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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. What do the carotid and aortic bodies respond to?
Mitral and tricuspid closure
Resting potential high K perm
Pulmonary flow murmur and diastolic rumble
Dec P02 - inc PC02 and dec pH

2. Where is the most posterior portion of the heart and What can it cause?
Can progess to V fib
Cyclophosphamide and corticosteroids
Activated histiocytes
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

3. Central chemoreceptors do not respond directly to which parameter?
Myxoma
PDA
Dressler's - autoimmune
P02

4. Which two mechanisms sense decrease MAP?
Group a beta hemolytic strep
No
Medullary vasomotor center senses baroreceptors and JGA
Black > white > asian

5. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
EKG
RF
S. aureus
P02

6. What is the cushing triad?
Isovolumetric contraction
HTN - bradycardia - and respiratory depression
Arteriolosclerosis in malignant hypertension
Increasing activity of Ca pump in SR

7. list the coronary vessels most likely to be occluded
Persistant truncus arteriosus
LAD > RCA > circumflex
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Cherry hemangioma

8. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
Dilation
Increasing activity of Ca pump in SR
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

9. What is the classic X ray finding for tet of fallot?
Boot shaped heart
Pulmonic stenosis and RBBB
Takayasu's arteritis
Resting potential high K perm

10. What cardiac change occurs in pregnancy?
Increased SV
If sodium channel
Dilated cardiomyopathy
Babies

11. In an EKG - What is the PR interval?
Conduction delay through AV node - nl < 200 msec
Extracellular calcium - calcium induced calcium release
Pulmonic stenosis and RBBB
Mitral stenosis

12. In an anterolateral infarct - which artery is effected and which leads show Q waves
Aortic insuffic - late
Myxoma
Increased efferent SANS and decreased efferent PANS
LCX - V4- V6

13. What is the characteristic pulse in aortic stenosis?
SA>AV>bundle of His>ventricles
Pulsus parvus and tardus - weak - can lead to syncope
Neg inotropy - HF - narcotic overdose
SA and AV nodes

14. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Systolic dysfunction
Stroke volume affected by contractility - afterload - and preload
No - no pressure gradient
Wegener's

15. in the JVP - What is the a wave?
Systolic dysfunction
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Atrial contraction
2-4 day - early coag necrosis on the first day

16. What is association with fixed S2 splitting - does not increase with inspiration
Non
Mitral valve prolapse
ASD
Kidney

17. When and why do you hear the S4 sound
Eccentric - concentric hypertrophy causes diastolic disfunction
Angiosarcoma
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
...

18. Which murmur do you hear in mitral stenosis?
Viridans streptococci
Late diastolic murmur following an opening snap
Babies
CO

19. Which enzymes are useful for diagnosing reinfarction
CK- MB
Dressler's - autoimmune
Increase in Pc
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

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

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21. The cause of cardiac dilation?
Activated histiocytes
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Decrease in activity of Na/Ca exhanger and increase in contractility
Greater ventricular EDV

22. What causes the cushing reflex and why
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
TAPVR
Subendocardial - fewer collaterals and higher pressure

23. What does FEVERSS stand for in rheumatic heart disease
Tempral arteritis - may cause irreversible blindness
Mean arterial pressure
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

24. in the JVP - What is the c wave?
RV contraction (closed tricuspid valve bulding into atrium
7 weeks
EKG
Right sided

25. PCWP is an estimate of...
Inc Kf - capillary perm
Troponin I
Left atrial pressure
In parallel

26. Mitral stenosis is most often secondary to which condition?
RF
Myxoma
2nd degree AV block - mobitz type 1
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

27. When do coronary arteries fill?
10%
During diastole
Hematocrit
Changes in CO as a function of preload

28. most common heart tumor
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Metastasis from melanoma or lymphoma
Eisenmenger's syndrome
LAD - V1- V2

29. The carotid sinus transmits along which nerve?
Glossopharyngeal to soliary nucleus of medulla
Transfusion
Indomethacin closes - and pge keeps it open
Increase in Pc

30. Churg Strauss - presentation and test
Acute thrombosis of coronary artery
Stroke volume
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Metastasis from melanoma or lymphoma

31. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
Increase - increase the chance the If are open
Inc RA pressure - due to filling against closed tricupsid valve
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

32. What happends in phase 1 of the ventricular cardiac action potential?
Mean arterial pressure
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Medullary vasomotor center senses baroreceptors and JGA
Glossopharyngeal to soliary nucleus of medulla

33. clinical signs of cardiac tamponade
Stroke volume
No
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
ASD - VSD - AV septal defect (endocardial cushion defect)

34. Which valve is most commonly involved in bacterial endocarditis?
LV failure - pulm venous distention transudation of fluid
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Mitral valve
Lower right - MC - upper right - AO - upper right AC - lower left MO

35. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Resting potential high K perm
Fetal right to left - neonate left to right leading to RVH and failure
Dilated cardiomyopathy
Tempral arteritis - may cause irreversible blindness

36. In an anterior wall infarct - which artery is effected and which leads show Q waves
Vasocxn
LAD - V1 - V4
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Boot shaped heart

37. What are the different etiologies of dialted cardiomyopathy
Vasodilators - (hydrAlAzine)
Aburpt halting of valve leaflets
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

38. Where does coronary artery occlusion occur most commonly?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Prinzmetal angina
Vagus to medulla
LAD

39. 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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40. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Vasodilators - (hydrAlAzine)
Stable angina
Cyclophosphamide and corticosteroids
Transposition of great vessels

41. sawtooth wave

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42. 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
Black > white > asian
Lymphangiosarcoma
10%

43. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
Wegener's
Failure of LV to in CO during exercise
Hematocrit

44. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Patent ductus arteriosus - congenital rubella or prematurity
Sudden tensing of chordae tendinae
Dilated cardiomyopathy
Turners

45. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Kawasaki
Wegener's
Cardiac tamponde

46. Which sympathetic receptors raise MAP
Vagus to medulla
Glossopharyngeal to soliary nucleus of medulla
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Dilated cardiomyopathy

47. tearing chest pain radiation to the back - associated with marfan
Aortic disecction - intraluminal tear forming false lumen
Hypertrophied cardiomyopathy
LV failure - pulm venous distention transudation of fluid
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

48. What do patients die early from in rheumatic heart disease?
Vagus to medulla
LCX - I - aVL
Group a beta hemolytic strep
Early deaths from myocarditis

49. What does an isoelectric ST segment indicate?
Ventricles are depolarized
Wegener's
7 weeks
Arteriolosclerosis in malignant hypertension

50. What masks atrial repolarization?
QRS complex
2-4 day - early coag necrosis on the first day
Sudden tensing of chordae tendinae
Mitral valve