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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. What causes aortic regurg
Vasocxn
Late systolic crescendo murmur with a midsystolic click
Aortic dilation - bicuspid aortic valve - RF -
SV/ EDV

2. What does FEVERSS stand for in rheumatic heart disease
LAD - V1 - V4
Cardiac tamponde
Tricuspid atresia - requires ASD and VSD
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

3. What is the association with wide S2 splitting?
Pulmonary flow murmur and diastolic rumble
S. bovis
Pulmonic stenosis and RBBB
Apex and anterior interventricular septum

4. What 4 things drive myocardial 02 demand?
140/90
ANP
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

5. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
10%
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Atrial contraction
Aortic/pulmonic stenosis and mitral/tricuspid regurg

6. Which vessels account for the most total peripheral resistance
Dec plasma proteins
Fetal right to left - neonate left to right leading to RVH and failure
Arteriorles
Pulmonary flow murmur and diastolic rumble

7. congenital heart defect with congenital rubella
Septal defects - PDA - pulm art stenosis
Neg inotropy - HF - narcotic overdose
Atherosclerosis
2nd degree AV block - mobitz type 1

8. prolonged PR interval
Holosystoiic
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Cherry hemangioma
1st degree AV blodck

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

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10. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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11. Inspiration causes an increase in which sided heart sounds?
Angiosarcoma
Vagus to medulla
Right sided
Turners

12. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Rapid upstroke - voltage gated Na channels open
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
TAPVR
Microscopic polyangiitis - like wegener's without granulomas

13. How are cadiac myocytes eltrically coupled?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
ANP
Extracellular calcium - calcium induced calcium release
Gap junctions

14. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Right sided
MI
Metastasis from melanoma or lymphoma
Glomus tumor

15. In an EKG - What is the PR interval?
Conduction delay through AV node - nl < 200 msec
Pulmonic stenosis and RBBB
Inc RA pressure - due to filling against closed tricupsid valve
SA and AV nodes

16. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Mitral and tricuspid closure
Vasocxn - while other tissues it causes vasodilation
Subendocardial - fewer collaterals and higher pressure

17. What are the diastolic heart sounds?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Stable angina
Eisenmenger's syndrome
SV/ EDV

18. The cause of dyspnea on exertion?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Transmural
Failure of LV to in CO during exercise
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

19. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Posterior descending (80% off the RCA - 20% off the circumflex)
Crescendo - decrescendo systolic ejection murmur following ejection click
Sturge weber - vasculitis of caps

20. Which two mechanisms sense decrease MAP?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Medullary vasomotor center senses baroreceptors and JGA
Septal defects - PDA - pulm art stenosis
CO

21. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dilated cardiomyopathy
Aortic dilation - bicuspid aortic valve - RF -
R to L shunt caused by stenoic pulmonic valve
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

22. What is association with fixed S2 splitting - does not increase with inspiration
No - no pressure gradient
Aburpt halting of valve leaflets
Pulse pressure
ASD

23. SV CAP means?
Septal defects - PDA - pulm art stenosis
Hematocrit
Stroke volume affected by contractility - afterload - and preload
Crescendo - decrescendo systolic ejection murmur following ejection click

24. most common primary cardiac tumor in children - associated with tuberous sclerosis
MAP
Rhabdomyomas
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

25. sawtooth wave

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26. in the JVP - What is the a wave?
Fluid movement through capillaries
Aburpt halting of valve leaflets
Atrial contraction
Decreased

27. Which enzymes are useful for diagnosing reinfarction
In series
CK- MB
Varicose veins - thromboembolism rare
Mitral and tricuspid closure

28. Where does coronary artery occlusion occur most commonly?
LAD
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Group a beta hemolytic strep
R to L shunt caused by stenoic pulmonic valve

29. Which murmur is heard with VSD?
HTN - bradycardia - and respiratory depression
SA>AV>bundle of His>ventricles
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Failure of LV to in CO during exercise

30. What supplies the posterior left ventricle?
The first 4 days
Polyarteritis nodosum
CFX
Mitral and tricuspid closure

31. Which class of drugs decrease the murmur heard in aortic regurg?
Varicose veins - thromboembolism rare
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Vasodilators
MI

32. in the JVP - What is the v wave?
Inc RA pressure - due to filling against closed tricupsid valve
Right sided
Indomethacin closes - and pge keeps it open
LV failure - pulm venous distention transudation of fluid

33. What do patients die early from in rheumatic heart disease?
Crescendo - decrescendo systolic ejection murmur following ejection click
Pulmonary flow murmur and diastolic rumble
LV failure - pulm venous distention transudation of fluid
Early deaths from myocarditis

34. What is the time frame for arrhythmia risk in the evolution of MI
The first 4 days
Ventricular repolarization
Total anomalous pulmonary trunk venous return
Chordae rupture - GN - suppurative pericarditis - emboli

35. no relation between p waves and QRS intervals - treatment and predisposing factor
Inc TPR and LA return (expiration)
Takayasu's arteritis
Tempral arteritis - may cause irreversible blindness
3rd degree block - pacemaker - Lyme disease

36. Why is contractility decreased in heart failure?
Cherry hemangioma
S. bovis
Henoch - Schlonlein purpura
Systolic dysfunction

37. disease of elastic arteries and large and medium sized muscular arteries
Atherosclerosis
RCA - II - III - aVF
LV failure - pulm venous distention transudation of fluid
Aortic insuffic - late

38. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Raynaud's
Yes
Atrial contraction
Cardiac tamponde

39. What causes orthopnea?
Inc venous return exaccerbates pulm vasc congestion
Myxomatous degeneration - RF - chordae rupture
Lower right - MC - upper right - AO - upper right AC - lower left MO
Aortic and pulmonary closing

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

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41. How does angiotensin II raise MAP
C - ANCA
Vasodilators
Hypertrophied cardiomyopathy
Vasocxn

42. What are the complications from bacterial endocarditis?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Chordae rupture - GN - suppurative pericarditis - emboli
Fick principle
SA>AV>bundle of His>ventricles

43. What is the most common cause of MI
Acute thrombosis of coronary artery
Decreased
EKG
LAD

44. What is the result of not have fast sodium channels in pacemaker cells?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Purkingee>atria>ventricles>AV node
Sudden tensing of chordae tendinae
Systolic dysfunction

45. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
ASD
Fluid movement through capillaries
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Unstable/crescendo angina

46. Which organ gets the largest share of systemic cardiac output
Increasing activity of Ca pump in SR
Liver
Apex and anterior interventricular septum
Glomus tumor

47. What is the machine like murmur? What is the heart pathology and the predisposing causes
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Patent ductus arteriosus - congenital rubella or prematurity
Varicose veins - thromboembolism rare

48. with what heart sounds do ASD usually present?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Vasodilators - (hydrAlAzine)
Pulmonary flow murmur and diastolic rumble
Buerger's disease

49. What other sign is often present with congenital long QT syndrome - why?
Rapid upstroke - voltage gated Na channels open
Aortic and pulmonary closing
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Increase - increase the chance the If are open

50. what conditions are associated with pulsus paradoxus
EKG
Filling is incomplete and CO falls
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

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Cardiology

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