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Cardiology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
LAD - V1- V2
Pulmonic stenosis and RBBB
Late diastolic murmur following an opening snap
During HF from microhemorrhages from inc pulm cap pressure

2. What causes ankle - sacral edema - jugular venous distention
Indomethacin closes - and pge keeps it open
Aortic/pulmonic stenosis and mitral/tricuspid regurg
RV failure - in venous pressure
2nd degree AV block - mobitz type 1

3. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Vasocxn
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
TAPVR
LAD > RCA > circumflex

4. How are cadiac myocytes eltrically coupled?
Kaposi's sarcoma
Gap junctions
Dec plasma proteins
RF

5. What do patients die early from in rheumatic heart disease?
2-4 day - early coag necrosis on the first day
RCA - II - III - aVF
Inc RA pressure - due to filling against closed tricupsid valve
Early deaths from myocarditis

6. What kind of infarct show ST depression
Subendocardial
S. bovis
Boot shaped heart
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

7. What does FAN MY SKIN On Wednesday stand for?
Increase in Pc
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Pulmonary flow murmur and diastolic rumble
R to L shunt caused by stenoic pulmonic valve

8. in the JVP - What is the a wave?
Cherry hemangioma
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Atrial contraction

9. What is the machine like murmur? What is the heart pathology and the predisposing causes
Ischemic heart dz - mitral valve prolapse - LV dilation
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Patent ductus arteriosus - congenital rubella or prematurity

10. What do the starling forces determine
Henoch - Schlonlein purpura
Fluid movement through capillaries
No - no pressure gradient
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

11. Which organ has ht highest blood flow per gram of tissue
Atherosclerosis
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Kidney
Aortic insuffic - late

12. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

13. What are the four most common locations for atherosclerosis?
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Posterior descending (80% off the RCA - 20% off the circumflex)
Mitral valve

14. What causes the ejection click in the Cres - decres murmur?
Raynaud's
Aburpt halting of valve leaflets
Can progess to V fib
Early deaths from myocarditis

15. What channels do the the pacemaker cells lack?
C - ANCA
S. bovis
Mitral and tricuspid closure
Fast volatge gated Na channels

16. Central chemoreceptors do not respond directly to which parameter?
P02
In HF
Dec plasma proteins
Conduction delay through AV node - nl < 200 msec

17. disease of elastic arteries and large and medium sized muscular arteries
Temporal arteritis
Atherosclerosis
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Aortic and pulmonary closing

18. What causes the early cyanosis in Tet of Fallot?
Failure of LV to in CO during exercise
1st degree AV blodck
R to L shunt caused by stenoic pulmonic valve
Afterload (proportional to peripheral resistance)

19. which ethnic groups have higher association with HTN?
Black > white > asian
HypoK and bradycardia
ASD
During diastole

20. Which bacteria can cause endocarditis from prosthetic valves?
7 weeks
S. epidermidis
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Yes

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

22. EDV - ESV
V fib
Inc blood volume
In RA return (inspiration)
Stroke volume

23. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Cherry hemangioma
Viridans streptococci
Aortic stenosis or LBBB

24. What is the formula for EF?
Pos inotropy - exercise
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
SV/ EDV

25. What causes the midsystolic click
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Eccentric - concentric hypertrophy causes diastolic disfunction
Sudden tensing of chordae tendinae
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

26. What is associated with paradoxical spliting of S2
Aortic stenosis or LBBB
Aortic/pulmonic regurg and mitral/tricuspid stenosis
No - no pressure gradient
Fast volatge gated Na channels

27. What does autoregulation do?
ANP
Diastolic
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Maintain blood flow to organ over wide range of perfussion pressures

28. serum marker for wegener's
Squat. Compression of femoral arteries - inc TPR - dec
Maintain blood flow to organ over wide range of perfussion pressures
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
C - ANCA

29. Wegener's tx
Cyclophosphamide and corticosteroids
CHF
SA>AV>bundle of His>ventricles
Glossopharyngeal to soliary nucleus of medulla

30. list the coronary vessels most likely to be occluded
CHF
Left atrial pressure
LAD > RCA > circumflex
Cystic hygroma

31. In normal S2 splitting - which valve closes first? What increases it?
The aortic before pulmonic - inspiration increases diff
1st degree AV blodck
Postinfarction fibrinous pericarditis
Glomus tumor

32. In an EKG - What is the p wave?
Prinzmetal angina
In parallel
CK- MB
Atrial contraction

33. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
7 weeks
Ventricles are depolarized
Angiosarcoma
Libman - sacks endocarditis

34. most common heart tumor
Failure of LV to in CO during exercise
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Metastasis from melanoma or lymphoma
Sudden tensing of chordae tendinae

35. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
Tricuspid atresia - requires ASD and VSD
Increase intracellular Na - resulting in increased Ca
No

36. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
Left heart failure
Increased SV
Tricuspid atresia - requires ASD and VSD

37. prolonged PR interval
1st degree AV blodck
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
LAD - V1- V2
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

38. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Medullary vasomotor center senses baroreceptors and JGA
CK- MB
Glomus tumor
Resting potential high K perm

39. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
The plateau period
TAPVR
Stable angina
Increase contractility

40. Exercise - overtransfusiion and excitiment causes and increase in...?
Aortic and pulmonary closing
5-10 days - macs have degraded structural components
Inc TPR and LA return (expiration)
Preload

41. systolic - diastolic
Pulse pressure
Transposition of great vessels
Inc interstitial osmotic pressure pulling fliud out of capillaries
Glomus tumor

42. When and why is the S3 sound heard?
Inc blood volume
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
SV/ EDV

43. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Non
Infective endocarditis
S. aureus

44. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Wolff - Parkinson white syndrome
Ventricular repolarization
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
LV failure - pulm venous distention transudation of fluid

45. what conditions are associated with pulsus paradoxus
Mitral valve prolapse
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
MAP
Vasocxn - while other tissues it causes vasodilation

46. which heart valves are afected most in rheumatic heart diseease
Mitral>aortic>>tricuspid - high pressure valves affected most
Fetal right to left - neonate left to right leading to RVH and failure
Truncus - tet of fallot
Pyogenic granuloma - associated with trauma and pregnancy

47. What is the gold standard for dx of MI in the first 6 hours
EKG
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Acute thrombosis of coronary artery
5-10 days - macs have degraded structural components

48. What is the time frame for arrhythmia risk in the evolution of MI
The first 4 days
Increased efferent SANS and decreased efferent PANS
Babies
SV/ EDV

49. What does T wave inversion indicated?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
MI
Crescendo - decrescendo systolic ejection murmur following ejection click
During HF from microhemorrhages from inc pulm cap pressure

50. How are the sarcomeres added in eccentric hypertrophy?
2-4 day - early coag necrosis on the first day
Ventricular depolarization - nl < 120 msec
Buerger's disease
In series