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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. congenital heart defect withdown syndrome
ASD
ASD - VSD - AV septal defect (endocardial cushion defect)
Atrial contraction
Greater ventricular EDV

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

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3. EDV - ESV
Kaposi's sarcoma
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
1st degree AV blodck
Stroke volume

4. What does FEVERSS stand for in rheumatic heart disease
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Mitral>aortic>>tricuspid - high pressure valves affected most
7 weeks
Subendocardial - fewer collaterals and higher pressure

5. in the JVP - What is the a wave?
Takayasu's arteritis
LV failure - pulm venous distention transudation of fluid
Sturge weber - vasculitis of caps
Atrial contraction

6. The 7 complications of MI

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7. How does angiotensin II raise MAP
Vasocxn
Pulse pressure
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Neg inotropy - HF - narcotic overdose

8. decrease stretch in baroreceptors leads to what response?
Increased efferent SANS and decreased efferent PANS
Diastolic
Hyperlipidemia
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

9. Where is the most posterior portion of the heart and What can it cause?
Stroke volume
Troponin I
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
In RA return (inspiration)

10. Rank the pacemakers cells
Filling is incomplete and CO falls
SA>AV>bundle of His>ventricles
Fluid movement through capillaries
Babies

11. How does a patient with Tet of fallot learn to improve symptoms?
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Aortic dilation - bicuspid aortic valve - RF -
Squat. Compression of femoral arteries - inc TPR - dec
Kaposi's sarcoma

12. What is the machine like murmur? What is the heart pathology and the predisposing causes
MI
Inc TPR and LA return (expiration)
Patent ductus arteriosus - congenital rubella or prematurity
Fetal right to left - neonate left to right leading to RVH and failure

13. Which organ has the largest arteriovenous difference
Acute thrombosis of coronary artery
Heart - 02 extraction is always around 100%
Mitral>aortic>>tricuspid - high pressure valves affected most
Subendocardial

14. In what disease states is blood viscosity increased?
Pos inotropy - exercise
Myxomatous degeneration - RF - chordae rupture
10%
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

15. What is association with fixed S2 splitting - does not increase with inspiration
Hemorrhage
Mechanican contraction of the ventricles
ASD
MI

16. Which bacteria causes endocarditis in the presence of colon cancer
Pulmonic stenosis and RBBB
Aortic and pulmonary closing
Metastasis from melanoma or lymphoma
S. bovis

17. Which sympathetic receptors raise MAP
Wegener's
S. bovis
Aortic and pulmonary closing
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

18. 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
CK- MB
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
...

19. When does EF decrease
Metastasis from melanoma or lymphoma
Fick principle
Apex and anterior interventricular septum
In HF

20. exaggerated decrease in pulse during inspiration.

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21. which medications are used to maintain patency or close the ductus arteriosus?
In RA return (inspiration)
Indomethacin closes - and pge keeps it open
Myxoma
Cardiac tamponde

22. What does FAN MY SKIN On Wednesday stand for?
No - no pressure gradient
Dec P02 - inc PC02 and dec pH
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Lymphangiosarcoma

23. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
MAP
Maintain blood flow to organ over wide range of perfussion pressures
Inc RA pressure - due to filling against closed tricupsid valve
Dec plasma proteins

24. What does an isoelectric ST segment indicate?
Ventricles are depolarized
Decreased
Crescendo - decrescendo systolic ejection murmur following ejection click
Vasodilators

25. prolonged PR interval
Sudden tensing of chordae tendinae
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
1st degree AV blodck
No - no pressure gradient

26. What is the difference between adult and infantile type aortic coarctation?
Ventricles are depolarized
Filling is incomplete and CO falls
Tricuspid atresia - requires ASD and VSD
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

27. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Ventricles are depolarized
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Purkingee>atria>ventricles>AV node

28. PCWP > LV diastolic pressure
Changes in CO as a function of preload
Mitral valve prolapse
Mitral stenosis
Decreased

29. What causes tet of fallot?
Vasodilators
RV failure - in venous pressure
Cherry hemangioma
Anterosuperior displacement of the infundibular septum

30. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
SV/ EDV
Vasocxn - while other tissues it causes vasodilation
RF

31. What is the S1 sound?
Mitral and tricuspid closure
Vasocxn
Changes in CO as a function of preload
Raynaud's

32. Mitral stenosis is most often secondary to which condition?
Eisenmenger's syndrome
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
RF
Posterior descending (80% off the RCA - 20% off the circumflex)

33. congenital heart defect with turner's
Coarcation of aorta
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Ischemic heart dz - mitral valve prolapse - LV dilation

34. How does acidosis affect contractility?
Glossopharyngeal to soliary nucleus of medulla
V fib arrhythima
Decreased
Aortic stenosis or LBBB

35. Which murmur is heard with VSD?
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Proportional to viscosity and inversely proportional to the radius to the 4th power
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

36. Which artery supplies the inferior portion of the left ventricle and posterior septum?
In series
Babies
Posterior descending (80% off the RCA - 20% off the circumflex)
LV failure - pulm venous distention transudation of fluid

37. What is the time frame for arrhythmia risk in the evolution of MI
The first 4 days
Pulse pressure
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Polyarteritis nodosum

38. 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
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Aortic dilation - bicuspid aortic valve - RF -
10%

39. What is a normal EF
MI
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
At least 55%
Failure of LV to in CO during exercise

40. What does TAPVR stand for
Temporal arteritis
Total anomalous pulmonary trunk venous return
V fib arrhythima
Indomethacin closes - and pge keeps it open

41. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Acute thrombosis of coronary artery
Dilated cardiomyopathy
Mean arterial pressure

42. tearing chest pain radiation to the back - associated with marfan
Aortic disecction - intraluminal tear forming false lumen
Neg inotropy - HF - narcotic overdose
Septal defects - PDA - pulm art stenosis
Arteriorles

43. What causes the CO curve to shift downwards?
Posterior descending (80% off the RCA - 20% off the circumflex)
PDA
SV/ EDV
Neg inotropy - HF - narcotic overdose

44. moncekberg
Eisenmenger's syndrome
...
Cystic hygroma
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

45. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
Wolff - Parkinson white syndrome
Increased SV
No - no pressure gradient

46. What is the definition of HTN?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Acute thrombosis of coronary artery
In HF
140/90

47. Right to left shunts are more common in babies or kids?
Babies
Subendocardial
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Tricuspid atresia - requires ASD and VSD

48. 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
If sodium channel
Squat. Compression of femoral arteries - inc TPR - dec
Prinzmetal angina

49. What are the different etiologies of dialted cardiomyopathy
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
LAD - V1- V2
Hemorrhage
Persistant truncus arteriosus

50. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Heart - 02 extraction is always around 100%
Volatage gated Ca channels
Troponin I
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics