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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. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Glomus tumor
Hypertrophied cardiomyopathy
Pulmonary flow murmur and diastolic rumble
CO

2. most common primary cardiac tumor in children - associated with tuberous sclerosis
Vasocxn - while other tissues it causes vasodilation
Rhabdomyomas
Kidney
Medullary vasomotor center senses baroreceptors and JGA

3. How do catecholamines increase contractility?
Eisenmenger's syndrome
Increasing activity of Ca pump in SR
Strawberry hemangioma
Ventricular depolarization - nl < 120 msec

4. How does acidosis affect contractility?
Apex and anterior interventricular septum
Tricuspid atresia - requires ASD and VSD
Decreased
S. epidermidis

5. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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6. Which bacteria can cause endocarditis from prosthetic valves?
S. epidermidis
Eisenmenger's syndrome
Stroke volume
RV failure - in venous pressure

7. Where are pacemaker cells?
SA and AV nodes
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Inc venous return exaccerbates pulm vasc congestion
Pulmonic stenosis and RBBB

8. What does hypoxia cause in the lung versus other tissues?
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Vasocxn - while other tissues it causes vasodilation
Inc venous return exaccerbates pulm vasc congestion
Polyarteritis nodosum

9. What are common causes of mitral regurg?
Increase in Pc
CHF
Ischemic heart dz - mitral valve prolapse - LV dilation
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

10. list the coronary vessels most likely to be occluded
Pos inotropy - exercise
The aortic before pulmonic - inspiration increases diff
LAD > RCA > circumflex
Lymphangiosarcoma

11. stroke volume x HR =?
Wolff - Parkinson white syndrome
CO
LAD > RCA > circumflex
If sodium channel

12. What are the diastolic heart sounds?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Left heart failure
Lower right - MC - upper right - AO - upper right AC - lower left MO
Vagus to medulla

13. What is the S2 sound?
Volatage gated Ca channels
Aortic and pulmonary closing
Conduction delay through AV node - nl < 200 msec
V fib arrhythima

14. In what disease states is blood viscosity increased?
The first 4 days
Aortic stenosis or LBBB
Venodilators (nitrogylcerine)
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

15. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
At least 55%
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Acute thrombosis of coronary artery
Fick principle

16. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Increase - increase the chance the If are open
Sturge weber - vasculitis of caps
Vagus to medulla

17. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
CO
Late diastolic murmur following an opening snap
Libman - sacks endocarditis

18. Hyperplastic onion skinning
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Arteriolosclerosis in malignant hypertension
HTN - bradycardia - and respiratory depression
SA and AV nodes

19. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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20. failure of truncus arteriosus to divide?
Persistant truncus arteriosus
Cardiac tamponde
Kidney
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

21. Which channel accounts for automaticity of the SA and AV nodes?
MAP
LAD > RCA > circumflex
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
If sodium channel

22. When and why do you hear the S4 sound
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Stroke volume affected by contractility - afterload - and preload
Increased efferent SANS and decreased efferent PANS
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

23. What happens in phase 4 of the cardiac ventricular action potential?
Resting potential high K perm
Fluid movement through capillaries
2nd degree AV block - mobitz type 1
Arteriorles

24. Why is there edema after burns or during infection
Late diastolic murmur following an opening snap
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Inc Kf - capillary perm
Atherosclerosis

25. What does HTN predispose to?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Aortic and pulmonary closing
Gap junctions
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

26. Which organ has ht highest blood flow per gram of tissue
Kidney
Atherosclerosis
Lower right - MC - upper right - AO - upper right AC - lower left MO
Cystic hygroma

27. Most common vasculitis affecting medium and large arteries
Temporal arteritis
Buerger's disease
Anterosuperior displacement of the infundibular septum
In HF

28. Which bacteria causes endocarditis in the presence of colon cancer
Vasodilators - (hydrAlAzine)
S. bovis
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Aortic disecction - intraluminal tear forming false lumen

29. What causes tet of fallot?
In RA return (inspiration)
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Anterosuperior displacement of the infundibular septum
Acute thrombosis of coronary artery

30. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Activated histiocytes
Atrial contraction
Wolff - Parkinson white syndrome
...

31. Which sympathetic receptors raise MAP
Squat. Compression of femoral arteries - inc TPR - dec
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Tricuspid atresia - requires ASD and VSD

32. with what heart sounds do ASD usually present?
Cherry hemangioma
Pulse pressure
Pulmonary flow murmur and diastolic rumble
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

33. CO x Total peripheral resistance
Mean arterial pressure
5-10 days - macs have degraded structural components
Pulsus parvus and tardus - weak - can lead to syncope
Pulmonary flow murmur and diastolic rumble

34. When does extracellular calcium enter the cardiac muscle cells during contraction?
The plateau period
Acute thrombosis of coronary artery
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Raynaud's

35. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Inc blood volume
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Boot shaped heart
Subendocardial - fewer collaterals and higher pressure

36. SV CAP means?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Holosystoiic
Stroke volume affected by contractility - afterload - and preload
Decrease in activity of Na/Ca exhanger and increase in contractility

37. What is the machine like murmur? What is the heart pathology and the predisposing causes
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Patent ductus arteriosus - congenital rubella or prematurity
Holosystoiic
Hyperlipidemia

38. Which kind of infarct show ST elevation - and/or pathologic Q waves
The operating point of the heart
Inc TPR and LA return (expiration)
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Transmural

39. What causes aortic regurg
CK- MB
Aortic dilation - bicuspid aortic valve - RF -
Postinfarction fibrinous pericarditis
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

40. What happens with a decrease of extracellular Na
Mitral valve prolapse
Cyclophosphamide and corticosteroids
Inc TPR and LA return (expiration)
Decrease in activity of Na/Ca exhanger and increase in contractility

41. What are the four most common locations for atherosclerosis?
Ventricular depolarization - nl < 120 msec
Myxomatous degeneration - RF - chordae rupture
P02
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

42. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Left heart failure
Activated histiocytes
TAPVR
Henoch - Schlonlein purpura

43. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dilated cardiomyopathy
LCX - V4- V6
2nd degree AV block - mobitz type 1
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

44. What causes aortic stenosis
Age related calcifications or bicuspid aortic valve
Tricuspid atresia - requires ASD and VSD
Aburpt halting of valve leaflets
In HF

45. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Purkingee>atria>ventricles>AV node
Wolff - Parkinson white syndrome
Transmural
MI

46. What does the U wave indicated?
Kidney
Inc RA pressure - due to filling against closed tricupsid valve
Transfusion
HypoK and bradycardia

47. When do coronary arteries fill?
RF
During diastole
Vagus to medulla
Septal defects - PDA - pulm art stenosis

48. What causes hepatomegaly?
Inc central venous pressure - inc resistance to portal flow
Dressler's - autoimmune
LAD - V1- V2
CK- MB

49. The carotid sinus transmits along which nerve?
Glossopharyngeal to soliary nucleus of medulla
Inc interstitial osmotic pressure pulling fliud out of capillaries
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Posterior descending (80% off the RCA - 20% off the circumflex)

50. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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