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Cardiology

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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. What does the U wave indicated?
No - no pressure gradient
R to L shunt caused by stenoic pulmonic valve
Ventricles are depolarized
HypoK and bradycardia

2. What happens in phase 3 of the cardiac ventricular action potential?
Systolic dysfunction
Vasocxn - while other tissues it causes vasodilation
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

3. stroke volume x HR =?
Kids
CO
Early deaths from myocarditis
The first 4 days

4. Which organ gets the largest share of systemic cardiac output
Liver
Heart - 02 extraction is always around 100%
Mean arterial pressure
Increase in Pc

5. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
LAD - V1- V2
MI
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Medullary vasomotor center senses baroreceptors and JGA

6. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Increased SV
Maintain blood flow to organ over wide range of perfussion pressures
RCA
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

7. failure of truncus arteriosus to divide?
Persistant truncus arteriosus
Increase contractility
RCA - II - III - aVF
...

8. Where are pacemaker cells?
Black > white > asian
In parallel
SA and AV nodes
Takayasu's arteritis

9. What causes ankle - sacral edema - jugular venous distention
RV failure - in venous pressure
Kaposi's sarcoma
Polyarteritis nodosum
Cyclophosphamide and corticosteroids

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

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11. disease of elastic arteries and large and medium sized muscular arteries
Conduction delay through AV node - nl < 200 msec
Cardiac tamponde
Atherosclerosis
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

12. sawtooth wave

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13. What are the complications from bacterial endocarditis?
Chordae rupture - GN - suppurative pericarditis - emboli
Pulsus parvus and tardus - weak - can lead to syncope
Sudden tensing of chordae tendinae
Cherry hemangioma

14. PCWP > LV diastolic pressure
Temporal arteritis
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Inc Kf - capillary perm
Mitral stenosis

15. What is the early and late lesion in rheumatic heart disease
Mitral valve prolapse
Aburpt halting of valve leaflets
Increasing activity of Ca pump in SR
Squat. Compression of femoral arteries - inc TPR - dec

16. What is the progression of atherosclerosis?
Microscopic polyangiitis - like wegener's without granulomas
Atrial contraction
Increase - increase the chance the If are open
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

17. What do patients die early from in rheumatic heart disease?
Granuloma with giant cells
Early deaths from myocarditis
Increased SV
Inc Kf - capillary perm

18. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Increase contractility
Diastolic
Increase - increase the chance the If are open
Pulmonary flow murmur and diastolic rumble

19. EDV - ESV
Inc central venous pressure - inc resistance to portal flow
Troponin I
Stroke volume
HypoK and bradycardia

20. Churg Strauss - presentation and test
Decreases
Conduction delay through AV node - nl < 200 msec
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Early deaths from myocarditis

21. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
Wegener's
Pulmonary flow murmur and diastolic rumble
Failure of LV to in CO during exercise

22. Which vessels account for the most total peripheral resistance
Microscopic polyangiitis - like wegener's without granulomas
2nd degree AV block - mobitz type 1
Arteriorles
Ischemic heart dz - mitral valve prolapse - LV dilation

23. What does FAN MY SKIN On Wednesday stand for?
During diastole
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

24. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Conduction delay through AV node - nl < 200 msec
Septal defects - PDA - pulm art stenosis

25. In an EKG - What is the PR interval?
1st degree AV blodck
Conduction delay through AV node - nl < 200 msec
3rd degree block - pacemaker - Lyme disease
Turners

26. what happens to capillaries in lymphatic blockage
2-4 day - early coag necrosis on the first day
LCX - V4- V6
Inc interstitial osmotic pressure pulling fliud out of capillaries
Vasocxn

27. How are sarcomeres added in concentric hypertrophy?
CK- MB
ASD - VSD - AV septal defect (endocardial cushion defect)
In parallel
Pulse pressure

28. When and why is the S3 sound heard?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Liver

29. What causes the murmur heard in tricuspid regurg to enhance
Inc interstitial osmotic pressure pulling fliud out of capillaries
In RA return (inspiration)
Kaposi's sarcoma
Stroke volume

30. absecnce of tricuspid valve - hypoplastic RV
Tricuspid atresia - requires ASD and VSD
2nd degree AV block - mobitz type 1
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Diastolic

31. When during cardiac nodal cells depolarize?
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Takayasu's arteritis
During diastole
Inc RA pressure - due to filling against closed tricupsid valve

32. How does angiotensin II raise MAP
10%
Resting potential high K perm
Vasocxn
Apex and anterior interventricular septum

33. Which murmur is heard in aortic stenosis?
Temporal arteritis
Stable angina
Crescendo - decrescendo systolic ejection murmur following ejection click
Cystic hygroma

34. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Total anomalous pulmonary trunk venous return
Late systolic crescendo murmur with a midsystolic click
Stable angina
Fast volatge gated Na channels

35. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Hemorrhage
SV/ EDV
Strawberry hemangioma
Lower right - MC - upper right - AO - upper right AC - lower left MO

36. Which class of drugs decrease preload
Liver
During diastole
Pulsus parvus and tardus - weak - can lead to syncope
Venodilators (nitrogylcerine)

37. CO x Total peripheral resistance
Mean arterial pressure
Posterior descending (80% off the RCA - 20% off the circumflex)
Viridans streptococci
Metastasis from melanoma or lymphoma

38. What causes the murmur heard in MR to enhance?
Inc TPR and LA return (expiration)
Kidney
10%
Hyperlipidemia

39. What does T wave inversion indicated?
Vasodilators
MI
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Increased efferent SANS and decreased efferent PANS

40. What are the complications of atherosclerosis?
Atrial contraction
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Fluid movement through capillaries
Prinzmetal angina

41. systolic - diastolic
R to L shunt caused by stenoic pulmonic valve
Pulse pressure
Left heart failure
Decreases

42. list the coronary vessels most likely to be occluded
Vasocxn
Septal defects - PDA - pulm art stenosis
LAD > RCA > circumflex
Troponin I

43. with what heart sounds do ASD usually present?
Indomethacin closes - and pge keeps it open
Pulmonary flow murmur and diastolic rumble
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Medullary vasomotor center senses baroreceptors and JGA

44. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
7 weeks
Proportional to viscosity and inversely proportional to the radius to the 4th power
Kawasaki
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

45. What happens in phase 0 of the cardiac ventricular action potential?
Persistant truncus arteriosus
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Rapid upstroke - voltage gated Na channels open
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

46. What is the classic X ray finding for tet of fallot?
Boot shaped heart
SA>AV>bundle of His>ventricles
Fluid movement through capillaries
Right sided

47. What is the danger of torsades to pointes?
Can progess to V fib
Failure of LV to in CO during exercise
3rd degree block - pacemaker - Lyme disease
Angiosarcoma

48. friction rub - 3-5 days post MI
Glossopharyngeal to soliary nucleus of medulla
Hyperlipidemia
Postinfarction fibrinous pericarditis
The plateau period

49. What happends in phase 1 of the ventricular cardiac action potential?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Rhabdomyomas
LAD - V1- V2
Takayasu's arteritis

50. Given P = QR - what factors influence resistance?
Subendocardial
Proportional to viscosity and inversely proportional to the radius to the 4th power
Anterosuperior displacement of the infundibular septum
S. aureus

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