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Test your basic knowledge |
Cardiology
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Subject
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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. Endothelial malignancy of the skin assocated with HHV-8 and HIV
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2. Which bacteria causes rheumatic heart disease
Torsades de pointes
Troponin I
SA and AV nodes
Group a beta hemolytic strep
3. When do coronary arteries fill?
Decreased
Right sided
During diastole
Vasocxn
4. When during cardiac nodal cells depolarize?
Pulsus parvus and tardus - weak - can lead to syncope
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
During diastole
Ischemic heart dz - mitral valve prolapse - LV dilation
5. Which sympathetic receptors raise MAP
MAP
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Raynaud's
Fick principle
6. Which enzymes are useful for diagnosing reinfarction
Anterosuperior displacement of the infundibular septum
Left atrial pressure
...
CK- MB
7. congenital heart defect withdown syndrome
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
The first 4 days
During diastole
ASD - VSD - AV septal defect (endocardial cushion defect)
8. Which bacteria can cause endocarditis from prosthetic valves?
S. epidermidis
In series
Mitral stenosis
Left atrial pressure
9. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Pos inotropy - exercise
V fib
Pulmonary flow murmur and diastolic rumble
10. What does T wave inversion indicated?
Granuloma with giant cells
If sodium channel
Truncus - tet of fallot
MI
11. Which murmur do you hear in mitral stenosis?
Late diastolic murmur following an opening snap
Vasocxn
Pyogenic granuloma - associated with trauma and pregnancy
In parallel
12. Which area of the endocardium is especially vulnerable to infarction? Why?
Ischemic heart dz - mitral valve prolapse - LV dilation
Kaposi's sarcoma
Subendocardial - fewer collaterals and higher pressure
Pulse pressure
13. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Venodilators (nitrogylcerine)
Adult type aortic coarctation
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
14. In an inferior wall infarct - which artery is affected and which leads show Q waves
Left heart failure
RCA - II - III - aVF
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Inc Kf - capillary perm
15. Left to right shunts are more common in babies or kids?
Kids
TAPVR
Indomethacin closes - and pge keeps it open
During diastole
16. fibrous plaques and atheromas in intima of arteries
Atherosclerosis
Buerger's disease
Atrial contraction
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
17. How are the sarcomeres added in eccentric hypertrophy?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
In series
Decrease in cAMP
CFX
18. What happends in phase 1 of the ventricular cardiac action potential?
Kids
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
During diastole
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
19. What does HTN predispose to?
Posterior descending (80% off the RCA - 20% off the circumflex)
Tempral arteritis - may cause irreversible blindness
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Cyclophosphamide and corticosteroids
20. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
Henoch - Schlonlein purpura
Troponin I
Preload
21. In what disease states is blood viscosity increased?
S. aureus
Volatage gated Ca channels
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aortic stenosis or LBBB
22. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Tempral arteritis - may cause irreversible blindness
ASD
Viridans streptococci
Lower right - MC - upper right - AO - upper right AC - lower left MO
23. What channels do the the pacemaker cells lack?
LAD - V1 - V4
Fast volatge gated Na channels
Crescendo - decrescendo systolic ejection murmur following ejection click
Persistant truncus arteriosus
24. PROVe
RF
MI
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
25. congenital heart defect with marfan's
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Aortic insuffic - late
Squat. Compression of femoral arteries - inc TPR - dec
Black > white > asian
26. What is the gold standard for dx of MI in the first 6 hours
Yes
EKG
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Patent ductus arteriosus - congenital rubella or prematurity
27. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Hemorrhage
Patent ductus arteriosus - congenital rubella or prematurity
Sturge weber - vasculitis of caps
Strawberry hemangioma
28. Which lab value indicates blood viscosity?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Hematocrit
In HF
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
29. In an EKG - What is the p wave?
Atrial contraction
Aortic stenosis or LBBB
Resting potential high K perm
10%
30. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Mitral valve
Stroke volume affected by contractility - afterload - and preload
31. What is association with fixed S2 splitting - does not increase with inspiration
ASD
ASD - VSD - AV septal defect (endocardial cushion defect)
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Holosystolic - harsh sounding murmur - loudest over tricuspid area
32. What stimulates release of calcium from the SR?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
SV/ EDV
Extracellular calcium - calcium induced calcium release
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
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
V fib
Increasing activity of Ca pump in SR
Polyarteritis nodosum
Activated histiocytes
34. What is the definition of HTN?
LAD - V1- V2
Fluid movement through capillaries
Patent ductus arteriosus - congenital rubella or prematurity
140/90
35. in the JVP - What is the a wave?
Stable angina
No
Atrial contraction
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
36. Which murmur is characteristic of mitral/tricuspid regurg?
Holosystoiic
Early deaths from myocarditis
Subendocardial
Temporal arteritis
37. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect
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38. What happens in phase 2 of the cardiac ventricular action potential?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Glossopharyngeal to soliary nucleus of medulla
MI
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
39. What causes hepatomegaly?
Inc central venous pressure - inc resistance to portal flow
Atrial contraction
TAPVR
RV contraction (closed tricuspid valve bulding into atrium
40. What is the S2 sound?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Hemorrhage
Aortic and pulmonary closing
Pulmonary flow murmur and diastolic rumble
41. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Apex and anterior interventricular septum
Extracellular calcium - calcium induced calcium release
Diastolic
42. What is the association with wide S2 splitting?
Increasing activity of Ca pump in SR
In RA return (inspiration)
Pulmonic stenosis and RBBB
Fick principle
43. Which murmur is heard in aortic stenosis?
Metastasis from melanoma or lymphoma
Transfusion
Crescendo - decrescendo systolic ejection murmur following ejection click
EKG
44. What can cause mitral prolapse?
Myxomatous degeneration - RF - chordae rupture
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Changes in CO as a function of preload
Increased SV
45. The cause of dyspnea on exertion?
5-10 days - macs have degraded structural components
The aortic before pulmonic - inspiration increases diff
Failure of LV to in CO during exercise
LCX - V4- V6
46. What are the systolic heart sounds
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Aortic/pulmonic stenosis and mitral/tricuspid regurg
LAD > RCA > circumflex
TAPVR
47. What causes the early cyanosis in Tet of Fallot?
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Neg inotropy - HF - narcotic overdose
R to L shunt caused by stenoic pulmonic valve
48. what happens to capillaries in lymphatic blockage
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Inc interstitial osmotic pressure pulling fliud out of capillaries
Kawasaki
Granuloma with giant cells
49. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Granuloma with giant cells
Patent ductus arteriosus - congenital rubella or prematurity
2nd degree AV block - mobitz type 1
50. What does prolonged QT predispose to?
Greater ventricular EDV
Torsades de pointes
Extracellular calcium - calcium induced calcium release
Resting potential high K perm
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