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Cardiology

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Answer 50 questions in 15 minutes.
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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. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Angiosarcoma
Viridans streptococci
Transmural
Diastolic

2. How are sarcomeres added in concentric hypertrophy?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
In parallel
Henoch - Schlonlein purpura
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

3. Which bacteria can cause endocarditis from prosthetic valves?
S. epidermidis
Microscopic polyangiitis - like wegener's without granulomas
Strawberry hemangioma
Aortic and pulmonary closing

4. most common heart tumor
Total anomalous pulmonary trunk venous return
Decreases
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Metastasis from melanoma or lymphoma

5. What is the S2 sound?
Stroke volume affected by contractility - afterload - and preload
2nd degree AV block - mobitz type 1
Aortic and pulmonary closing
Pyogenic granuloma - associated with trauma and pregnancy

6. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Left atrial pressure
S. aureus
Myxoma
SA>AV>bundle of His>ventricles

7. Where does coronary artery occlusion occur most commonly?
Dilation
Increasing activity of Ca pump in SR
LAD
RF

8. In an EKG - What is the PR interval?
Isovolumetric contraction
Vasocxn - while other tissues it causes vasodilation
Conduction delay through AV node - nl < 200 msec
Aortic/pulmonic stenosis and mitral/tricuspid regurg

9. with what heart sounds do ASD usually present?
5-10 days - macs have degraded structural components
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Pulmonary flow murmur and diastolic rumble
Late diastolic murmur following an opening snap

10. What does FAN MY SKIN On Wednesday stand for?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Inc blood volume
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

11. What is the result of not have fast sodium channels in pacemaker cells?
Temporal arteritis
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Increased efferent SANS and decreased efferent PANS
Aortic/pulmonic stenosis and mitral/tricuspid regurg

12. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Yes
Isovolumetric contraction
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

13. What causes tet of fallot?
If sodium channel
Anterosuperior displacement of the infundibular septum
Fluid movement through capillaries
Indomethacin closes - and pge keeps it open

14. What does hypoxia cause in the lung versus other tissues?
Ventricular depolarization - nl < 120 msec
Vasocxn - while other tissues it causes vasodilation
In RA return (inspiration)
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

15. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
CK- MB
Truncus - tet of fallot
Non
Septal defects - PDA - pulm art stenosis

16. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Aortic and pulmonary closing
CK- MB
Lymphangiosarcoma
Vasocxn - while other tissues it causes vasodilation

17. Which murmur is heard in aortic stenosis?
2-4 day - early coag necrosis on the first day
Extracellular calcium - calcium induced calcium release
At least 55%
Crescendo - decrescendo systolic ejection murmur following ejection click

18. The cause of dyspnea on exertion?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Transfusion
Failure of LV to in CO during exercise
Left sided

19. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Vasodilators
V fib
LAD - V1 - V4
Glomus tumor

20. fibrinous pericarditis several weeks post MI

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21. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Greater ventricular EDV
Neg inotropy - HF - narcotic overdose
Hyperlipidemia
Left atrial pressure

22. Which organ has ht highest blood flow per gram of tissue
During diastole
Inc blood volume
Myxoma
Kidney

23. In an EKG - What is the T wave?
2-4 day - early coag necrosis on the first day
Ventricular repolarization
Aortic stenosis or LBBB
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

24. 2/3 diastolic + 1/3 systolic
MAP
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Isovolumetric contraction
Dec P02 - inc PC02 and dec pH

25. What happens in phase 2 of the cardiac ventricular action potential?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
LV failure - pulm venous distention transudation of fluid
Granuloma with giant cells

26. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Posterior descending (80% off the RCA - 20% off the circumflex)
Pyogenic granuloma - associated with trauma and pregnancy
Chordae rupture - GN - suppurative pericarditis - emboli
Liver

27. What causes aortic regurg
Vasodilators
Pulse pressure
Aortic dilation - bicuspid aortic valve - RF -
S. bovis

28. How does aldosterone raise MAP
Increase in Pc
Inc blood volume
Left atrial pressure
Dec P02 - inc PC02 and dec pH

29. Where is the most posterior portion of the heart and What can it cause?
Stroke volume affected by contractility - afterload - and preload
Wegener's
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Ischemic heart dz - mitral valve prolapse - LV dilation

30. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Stable angina
LCX - V4- V6
Filling is incomplete and CO falls
Aortic dilation - bicuspid aortic valve - RF -

31. tearing chest pain radiation to the back - associated with marfan
Transposition of great vessels
During diastole
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Aortic disecction - intraluminal tear forming false lumen

32. What are the complications from bacterial endocarditis?
Stroke volume
Dressler's - autoimmune
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Chordae rupture - GN - suppurative pericarditis - emboli

33. How does digitatlis increase contractility?
LCX - I - aVL
Atherosclerosis
Increase intracellular Na - resulting in increased Ca
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

34. list the coronary vessels most likely to be occluded
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Liver
LAD > RCA > circumflex
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

35. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Lower right - MC - upper right - AO - upper right AC - lower left MO
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

36. In an EKG - What is the QRS complex?
MI
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
P02
Ventricular depolarization - nl < 120 msec

37. What does the atria release in response to inc blood volume and atrial pressure
ANP
Fick principle
Left atrial pressure
Aburpt halting of valve leaflets

38. congenital heart defect in an infant with a diabetic mother?
Transposition of great vessels
Chordae rupture - GN - suppurative pericarditis - emboli
During diastole
Total anomalous pulmonary trunk venous return

39. fibrous plaques and atheromas in intima of arteries
Mitral stenosis
Vasodilators
Atherosclerosis
Eisenmenger's syndrome

40. What happens in phase 0 of the cardiac ventricular action potential?
SV/ EDV
Rapid upstroke - voltage gated Na channels open
1st degree AV blodck
RV failure - in venous pressure

41. What causes the CO curve to shift upwards?
Mitral valve prolapse
Increased SV
Patent ductus arteriosus - congenital rubella or prematurity
Pos inotropy - exercise

42. PROVe
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Infective endocarditis
Greater ventricular EDV
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

43. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Rhabdomyomas
Mitral>aortic>>tricuspid - high pressure valves affected most
EKG
Eccentric - concentric hypertrophy causes diastolic disfunction

44. Which organ gets the largest share of systemic cardiac output
Aortic dilation - bicuspid aortic valve - RF -
Ischemic heart dz - mitral valve prolapse - LV dilation
Liver
Babies

45. What are the four most common locations for atherosclerosis?
At least 55%
LAD - V1- V2
RV contraction (closed tricuspid valve bulding into atrium
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

46. What causes the murmur heard in tricuspid regurg to enhance
Yes
Viridans streptococci
Babies
In RA return (inspiration)

47. What is associated with paradoxical spliting of S2
Aortic and pulmonary closing
Aortic stenosis or LBBB
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Ischemic heart dz - mitral valve prolapse - LV dilation

48. How does a patient with Tet of fallot learn to improve symptoms?
Vasodilators - (hydrAlAzine)
Squat. Compression of femoral arteries - inc TPR - dec
Increased efferent SANS and decreased efferent PANS
Neg inotropy - HF - narcotic overdose

49. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Ventricles are depolarized
Fluid movement through capillaries

50. Where are pacemaker cells?
SA and AV nodes
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
5-10 days - macs have degraded structural components
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

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