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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 the CO curve to shift downwards?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Neg inotropy - HF - narcotic overdose
Aortic stenosis or LBBB
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

2. What are common causes of mitral regurg?
Myxoma
Ischemic heart dz - mitral valve prolapse - LV dilation
Cyclophosphamide and corticosteroids
Decreases

3. When does EF decrease
Dressler's - autoimmune
Decrease in cAMP
Coarcation of aorta
In HF

4. How does angiotensin II raise MAP
LAD
Vasocxn
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Prinzmetal angina

5. congenital heart defect with 22q11
Inc interstitial osmotic pressure pulling fliud out of capillaries
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
V fib
Truncus - tet of fallot

6. EDV is also known as
RCA - II - III - aVF
Preload
Conduction delay through AV node - nl < 200 msec
LAD - V1 - V4

7. Which organ gets the largest share of systemic cardiac output
Liver
2nd degree AV block - mobitz type 1
LCX - I - aVL
7 weeks

8. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Polyarteritis nodosum
Takayasu's arteritis

9. 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
Aortic and pulmonary closing
RF
During HF from microhemorrhages from inc pulm cap pressure

10. What causes hepatomegaly?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Inc central venous pressure - inc resistance to portal flow
LAD
Aortic dilation - bicuspid aortic valve - RF -

11. What is the early and late lesion in rheumatic heart disease
Tempral arteritis - may cause irreversible blindness
HTN - bradycardia - and respiratory depression
Mitral valve prolapse
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

12. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Libman - sacks endocarditis
Fick principle
RCA
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

13. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Prinzmetal angina
MI
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Late systolic crescendo murmur with a midsystolic click

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

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15. What causes aortic regurg
Eccentric - concentric hypertrophy causes diastolic disfunction
Purkingee>atria>ventricles>AV node
Aortic dilation - bicuspid aortic valve - RF -
Cyclophosphamide and corticosteroids

16. Do you see elevaged ASO titers in rheumatic heart disease
Yes
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
2-4 day - early coag necrosis on the first day
Postinfarction fibrinous pericarditis

17. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Decrease in activity of Na/Ca exhanger and increase in contractility
Atrial contraction
In HF
Angiosarcoma

18. How does acidosis affect contractility?
Group a beta hemolytic strep
Inc venous return exaccerbates pulm vasc congestion
S. epidermidis
Decreased

19. In an EKG - What is the QRS complex?
Ventricular depolarization - nl < 120 msec
In RA return (inspiration)
In parallel
Hypertrophied cardiomyopathy

20. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Non
Pulmonary flow murmur and diastolic rumble
Stable angina
...

21. Which class of drugs decreases afterload?
Mitral>aortic>>tricuspid - high pressure valves affected most
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Vasodilators
Vasodilators - (hydrAlAzine)

22. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Turners
Cystic hygroma
ASD
Hyperlipidemia

23. Given P = QR - what factors influence resistance?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Aortic disecction - intraluminal tear forming false lumen
Changes in CO as a function of preload
Black > white > asian

24. What is association with fixed S2 splitting - does not increase with inspiration
Crescendo - decrescendo systolic ejection murmur following ejection click
Inc interstitial osmotic pressure pulling fliud out of capillaries
Cardiac tamponde
ASD

25. 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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26. systolic - diastolic
Pulse pressure
Squat. Compression of femoral arteries - inc TPR - dec
Dec plasma proteins
In RA return (inspiration)

27. What does an isoelectric ST segment indicate?
HTN - bradycardia - and respiratory depression
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Postinfarction fibrinous pericarditis
Ventricles are depolarized

28. What causes tet of fallot?
Failure of LV to in CO during exercise
Anterosuperior displacement of the infundibular septum
Babies
Dec plasma proteins

29. most common primary cardiac tumor in children - associated with tuberous sclerosis
Inc central venous pressure - inc resistance to portal flow
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Afterload (proportional to peripheral resistance)
Rhabdomyomas

30. Left to right shunts are more common in babies or kids?
Total anomalous pulmonary trunk venous return
Mitral stenosis
10%
Kids

31. What kind of infarct show ST depression
Pos inotropy - exercise
Subendocardial
Crescendo - decrescendo systolic ejection murmur following ejection click
The first 4 days

32. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Atherosclerosis
Lower right - MC - upper right - AO - upper right AC - lower left MO
Increasing activity of Ca pump in SR
Truncus - tet of fallot

33. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Hypertrophied cardiomyopathy
Anterosuperior displacement of the infundibular septum
Dec plasma proteins
Glomus tumor

34. What causes the murmur heard in tricuspid regurg to enhance
Vasodilators
Pulmonary flow murmur and diastolic rumble
Granuloma with giant cells
In RA return (inspiration)

35. Irregularly irregular ECG - no p waves: dx and treatment
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Mitral valve prolapse
PDA

36. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Increase in Pc
Non
Stroke volume
Viridans streptococci

37. Where are pacemaker cells?
SA and AV nodes
Yes
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Greater ventricular EDV

38. Wegener's presentation
LV failure - pulm venous distention transudation of fluid
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Diastolic
Volatage gated Ca channels

39. polypoid capillary hemangioma that can ulcerate and bleed
P02
Pyogenic granuloma - associated with trauma and pregnancy
Gap junctions
CO

40. In terms of starling forces - why does heart failure cause edema?
Right sided
Increase in Pc
Troponin I
RV failure - in venous pressure

41. Churg Strauss - presentation and test
Aortic and pulmonary closing
10%
Wegener's
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

42. Which class of drugs decrease the murmur heard in aortic regurg?
Dilation
RCA
Vasodilators
Hemorrhage

43. Which murmur is heard in aortic stenosis?
7 weeks
Hemorrhage
Crescendo - decrescendo systolic ejection murmur following ejection click
Infective endocarditis

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

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45. What is the most common cause of MI
Rapid upstroke - voltage gated Na channels open
Stroke volume affected by contractility - afterload - and preload
Acute thrombosis of coronary artery
7 weeks

46. How does aldosterone raise MAP
Hemorrhage
Cardiac tamponde
Inc blood volume
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

47. Where does coronary artery occlusion occur most commonly?
LAD
Mitral valve prolapse
Heart - 02 extraction is always around 100%
Early deaths from myocarditis

48. What constitues the upstroke in pacemaker cells?
In HF
Non
Volatage gated Ca channels
Aortic/pulmonic stenosis and mitral/tricuspid regurg

49. When is the scar completely formed in an MI?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
LAD - V1 - V4
In series
7 weeks

50. most common heart tumor
Troponin I
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Medullary vasomotor center senses baroreceptors and JGA
Metastasis from melanoma or lymphoma