purpura
In HF
Libman - sacks endocarditis
140/90

30. What causes aortic regurg
Mitral>aortic>>tricuspid - high pressure valves affected most
Libman - sacks endocarditis
Aortic dilation - bicuspid aortic valve - RF -
RCA

31. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Granuloma with giant cells
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Aortic insuffic - late

32. In an anterolateral infarct - which artery is effected and which leads show Q waves
P02
During HF from microhemorrhages from inc pulm cap pressure
Subendocardial - fewer collaterals and higher pressure
LCX - V4- V6

33. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Polyarteritis nodosum
Late systolic crescendo murmur with a midsystolic click
Kidney
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

34. What is indicated when CO and venous return are equal?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
...
Kaposi's sarcoma
The operating point of the heart

35. In normal S2 splitting - which valve closes first? What increases it?
The aortic before pulmonic - inspiration increases diff
Mechanican contraction of the ventricles
Chordae rupture - GN - suppurative pericarditis - emboli
Anterosuperior displacement of the infundibular septum

36. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dilated cardiomyopathy
Indomethacin closes - and pge keeps it open
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Pyogenic granuloma - associated with trauma and pregnancy

37. Hyperplastic onion skinning
Granuloma with giant cells
Diastolic
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Arteriolosclerosis in malignant hypertension

38. What does FEVERSS stand for in rheumatic heart disease
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Squat. Compression of femoral arteries - inc TPR - dec
Volatage gated Ca channels
Fluid movement through capillaries

39. What is the most common cause of MI
ASD - VSD - AV septal defect (endocardial cushion defect)
Acute thrombosis of coronary artery
Indomethacin closes - and pge keeps it open
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

40. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Dec P02 - inc PC02 and dec pH
Increase contractility
Troponin I
Posterior descending (80% off the RCA - 20% off the circumflex)

41. Chronic mitral stenosis can lead to what changes in size of the LA
LAD - V1 - V4
During diastole
Eccentric - concentric hypertrophy causes diastolic disfunction
Dilation

42. In an inferior wall infarct - which artery is affected and which leads show Q waves
Takayasu's arteritis
Failure of LV to in CO during exercise
RCA - II - III - aVF
Liver

43. clinical signs of cardiac tamponade
Prinzmetal angina
Dec plasma proteins
Preload
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

44. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Lower right - MC - upper right - AO - upper right AC - lower left MO
Microscopic polyangiitis - like wegener's without granulomas
Angiosarcoma
Increasing activity of Ca pump in SR

45. which ethnic groups have higher association with HTN?
Metastasis from melanoma or lymphoma
Black > white > asian
Liver
Pulse pressure

46. What is the formula for EF?
Turners
SV/ EDV
Dressler's - autoimmune
Pulmonary flow murmur and diastolic rumble

47. What is the cushing triad?
HTN - bradycardia - and respiratory depression
RF
The aortic before pulmonic - inspiration increases diff
Varicose veins - thromboembolism rare

48. What constitues the upstroke in pacemaker cells?
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Volatage gated Ca channels
5-10 days - macs have degraded structural components
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

49. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Changes in CO as a function of preload
Transfusion
Indomethacin closes - and pge keeps it open
Liver

50. What does autoregulation do?
Black > white > asian
Maintain blood flow to organ over wide range of perfussion pressures
At least 55%
Holosystoiic