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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. absecnce of tricuspid valve - hypoplastic RV
Inc blood volume
Inc central venous pressure - inc resistance to portal flow
5-10 days - macs have degraded structural components
Tricuspid atresia - requires ASD and VSD

2. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Lymphangiosarcoma
SA and AV nodes
Boot shaped heart
MAP

3. Chronic mitral stenosis can lead to what changes in size of the LA
Dilation
Persistant truncus arteriosus
In HF
In series

4. What does the LAD supply?
Apex and anterior interventricular septum
In HF
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
LAD > RCA > circumflex

5. What causes the early cyanosis in Tet of Fallot?
P02
R to L shunt caused by stenoic pulmonic valve
Viridans streptococci
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

6. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Cherry hemangioma
Liver

7. What are the complications of atherosclerosis?
LV failure - pulm venous distention transudation of fluid
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Kids
Hyperlipidemia

8. with what heart sounds do ASD usually present?
Truncus - tet of fallot
Greater ventricular EDV
Pulmonary flow murmur and diastolic rumble
Subendocardial

9. If HR is too fast (V tach) what happens during diastole?
Dec P02 - inc PC02 and dec pH
Filling is incomplete and CO falls
Ventricles are depolarized
The plateau period

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

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11. What is the classic X ray finding for tet of fallot?
V fib
ANP
Boot shaped heart
Medullary vasomotor center senses baroreceptors and JGA

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

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13. What happens with a decrease of extracellular Na
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Decrease in activity of Na/Ca exhanger and increase in contractility
Unstable/crescendo angina

14. When do coronary arteries fill?
Greater ventricular EDV
During diastole
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Extracellular calcium - calcium induced calcium release

15. What happens in phase 4 of the cardiac ventricular action potential?
Increasing activity of Ca pump in SR
V fib arrhythima
Adult type aortic coarctation
Resting potential high K perm

16. Churg Strauss - presentation and test
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
10%
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
S. bovis

17. What 4 things drive myocardial 02 demand?
Squat. Compression of femoral arteries - inc TPR - dec
CFX
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Fick principle

18. What stimulates release of calcium from the SR?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Extracellular calcium - calcium induced calcium release
Increase - increase the chance the If are open
Varicose veins - thromboembolism rare

19. 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
Decreased
LAD - V1- V2
Dec P02 - inc PC02 and dec pH

20. moncekberg
Wegener's
Squat. Compression of femoral arteries - inc TPR - dec
Ventricular repolarization
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

21. What is association with fixed S2 splitting - does not increase with inspiration
LAD - V1 - V4
ASD
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Mitral and tricuspid closure

22. What is the result of not have fast sodium channels in pacemaker cells?
Prinzmetal angina
Inc Kf - capillary perm
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

23. cavernous lymphangioma of the neck - associated with turner's
The first 4 days
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
CO
Cystic hygroma

24. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Increase contractility
LAD
Increase - increase the chance the If are open
Chordae rupture - GN - suppurative pericarditis - emboli

25. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
No - no pressure gradient
Truncus - tet of fallot
Septal defects - PDA - pulm art stenosis
Late systolic crescendo murmur with a midsystolic click

26. What kind of infarct show ST depression
Subendocardial
140/90
Increased efferent SANS and decreased efferent PANS
LCX - V4- V6

27. Left to right shunts are more common in babies or kids?
Wegener's
Purkingee>atria>ventricles>AV node
Buerger's disease
Kids

28. In an EKG - What is the p wave?
P02
Aortic and pulmonary closing
Filling is incomplete and CO falls
Atrial contraction

29. Do you see elevaged ASO titers in rheumatic heart disease
Varicose veins - thromboembolism rare
Yes
The aortic before pulmonic - inspiration increases diff
Liver

30. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Boot shaped heart
Extracellular calcium - calcium induced calcium release
Fick principle
MAP

31. Which artery supplies the SA and AV nodes?
LCX - V4- V6
RCA
Wolff - Parkinson white syndrome
Inc central venous pressure - inc resistance to portal flow

32. What are aschoff bodies
Kidney
ASD - VSD - AV septal defect (endocardial cushion defect)
Atherosclerosis
Granuloma with giant cells

33. What supplies the posterior left ventricle?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Libman - sacks endocarditis
CFX
Pos inotropy - exercise

34. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Boot shaped heart
R to L shunt caused by stenoic pulmonic valve

35. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Maintain blood flow to organ over wide range of perfussion pressures
Kids
140/90

36. What is the S1 sound?
Squat. Compression of femoral arteries - inc TPR - dec
Mitral and tricuspid closure
Vagus to medulla
Decreased

37. exaggerated decrease in pulse during inspiration.

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38. In an inferior wall infarct - which artery is affected and which leads show Q waves
Wegener's
Increased efferent SANS and decreased efferent PANS
RCA - II - III - aVF
Indomethacin closes - and pge keeps it open

39. What other sign is often present with congenital long QT syndrome - why?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Venodilators (nitrogylcerine)
LAD
Preload

40. PCWP > LV diastolic pressure
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Vasodilators
Mitral stenosis
Inc TPR and LA return (expiration)

41. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Cardiac tamponde
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Vasodilators
Venodilators (nitrogylcerine)

42. Which murmur do you hear in mitral stenosis?
CHF
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
...
Late diastolic murmur following an opening snap

43. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
2nd degree AV block - mobitz type 1
LAD - V1 - V4
Ventricular depolarization - nl < 120 msec
Cardiac tamponde

44. Which murmur is heard with mitral prolapse?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Late systolic crescendo murmur with a midsystolic click
Wegener's
Pulmonary flow murmur and diastolic rumble

45. In an anterolateral infarct - which artery is effected and which leads show Q waves
LCX - V4- V6
Total anomalous pulmonary trunk venous return
Transmural
Rapid upstroke - voltage gated Na channels open

46. Which enzymes are useful for diagnosing reinfarction
LCX - V4- V6
Increase in Pc
CK- MB
Proportional to viscosity and inversely proportional to the radius to the 4th power

47. What causes tet of fallot?
Purkingee>atria>ventricles>AV node
Buerger's disease
Anterosuperior displacement of the infundibular septum
Vagus to medulla

48. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Kidney
Transfusion
Septal defects - PDA - pulm art stenosis

49. What happens in phase 0 of the cardiac ventricular action potential?
Failure of LV to in CO during exercise
RCA
Transfusion
Rapid upstroke - voltage gated Na channels open

50. polypoid capillary hemangioma that can ulcerate and bleed
Inc interstitial osmotic pressure pulling fliud out of capillaries
Myxoma
Volatage gated Ca channels
Pyogenic granuloma - associated with trauma and pregnancy