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Cardiology
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Subject
:
health-sciences
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 is the result of not have fast sodium channels in pacemaker cells?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
RCA
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Fast volatge gated Na channels
2. Which organ has the largest arteriovenous difference
Lower right - MC - upper right - AO - upper right AC - lower left MO
Hematocrit
Heart - 02 extraction is always around 100%
The plateau period
3. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Ventricles are depolarized
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Aortic disecction - intraluminal tear forming false lumen
Lower right - MC - upper right - AO - upper right AC - lower left MO
4. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
2-4 day - early coag necrosis on the first day
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
LCX - I - aVL
Myxoma
5. 2/3 diastolic + 1/3 systolic
MAP
Babies
Glossopharyngeal to soliary nucleus of medulla
Ischemic heart dz - mitral valve prolapse - LV dilation
6. What are the different etiologies of dialted cardiomyopathy
Age related calcifications or bicuspid aortic valve
Kidney
Arteriorles
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
7. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Left heart failure
S. aureus
LAD
Lower right - MC - upper right - AO - upper right AC - lower left MO
8. Hyperplastic onion skinning
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Arteriolosclerosis in malignant hypertension
Fluid movement through capillaries
Increase contractility
9. The 7 complications of MI
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10. How are cadiac myocytes eltrically coupled?
Gap junctions
RV contraction (closed tricuspid valve bulding into atrium
Increasing activity of Ca pump in SR
LCX - V4- V6
11. clinical signs of cardiac tamponade
Apex and anterior interventricular septum
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
LAD
Non
12. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Atherosclerosis
Right sided
SA and AV nodes
13. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Myxomatous degeneration - RF - chordae rupture
Lower right - MC - upper right - AO - upper right AC - lower left MO
Kaposi's sarcoma
14. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
During diastole
Squat. Compression of femoral arteries - inc TPR - dec
Coarcation of aorta
15. Central chemoreceptors do not respond directly to which parameter?
PDA
Purkingee>atria>ventricles>AV node
Infective endocarditis
P02
16. What channels do the the pacemaker cells lack?
Activated histiocytes
Fast volatge gated Na channels
S. aureus
Arteriorles
17. What is the gold standard for dx of MI in the first 6 hours
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
EKG
Hypertrophied cardiomyopathy
Viridans streptococci
18. What is the characteristic pulse in aortic stenosis?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Pulsus parvus and tardus - weak - can lead to syncope
Decrease in cAMP
Kidney
19. Restrictive cardiomyopathy causes
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Acute thrombosis of coronary artery
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Hypertrophied cardiomyopathy
20. Given P = QR - what factors influence resistance?
Atrial contraction
Squat. Compression of femoral arteries - inc TPR - dec
Proportional to viscosity and inversely proportional to the radius to the 4th power
Failure of LV to in CO during exercise
21. PCWP is an estimate of...
Left atrial pressure
Glomus tumor
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Septal defects - PDA - pulm art stenosis
22. Which lab value indicates blood viscosity?
Subendocardial
Takayasu's arteritis
HTN - bradycardia - and respiratory depression
Hematocrit
23. moncekberg
Eccentric - concentric hypertrophy causes diastolic disfunction
LCX - I - aVL
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
24. When does EF decrease
SA and AV nodes
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Late systolic crescendo murmur with a midsystolic click
In HF
25. What causes the cushing reflex and why
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
LAD - V1- V2
Arteriolosclerosis in malignant hypertension
Troponin I
26. What are the systolic heart sounds
No
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Apex and anterior interventricular septum
S. epidermidis
27. In an EKG - What is the p wave?
Strawberry hemangioma
Atrial contraction
Dec P02 - inc PC02 and dec pH
HypoK and bradycardia
28. Which organ gets the largest share of systemic cardiac output
Wolff - Parkinson white syndrome
Troponin I
Liver
Activated histiocytes
29. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
QRS complex
Non
Angiosarcoma
Henoch - Schlonlein purpura
30. What happens in phase 0 of the cardiac ventricular action potential?
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Rapid upstroke - voltage gated Na channels open
Can progess to V fib
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
31. What is the early and late lesion in rheumatic heart disease
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Mitral valve prolapse
Vasocxn
Wolff - Parkinson white syndrome
32. What causes the murmur heard in tricuspid regurg to enhance
Pyogenic granuloma - associated with trauma and pregnancy
7 weeks
S. aureus
In RA return (inspiration)
33. When and why is the S3 sound heard?
Neg inotropy - HF - narcotic overdose
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
R to L shunt caused by stenoic pulmonic valve
Left heart failure
34. What causes tet of fallot?
CK- MB
2-4 day - early coag necrosis on the first day
Decrease in cAMP
Anterosuperior displacement of the infundibular septum
35. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
SV/ EDV
Left heart failure
Eccentric - concentric hypertrophy causes diastolic disfunction
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
36. What is indicated when CO and venous return are equal?
The operating point of the heart
LAD - V1 - V4
Yes
Squat. Compression of femoral arteries - inc TPR - dec
37. What does T wave inversion indicated?
Ischemic heart dz - mitral valve prolapse - LV dilation
MI
Aortic stenosis or LBBB
The aortic before pulmonic - inspiration increases diff
38. what percentage of HTN is secondary to renal disease?
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
10%
Pos inotropy - exercise
Turners
39. How does a patient with Tet of fallot learn to improve symptoms?
Pulse pressure
Dilated cardiomyopathy
Squat. Compression of femoral arteries - inc TPR - dec
Mitral stenosis
40. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40
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41. congenital heart defect in an infant with a diabetic mother?
Transposition of great vessels
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Wolff - Parkinson white syndrome
Aortic dilation - bicuspid aortic valve - RF -
42. most common heart tumor
Squat. Compression of femoral arteries - inc TPR - dec
Dressler's - autoimmune
CO
Metastasis from melanoma or lymphoma
43. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Vagus to medulla
Proportional to viscosity and inversely proportional to the radius to the 4th power
Changes in CO as a function of preload
44. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Hematocrit
CHF
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
45. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Myxoma
No - no pressure gradient
Vasodilators - (hydrAlAzine)
Torsades de pointes
46. What is the classic X ray finding for tet of fallot?
Boot shaped heart
Late systolic crescendo murmur with a midsystolic click
Hemorrhage
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
47. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
SV/ EDV
Cardiac tamponde
Sudden tensing of chordae tendinae
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
48. When does extracellular calcium enter the cardiac muscle cells during contraction?
LCX - V4- V6
The plateau period
Glomus tumor
Failure of LV to in CO during exercise
49. list the coronary vessels most likely to be occluded
LAD > RCA > circumflex
Apex and anterior interventricular septum
The operating point of the heart
Raynaud's
50. What are the 5 T's of cyanoitc babies
Holosystoiic
Inc TPR and LA return (expiration)
V fib arrhythima
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
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