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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. How are sarcomeres added in concentric hypertrophy?
Aortic dilation - bicuspid aortic valve - RF -
3rd degree block - pacemaker - Lyme disease
In parallel
Kaposi's sarcoma

2. What does FROM JANE stand for in bacterial endocarditis?

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3. What causes ankle - sacral edema - jugular venous distention
Total anomalous pulmonary trunk venous return
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
RV failure - in venous pressure
Pulmonic stenosis and RBBB

4. What are aschoff bodies
10%
Dilation
Granuloma with giant cells
Angiosarcoma

5. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Arteriorles
Transfusion
Vasodilators
Decreases

6. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Resting potential high K perm
Hyperlipidemia
V fib arrhythima
Troponin I

7. When do coronary arteries fill?
During diastole
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Afterload (proportional to peripheral resistance)
Patent ductus arteriosus - congenital rubella or prematurity

8. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
The first 4 days
140/90
Adult type aortic coarctation
Subendocardial

9. How does angiotensin II raise MAP
Mitral>aortic>>tricuspid - high pressure valves affected most
Afterload (proportional to peripheral resistance)
Ventricular depolarization - nl < 120 msec
Vasocxn

10. Which bacteria can cause endocarditis from prosthetic valves?
S. epidermidis
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Buerger's disease
Lymphangiosarcoma

11. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Pulmonary flow murmur and diastolic rumble
Fick principle
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Lower right - MC - upper right - AO - upper right AC - lower left MO

12. What does T wave inversion indicated?
Kids
Crescendo - decrescendo systolic ejection murmur following ejection click
Mitral valve prolapse
MI

13. How does aldosterone raise MAP
Inc blood volume
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Early deaths from myocarditis
C - ANCA

14. failure of truncus arteriosus to divide?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
No
S. aureus
Persistant truncus arteriosus

15. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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16. What are the four most common locations for atherosclerosis?
Pulmonic stenosis and RBBB
Glomus tumor
Mitral>aortic>>tricuspid - high pressure valves affected most
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

17. congenital heart defect with 22q11
Turners
Truncus - tet of fallot
Transfusion
5-10 days - macs have degraded structural components

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

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19. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Failure of LV to in CO during exercise
Sturge weber - vasculitis of caps

20. What kind of dysfunction ensues in restrictive cardiomyopathy
Atherosclerosis
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Diastolic
Heart - 02 extraction is always around 100%

21. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Patent ductus arteriosus - congenital rubella or prematurity
Persistant truncus arteriosus
No
Prinzmetal angina

22. Central chemoreceptors do not respond directly to which parameter?
Aortic and pulmonary closing
Increase in Pc
Black > white > asian
P02

23. Exercise - overtransfusiion and excitiment causes and increase in...?
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Subendocardial - fewer collaterals and higher pressure
Preload
Aortic stenosis or LBBB

24. Which organ gets the largest share of systemic cardiac output
Hematocrit
Left heart failure
Liver
Mean arterial pressure

25. What causes the cushing reflex and why
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Age related calcifications or bicuspid aortic valve
Eisenmenger's syndrome
3rd degree block - pacemaker - Lyme disease

26. Irregularly irregular ECG - no p waves: dx and treatment
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Vasodilators - (hydrAlAzine)
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

27. What murmur is heard with aortic regurg?
Neg inotropy - HF - narcotic overdose
Hyperlipidemia
Henoch - Schlonlein purpura
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

28. What does the atria release in response to inc blood volume and atrial pressure
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Decreases
Pulmonic stenosis and RBBB
ANP

29. When during cardiac nodal cells depolarize?
Babies
Atrial contraction
During diastole
Pulmonic stenosis and RBBB

30. What do patients die early from in rheumatic heart disease?
SA>AV>bundle of His>ventricles
SV/ EDV
Sturge weber - vasculitis of caps
Early deaths from myocarditis

31. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Inc blood volume
S. bovis
LAD - V1 - V4

32. What kind of infarct show ST depression
Indomethacin closes - and pge keeps it open
7 weeks
Decrease in activity of Na/Ca exhanger and increase in contractility
Subendocardial

33. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Purkingee>atria>ventricles>AV node
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Microscopic polyangiitis - like wegener's without granulomas
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

34. MAP is also known as
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Stroke volume
Afterload (proportional to peripheral resistance)
LCX - V4- V6

35. What causes the midsystolic click
Adult type aortic coarctation
Patent ductus arteriosus - congenital rubella or prematurity
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Sudden tensing of chordae tendinae

36. coronary artery spasm - ST elevation
Prinzmetal angina
Transposition of great vessels
Rhabdomyomas
HypoK and bradycardia

37. In the cardiac cycle - which period has the highest 02 consumption?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Isovolumetric contraction
SV/ EDV
Glossopharyngeal to soliary nucleus of medulla

38. Wegener's presentation
Right sided
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Filling is incomplete and CO falls
Granuloma with giant cells

39. Where is the most posterior portion of the heart and What can it cause?
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Pulmonary flow murmur and diastolic rumble
Dilated cardiomyopathy
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

40. Wegener's tx
LAD
Mitral valve prolapse
2nd degree AV block - mobitz type 1
Cyclophosphamide and corticosteroids

41. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Can progess to V fib
Lower right - MC - upper right - AO - upper right AC - lower left MO
Angiosarcoma
Hypertrophied cardiomyopathy

42. When do you find hemosiderin laden macrophages in the lungs?
LAD
During HF from microhemorrhages from inc pulm cap pressure
Decrease in activity of Na/Ca exhanger and increase in contractility
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

43. What is the danger of torsades to pointes?
Metastasis from melanoma or lymphoma
Can progess to V fib
Mean arterial pressure
Systolic dysfunction

44. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Hypertrophied cardiomyopathy
Resting potential high K perm
S. epidermidis
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

45. Chronic mitral stenosis can lead to what changes in size of the LA
Turners
Dilation
Granuloma with giant cells
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

46. What is the machine like murmur? What is the heart pathology and the predisposing causes
Patent ductus arteriosus - congenital rubella or prematurity
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
TAPVR
Boot shaped heart

47. What causes tet of fallot?
Isovolumetric contraction
Anterosuperior displacement of the infundibular septum
Prinzmetal angina
Subendocardial

48. dyspnea - fatigue - edema and rales - multiple causes
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Cystic hygroma
CHF

49. What is a normal EF
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
At least 55%
Activated histiocytes
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

50. sawtooth wave

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